Sunday, June 3, 2012

Induced Lactation

I'm convinced that more women who adopt or do surrogacy would breastfeed if they only knew it was possible. I have PCOS, so chances are that combined with not having been pregnant AND having twins I will not produce enough. That's fine. I'll be proud and consider it a success if I produce some. Everyone has their own opinion that I won't get into, but for me I need to try breastfeeding and see if my body that has let me down will finally help me be a mother in this one important way. I'm not saying anything bad about bottle/formula feeding and in all likelihood we will wind up supplementing with formula.

Dr. Patel has had several mother's do induced lactation with success, so I know it is supported there. You can pay for breastmilk for at least the first two weeks there, but they get a different surrogate to pump it and then you may need to arrange for delivery to the NICU or your hotel. It is inexpensive but an extra charge.

If you are determined, you probably can do it. A man can breastfeed if he wanted to. It has more to do with the sucking action of a baby on the nipple, and not as much about supplements and hormones. But the best chance you have is to follow the Newman Goldfarb protocol. Google or see link above.  I did lots of research, but the best place hands down to go is to go to the website at the top of this post. You can also search Yahoo groups for "induced lactation" or "adoptive lactation" and I found great resources there. I won't repost the plethora of info I've gotten from the website and two Yahoo groups, but suffice to say that you can find an answer and inspiration for everything at these places.

I have extensively researched the two types of SNS, or supplemental nursing systems. Medela is not worth the money from all the reviews I've read. It seems appealing, but it breaks and leaks. The Lact-Aid is the way to go and the below link has practical tips on how to use it.

You will probably have to chart to make sure your baby is getting enough to eat if you are doing this. Sample below, but I found a twin site somewhere that sells a cool log book for twins for this purpose.

There are lots of supplement you can take, and I'll probably take them all. Fenugreek is the most reputed for helping increase supply...even if it does make you smell like maple syrup. A healthy diet, lots of water, and oatmeal at least once a day are good for lactation. Oatmeal is a "galactologue" that promotes lactation, and below are two lactation cookie recipes. I've made and frozen two dozen of both, and they taste fine to me.

Major Milk Makin' Cookies
Recipe by Kathleen Major
Detailed recipe with photos found here

1 1/2 c. whole wheat flour
1 3/4 c. oats
1 tsp baking soda
1 tsp salt
3/4 c.
almond butter or peanut butter
1/2 c. butter, softened
1 c. flax
3 T brewer's yeast
1/3 c. water
1 tsp cinnamon
1/2 c. sugar
1/2 c. brown sugar
2 tsp vanilla
2 large eggs
2 c. (12oz) chocolate chips
1 c. chopped nuts of your choice

Preheat oven to 350 degrees Fahrenheit

Combine flour, baking soda, cinnamon and salt in a bowl.
In a large bowl, beat almond butter, butter, sugar, brown sugar, vanilla, brewer's yeast, flax and water until creamy.
Mix in eggs.
Gradually beat in flour mixture.
Mix in nuts and chocolate chips.
Add oats slowly, mixing along the way.

Place balls of dough onto greased baking sheets or baking stones.
Press down each ball lightly with a fork.
Bake 12 minutes.

Momma's Milk Cookies
recipe by Danelle Frisbie

2 eggs
1/2 c. unsweetened applesauce
1 c. flax
1 1/2 c. whole wheat flour
1/2 c. melted butter
2 c.
Agave nectar
3/4 c. walnuts (crushed)
2 c. chocolate chips
3/4 c. raisins
4 T water
1 tsp vanilla
1 tsp baking soda
1 tsp salt
4 T brewer's yeast
3 c. oats

Preheat oven to 350 degrees Fahrenheit

I have found greased cookie sheets work best, but you can also use parchment lined sheets or a baking stone.

In a bowl mix flax and water until thoroughly mixed.
In a large bowl mix flour, baking soda, salt and brewer's yeast.
In another bowl mix together butter and ONE cup Agave nectar (the other cup will be used later). Stir well until the butter and nectar are completely mixed.
Add eggs to the nectar mix, stirring well after each one.
Add vanilla, stir.
Add the nectar blend to the flax and mix well. (A hand mixer or mixing bowl works best)
Pour the nectar/flax blend into the large bowl of flour and mix well.
Mix in walnuts, chocolate chips, raisins.
Mix in oats.
After everything is blended together well, add the applesauce and final 1 cup of Agave nectar and stir through well.

Scoop onto sheets, and press down each ball of dough lightly with a fork.
Bake 13-14 minutes.
And lastly, a good collection of info I found on Freezing and Storing Breastmilk.

Now that you have pumped milk, you may be wondering what exactly to do next. There are several options for storing breastmilk.
Many moms choose to just store their milk in the fridge (rather than freezing it) if they're going to be using it soon. This is actually the preferred method of storage, if it will be used within a few days. Remember when choosing this method to store the milk in coldest section of your fridge, NOT in the door.
Some moms have found a system, like the Milk Mate System to be helpful. This stores the fresh breastmilk in a way that you don't have to guess which bottle is older, as it is dispensed from oldest to freshest.
If the bulk of baby's milk is expressed breastmilk, plastic containers are the best choice for storing in the refrigerator as more of human milk's leukocytes or white cells adhere to glass.
When freezing your milk, there are several things to take into consideration. The type of container chosen may be important if the bulk of your baby's milk is frozen milk. In that case, freezing in glass is best because it is less porous and offers the best protection in the freezer. If the frozen milk is for occasional bottles, the type of container is not as important. Also keep in mind that freezing does destroy most of the leukocytes, so whenever possible the bulk of baby's expressed breastmilk should be "fresh" vs frozen.
Hard plastic containers of any kind are also good choices for both refrigeration and freezing
Another option is to use milk storage bags that are designed specifically for human milk. These are available from several sources, including on line sources as well as local stores like Kmart, Target, and Wal-Mart stores. These bags are pre-sterilized, thicker, coated with polyethylene, and lined with nylon, which prevents the fat from sticking to the sides.

Some moms wonder about using the bottle liners, such as those for the Playtex or Gerber "disposable" bottles. Most experts recommend against using these because they are not as durable as the bags designed specifically for freezing milk. The seams of the bottle liners may burst during the freezing process, and precious breastmilk wasted.
Can I Freeze My Milk After It Has Been Refrigerated Several Days?

Yes - most sources seem to indicate that you should be safe to use ALL the storage options in succession if you need to.

For example, storing freshly expressed breastmilk at room temperature for up to 10 hours, THEN in a refrigerator for up to 8 days, and THEN in a freezer for 3-12 months (depending on the type of freezer).

You're likely to get to stretch your storage times to the maximum (or even a little longer) if you don't "use up" all of your "warmer" storage - for example, you can expect a longer storage time if you freeze the milk immediately (if you know you'll want it frozen) rather than keep it at room temp for 10 hours, then refrigerate for 8 days and THEN freeze the milk.

Even though storage times may be decreased, most bf experts suggest *not* throwing out any milk before the maximum storage time unless when you warm it you notice that it has a very distinct foul smell.

Remember: When using your frozen milk, always use the "oldest" milk first, or rotate your stock of milk. A simple way to do this is to use fresh milk from fridge through most of work week, and then once or twice a week thaw a bag or two of frozen milk. You can freeze a bag or two of freshly pumped milk to replace what frozen you've used.  This keeps your stock "rotated" and still allows baby to have bulk of milk be fresh milk.  
A Few Tips from moms on freezing ebm (expressed breastmilk):
  • Freeze in small amounts - 2 or 3 oz increments - it thaws faster and less waste. (Kim)
  • Make "breastmilk shingles" - I used the Avent bags with the plastic locking clip. I always lay them horizontally, so they would freeze in a flat shingle. This made them thaw faster, and take up much less space in the freezer. After they were frozen I would take the plastic clip off and put the bags into a big freezer Ziploc with the quantities and amounts listed on the outside of the bag along with the date. This made it easy to find the quantity I needed as well as the milk I should use first. btw, the plastic clips have come in handy for all kinds of things now that they are not being used for ebm. . (LaRee)
  • I like the Gerber bags. They Ziploc. I would store them in a large Ziploc with the range of dates on the outside. It made it easy to rotate but I never had a lot of stash. (Lori)
  • You know how Medela and other expensive brands sell the bags for freezing/storing? Well, Gerber has one that is just as thick, good for freezing, and stands "up" when you pour the milk into it- making it MUCH easier to not spill your liquid gold! They are so much cheaper of course and you can buy them at Wal-Mart - right beside the expensive ones! After storing them in the bags- I would then place them in a BIG plastic bin- and store them in a freezer- "ideally" the big box freezers, but- if you need to put it in your refridge/freezer- make sure it's definitely in a plastic container so the bags don't touch the side walls of the freezer- since most freezers have an "automatic defrost" and your milk will defrost too if it's touching the side of the freezer. (Adele)
  • I am a paranoid freak, so I will put the milk in one Gerber bag and then put another Gerber bag over that bag. LOL! Then I put several ebm bags in a Ziploc bag labeled with the month/dates of the milk on the outside so I know when I need to use that milk.
  • I have also used the Lansinoh before, but those were way too expensive and did not have the "Ziploc" feature that the Gerber bags have. The hospital also gave me sterilized urine sample cylinders to use for frozen ebm. I know that sounds yucky, but my LC said it was a great way to store milk. I only used a few and found them too much of a pain, if you are going to have to wash them and reuse them.
  • I have heard that Tupperware ice cube trays (they have a lid on them) are great to use for smaller serving sizes. (Karen)
  • Making Milk Cubes (or "Boob Cubes") - pour the milk into a scrupulously clean ice cube tray & freeze. When it's frozen, pop the cubes into a FREEZER Ziploc. Since most ice cubes are between .5 and 1 oz, this is a GREAT way to deal with small increments - and you only thaw what you need. You might be able to find Oxo trays (covered), as does Tupperware(Freezer Mates Fresh & Pure Ice Tray) .

    I do NOT recommend the
    Oxo trays for anybody who routinely spills half the ice cube tray on the way to the freezer, LOL. When using them, it's best to have the lid already partially on the tray when you put the milk in, so you don't jerk an already full tray when you put the lid on. (Hope that makes sense) Mine go in the dishwasher every day, and are holding up pretty well. I think the cube is about .6 oz in volume.
You can figure the volume of an ice cube pretty easily (if it's important to you) by just filling up a measuring cup with water, finding out how much it takes to fill the tray, and dividing by the number of cubes. It's approximate though, depending on how much you fill it on any given day. Be sure to use a FREEZER Ziploc to store the cubes once they're frozen. (Sharon)
  • I use a clean ice tray and Freezer Ziplocs. I freeze the milk in the ice tray and then put the cubes into a freezer bag. I like it b/c I know each cube is 1 oz and I can pick and choose how much I use without having to thaw the whole bag or use lots of expensive liners for freezing (I use the cheep liners anyways when I use a bottle). (Darci)
  • I always liked the Mother's milk storage bags. They have this really neat top that opens into a diamond shape and stays open (easier for you to pour in the milk) then you just pull it shut and fold it over (kind of like a chips ahoy bag). They are about 8.00 for 25 bags. Although I think I might try some of the other ideas this time around :o) (Dottie)
Special thanks to the moms who have shared their tips on storing/freezing breastmilk!

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