It is possible for some women who have never been pregnant or given birth to produce milk and breastfeed a baby. This is called induced lactation. While rare, induced lactation is most commonly seen when a woman adopts a baby and wishes to breastfeed them. It requires the adoptive mother to take hormones and medications to stimulate milk production before beginning a breastfeeding routine with the infant.
How does induced lactation work?
Induced lactation relies on the hormones prolactin and oxytocin to initiate milk production. All women have mammary glands that can potentially make milk with the right hormone stimulation. The process takes several weeks to months and requires persistence, but it can allow a woman to fully breastfeed an adopted infant without being pregnant herself.
Here is a general overview of how induced lactation works:
- Take hormones like birth control pills and domperidone to increase prolactin levels
- Use an electric breast pump to stimulate the breasts and nipples
- Begin a breastfeeding routine with the adopted infant right away
- The suckling of the baby at the breast further increases prolactin and oxytocin
- Gradually milk production will start within weeks to months
- Keep pumping and nursing consistently to bring in an ongoing milk supply
The process takes dedication but can allow an adoptive mother to fully breastfeed her infant. Some women may produce a full milk supply while others may only partially breastfeed alongside formula or donated breastmilk from another mother.
What hormones increase milk supply?
The two main hormones involved in breastmilk production are:
- Prolactin – Stimulates milk production and secretion. Levels rise in response to nipple/breast stimulation.
- Oxytocin – Triggers milk let down and flow. Released when the baby nurses at the breast.
These two hormones work together to initiate and maintain milk supply. To induce lactation without pregnancy, hormone medications are used to mimic high prolactin levels in the body:
- Birth control pills containing estrogen and progesterone
- Domperidone – Increases prolactin. Not FDA approved for lactation in the US.
- Metoclopramide – Can also increase prolactin.
- Herbal supplements like fenugreek, blessed thistle, and fennel may help.
Phases of induced lactation
Inducing lactation without giving birth involves three main phases:
- Hormone stimulation – Taking hormones and medications to increase prolactin. Lasts 1-2 months.
- Nipple preparation – Using a breast pump to stimulate nipples/breasts. Done for 2-3 months prior to baby’s arrival.
- Breastfeeding – Putting baby to breast frequently once they are home. Milk production begins within days to weeks.
This gradual process takes around 3-6 months from start to developing a full milk supply. The breastfeeding relationship with the adopted infant then continues as normal for as long as desired.
What are the steps to induce lactation?
Here is an overview of the key steps involved in induced lactation without giving birth:
- Take hormone medications – Birth control pills or domperidone prescribed by a doctor who is experienced in induced lactation.
- Pump breasts – Use an electric double breast pump for 10-15 minutes 2-3 times per day.
- Stimulate nipples – Gently roll nipples between fingers to mimic baby sucking.
- Begin nursing/pumping – Put baby to breast immediately when they are home. Pump after for extra stimulation.
- Ensure proper latch – Get help from a lactation consultant to achieve a proper latch and suckling.
- Offer both sides – Nurse 8-12 times a day offering both breasts each session.
- Be patient – It may take days or weeks for milk to come in. Keep pumping and nursing frequently.
Having an IBCLC lactation consultant to help with the process increases the chances of success. Most importantly, the adoptive mother must be very determined, patient, and consistent in pumping/nursing for it to work.
What are the success rates?
Success rates for induced lactation allowing complete or partial breastfeeding are:
- More than 200 mL (7 ounces) per day – Up to 70% with domperidone protocol
- 50-200 mL (2-7 ounces) per day – Up to 90% can produce some milk
- Less than 50 mL (2 ounces) per day – Approx. 10% produce only drops/drips
These numbers demonstrate that the majority of women are able to produce at least some breastmilk through induced lactation. However, there is a wide variation in milk production depending on the individual and persistence with the process.
How much milk is produced?
| Breastmilk Amount | Percentage of Women |
|---|---|
| 200 mL/day or more | 70% |
| 50-200 mL/day | 20% |
| Less than 50 mL/day | 10% |
As the table shows, most women are able to produce significant amounts of milk through induced lactation. However, almost a third will only produce small quantities and may need to supplement.
What affects the success rate?
Some factors that impact the success of induced lactation include:
- Age – Younger women tend to have higher milk production.
- Breast size – Larger breasts can store more milk.
- Persistence – Dedication to the pumping/nursing routine.
- Hormone response – Individual response to hormone medications.
- Breast stimulation – How often/effectively breasts are pumped and nursed.
The most important factor is dedication and commitment to the process. Women must be willing to pump and nurse very frequently, around the clock if needed, for production to begin.
How long does it take for milk to come in?
For most women, the timeline for milk production is:
- Drops of milk may appear within 2-6 weeks
- Light milk flow after 6-8 weeks
- Full milk supply around 8-12 weeks
However, the timeline can vary substantially based on the individual. Some women may take only a few weeks to produce milk while others may take months before seeing full results.
Is domperidone safe and effective?
Domperidone is a prescription medication that increases prolactin and stimulates milk production. However, it has some important caveats:
- Not FDA approved for lactation in the US but often prescribed off-label.
- Can increase the risk of heart rhythm problems in some women.
- May cause other side effects like headache, nausea, and dry mouth.
- Shown to be safe for lactation when taken at low doses (10 mg 3 times daily).
- Allows most women to produce substantial milk volumes, up to 250 mL per day.
Domperidone is relatively effective for induced lactation but does come with some risks that should be considered carefully. Working with a doctor familiar with the protocol is advised.
Is induced lactation right for an adoptive mother?
Induced lactation can be an option for adoptive mothers but has pros and cons to weigh:
Potential benefits:
- Allows breastmilk feeding and its nutritional benefits
- Promotes bonding, comfort, and closeness
- Provides immunity benefits to the infant
- Avoids challenges of finding donor breastmilk
Potential drawbacks:
- Can be a difficult, lengthy process
- Milk supply may be low or unreliable
- Requires medications that can have side effects
- Need for persistence and commitment
- May still need formula or donor milk to supplement
Adoptive mothers should consider both the benefits and drawbacks when deciding if induced lactation feels right for them and their infant.
Conclusion
Induced lactation is possible for some adoptive mothers and allows them to breastfeed without giving birth. However, it is a challenging process requiring hormones, frequent pumping, and persistence over weeks to months before milk is produced. While many women will produce at least some milk this way, supplementing with formula or donor milk may still be needed. Women who wish to induce lactation should work closely with their doctor and a lactation consultant to be successful. With dedication and commitment, adoptive breastfeeding is an option, but one that should be considered carefully based on each woman’s individual circumstances.
