Inducing lactation refers to making it possible for people—including mothers who did not give birth to a baby—to breastfeed. By controlling hormones and using a supplemental nursing system, many more people can breastfeed.
What is inducing lactation?
Inducing lactation is the act of literally tricking a mammal’s body into thinking it’s pregnant by boosting hormones and then simulating the delivery of a placenta by removing those hormones. Lactation can be induced in a minimum of 30 days. People who are most often interested in inducing lactation are adoptive parents, parents who used a surrogate, and same-sex couples. It is truly amazing that a woman can breastfeed even if she didn’t physically give birth to the child.
Anyone can induce lactation, but it’s a matter of whether enough milk can be produced to feed a baby. If someone has previously lactated, they will generate more milk volume because the prolactin receptor sites have already been established. That’s also why a woman giving birth makes more milk with each subsequent child.
What are the benefits of breastfeeding?
It can be difficult to induce a milk supply to fully exclusively breastfeed, but evidence shows that even one drop of breast milk has benefits for both mom and baby.
People who are most often interested in inducing lactation are adoptive parents, parents who used a surrogate, and same-sex couples.
Each drop of breast milk contains 1 million white blood cells. These are the cells that kill bacteria, fight infection, fight disease, and destroy old or damaged cells in the body. Breast milk also contains antibodies that bind to microorganisms and keep them away from the body’s tissues. Another benefit to breastfeeding is the release of the hormone oxytocin, and skin-to-skin contact helps establish the much-needed receptor sites. Oxytocin strengthens trust and closeness in relationships and can be triggered by eye contact, empathy, or touch. Infants that are breastfed also have a lower risk of asthma, obesity, ear and respiratory infections, sudden infant death syndrome, and gastrointestinal infections such as diarrhea. Breastfeeding also lowers a mother’s risk of high blood pressure, type 2 diabetes, and breast and ovarian cancers.
How is lactation induced?
With the guidance of an OB-GYN or family practitioner, the first step is to boost your hormone levels by using prescription birth control pills to simulate pregnancy. Birth control pills contain a combination of two hormones: an estrogen (ethinyl estradiol) and a progestin (drospirenone). Your doctor will likely give you the pills with the highest estrogen level available, such as Yasmin. You will be instructed to take active pills until you are ready to lactate, then discontinue. Thirty days is the minimum, but if you have several months to prepare to lactate, it is recommended to surge your estrogen for as long as possible.
The body only gets prolactin surges when the baby is on the breast, not with a pump, so feeding on the breast will keep milk supply up and reduce the risk of lowering the supply.
Simultaneously, you will need to boost your prolactin levels, and continue to do so as long as you are lactating.
There are two drugs for acid reflux and nausea that have a side effect of boosting prolactin: Reglan and Domperidone. Prolactin is a hormone produced by your pituitary gland, which sits at the bottom of the brain. Normally, both men and women have small amounts of prolactin in their blood, but during pregnancy and breastfeeding, the levels increase from 1 to about 250. Reglan is the most commonly used medication to boost prolactin and to increase milk supply in the United States, but it does cross the blood-brain barrier and has an FDA warning. Side effects include severe depression and tardive dyskinesia and may not be recommended for women at risk for postpartum depression. Domperidone (or Motilium) does not cross the blood-brain compartment and is in a safe lactation risk category. The medication does not have the side effect of depression and does not enter the milk. Speak to your doctor about both options and choose the best medication based on your medical history.
How does inducing lactation work?
Once you’ve boosted your estrogen and prolactin levels, your body responds to the discontinuation of birth control pills and to the increase in prolactin. By discontinuing the birth control pills, you simulate the delivery of the placenta and will trigger the body to enter the second stage of lactation. Typically a woman enters the first stage of lactation at 10 weeks of pregnancy, which causes her breasts to increase in size. Colostrum becomes available at this time, ready and waiting for the baby to be born. In the second stage of lactation, milk volume increases from 5 cubic centimeters to an average of 650.
Studies have shown that prolactin surges can also come from the act of physical touch to the nipple once you’ve started lactating.
How do you make the most of induced lactation?
To make the most milk possible, the best way to feed your baby is to supplement on the breast with a long-term supplemental nursing system (SNS). An SNS typically is a bottle that hangs around your neck or clips to your bra strap, and has one or two tubes that you tape to the nipple. When the baby latches to the nipple and creates the suction to extract milk from the breast, the baby also extracts supplemental milk or formula from the SNS bottle. The baby receives the supplement at the same time as the milk from the breast, so there is no need to supplement with a bottle. If you prefer to not feed on the breast, a hospital-grade breast pump is preferred.
With the guidance of an OB-GYN or family practitioner, the first step is to boost your hormone levels by using prescription birth control pills to simulate pregnancy.
There are several benefits to supplementing on the breast. The first is time. A 12-pound baby needs four ounces of milk eight times a day, and when inducing lactation, it may be difficult to make this volume. If supplementing without an SNS, this would require breastfeeding first, then feeding the baby with a bottle. That takes time, and babies aren’t exactly the most patient. If you supplement on the breast, however, you simply breastfeed and know your baby is getting enough milk. You’re also emptying the breast without the need for a pump.
The second benefit to supplementing on the breast is increased prolactin, the hormone that controls your milk supply. The body only gets prolactin surges when the baby is on the breast, not with a pump, so feeding on the breast will keep milk supply up and reduce the risk of lowering the supply.
Inducing lactation takes time and effort, and chances are you will still need to supplement with some formula, but putting in the effort today will lead to lifelong benefits for both mom and baby.
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