Adoption and Breast Milk

mom baby on beachCasey Brown is a wife, Paramedic-turned-stay-at-home mom, and adoptive mom of one princess. She is passionate about adoption and breast milk and her journey to make sure her baby could have breastmilk in the NICU hit the national stage in social media.  She encourages other adoptive mamas to fight for the liquid gold, to not back down, and stand up for what they believe in. Ending discrimination against adoptive mamas has become a passion of Casey’s.  She is co-founder of the company Quiver Full Adoptions, an adoption consultation service based out of Greenville, SC.  You can also follow her on Twitter and Facebook.

When I was little, I had one million baby dolls. Almost. I played “house” every single day and ever since I can remember, I have wanted to be a mama. Not a teacher, not a doctor, but a mom. Maybe that desire came from seeing my mom making it look like the best “job” in the world. I won’t bore you with the details or make you feel inferior by telling you about how awesome my mother is, instead, I’ll tell you about the day I found out I was going to be a mom. Let’s rewind. My husband and I had been married four years and had been trying to conceive since the day we were married. Hey! I told you I wanted to be a mom! The stars weren’t aligning and the doctors were saying I would need science to help our dreams come true. Science. That’s something I was familiar with, being a Paramedic for three years and being in the health field for seven. After much prayer, Josh and I decided to forgo the science and medicine and pursue adoption. Adoption had always been in our hearts and on our minds, but something that we imagined doing when our biological children were older.

Three weeks after announcing that we were adopting, we were matched with our birth mom. Now if that wasn’t a sign from the good Lord, I don’t know what is. Crystal, our birth mom, asked me to attend her doctor’s appointments with her, and of course I said, “Yes!” I was going to be a mom and she was allowing me to experience as much of the process as I could. During the second or third doctor appointment, I was sitting in the room with Crystal, and she sat up on the exam table and said, “Have you thought about breastfeeding your baby?” Wait. What? Our birthmom has to be the coolest birthmom on earth to be asking me this question. I replied, “No,” although I had actually been thinking about it. I had been in contact with Krista Gray from Nursing Nurture and had already started the Newman-Goldfarb protocol – that’s how much I had thought about adoption and breast milk. I’m not sure why my immediate response was “No,” it wasn’t meant to deceive her, it was just a knee jerk reaction. I later told her the truth and she was very supportive. Crystal was already sixteen weeks pregnant when I began the protocol. Ila Mae, my princess, was born six weeks early and had a two week stay in the NICU. I had no time to stop the birth control and begin pumping, as the protocol needs eight weeks of pumping to start producing milk. Ila Mae was on a ventilator, had a chest tube due to a collapsed lung, and was on TPN. Seeing her fragile, tiny four pound, thirteen ounce body lying in the isolette, I knew I had to do something to get her that liquid gold. I did what any mama would do. I fought. Then I took on the hospital.  Below, you will find my Facebook post that went viral just a few days after Ila Mae was born.

“Baby Ila Mae was born July 23. The adoption papers were completed today. Through this group [Breast Friends] and Adoptive Breastfeeding group, I have begun the Newman Goldfarb Protocol. I haven’t started

NICU battle for adoption and breast milk

NICU battle for adoption and breast milk

pumping yet to induce lactation. I have a ton of donor milk that I was planning to use with my Lact-aid. Today, I experienced bullying for the first time that I can remember. It was so real. I said to the nurse, ‘When Ila Mae gets off the ventilator, we have breast milk that we want her to have instead of formula.’ She looked at me like I had three heads, turned around and went and got the lactation consultant. This lady comes over and says, ‘So, I hear you have breast milk. Where did you get it?’ This breast milk comes from my best friend. I told her this and she looked at me like I was disgusting and said, ‘you cannot use that unless you get it from a milk bank.’ I said ok, and asked how to go about doing that and if I could see the protocol they have set in place that says I cannot use donor milk. They could NEVER produce one and then finally admitted that they had never had this happen ‘because adoptive moms just don’t do this kind of thing. Mam, if you want to give this baby donated milk, then you’ll have to do it when she is actually yours in your own home.’ Ummmm, I about lost it at this point. This baby is MINE. Then, I leave and come back three hours later in hopes that she has left, only to get cornered by her and the neonatologist. While I was gone, they decided that I wouldn’t be able to use milk from a milk bank ‘because there isn’t one close enough’ and 4pounds 13 ounces isn’t a low enough birth weight and adoption isn’t a special circumstance that they could write a prescription for.’ They went on to tell me about all of the “risks” of donor milk and I politely informed them of how misinformed they are. My question is, would y’all be willing to write a letter to this hospital informing them of the benefits of breast milk, donated whether through a milk bank or not, and the non benefits of formula? They also told me that in order for me to use the Lact-aid, I’d have to have blood work done!! WTH?! Seriously? Ok, what’s the difference then? Why can’t my milk donor go have blood work done to show she isn’t infectious and then allow me to use her milk? I’m so aggravated that I can’t make an informed decision and I have been bullied into using formula. It will still be a few days before she is off the ventilator and able to nurse, but this is a big deal to me!”

Adopted yet thriving on breast milk!

Adopted yet thriving on breast milk!

Six months later, here I am reading what I posted on Facebook, and all I can see is how stressed I sounded. I could hardly form complete sentences. The group Breast Friends has approximately 5,000 members. About 300 of them wrote the hospital handwritten letters, fighting on behalf of me and my princess. Four of the members called the hospital, and one of the members spoke directly with the President of the hospital. After some threatening of getting the news involved and threatening to picket on the sidewalk while mothers nursed their babies, the hospital finally caved. They finally agreed to get me the donor milk from a milk bank. I compromised since they were getting me breast milk, to agree to not use the Lact-aid and to not use my personal stash of donor milk. Ila Mae is now six months old and has never had a drop of formula. We have had a total of eighteen milk donors (plus how many ever donors from the milk bank), all friends or friends of friends. (And due to Casey’s battle with the hospital, the policy has officially been changed regarding donor milk.  Here is more information on Spartanburg Memorial in SC.)

You have a choice, mamas! You don’t have to settle for fourth best, according to the World Health Organization, you can have that liquid gold. Fight if you have it in you, settle if you don’t. Either way, I won’t judge you, but I will stand behind you if you decide to fight!

You may also be interested in reading more about Adoptive Breastfeeding, Induced Lactation, 5 Challenges of Adoptive Breastfeeding, and Tube Feeding Devices.


Exclusive Pumping

When a baby isn’t breastfeeding, effective milk removal from the breasts becomes critical in order to build or maintain a milk supply.   Exclusive pumping can be necessary in a variety of settings: when a baby is born prematurely or cannot breastfeed due to illness; when a baby refuses to latch at the breast; in cases of adoptive breastfeeding, induced lactation, and relactation, or when mom needs to be away for a period of time.  Some moms begin pumping and, though the reason they initially began to express is resolved, find that their baby prefers receiving expressed breast milk. If you are in a situation of exclusively pumping, here are 5 tips for your situation.

  1. Establish your milk supply.
    The most important thing you need to do when exclusively pumping is establish a full milk supply. Your body needs to get the message to make enough milk for your baby. Perhaps your baby was born prematurely and isn’t taking much milk in a 24 hour period. This will change in a few weeks and your body needs to make sure it has the supply ready for your baby. In the beginning, a mother should pump a minimum of eight times in a 24 hour period for at least 20 minutes on each breast.  It will help to record what time you pump and how much milk you get. A double electric pump is the most efficient way to do this.  Though hand expression, single pumps, and manual pumps are all other options, a double electric pump of good quality has been found to stimulate greater milk production. 1
  2. An empty breast makes more milk.
    It’s the law of supply and demand. Therefore the more completely the breast is drained and the more frequently this occurs, the more milk a mother’s body will make. 2 It is completely possible for you to make enough milk to exclusively nurse twins or even triplets!
  3. Shorten pumping duration AFTER supply is established.
    After a full supply is established (25-35 ounces per baby every 24 hours) 3 then you can shorten the duration of pumping at each session to the amount of time necessary to gather the required milk. Many times this is as short as 5 minutes!  In general, once a strong milk supply is established, one nighttime pumping session can be dropped but it is important to ensure you are still pumping at least once during the night and never going more than 4-6 hours between pumping during the longest interval between sessions. Every mother is different and every breast has a different storage capacity. While a few mothers may be able to go 10-12 hours between their longest stretch, other mothers can only go 3-4 hours. Full breasts make milk more slowly so the longer a mother waits between pumping sessions, the slower the milk production becomes. Every mother will have to work out what her “magic number” is for how many times to pump and how long in order to maintain supply.
  4. If you begin to notice a drop in supply, increase pumping sessions and/or duration.
    A general guide, once milk supply is established, is to pump 6-7 times in a 24 hour period, at least once during the night, and only for the time it takes to get the required amount of milk. Should you notice your milk supply beginning to decrease from the shortened pumping duration and/or number of sessions you should return to pumping more often and for a longer duration.
  5. Your “magic number” will be different than another person’s.
    Don’t worry if you have to pump more often than another mother to get enough milk. Don’t worry if you don’t have to pump nearly as often. Every mother is different. Not only is every mother’s breast storage capacity different, but each breast on the same mother can vary! It only matters what your magic number is. Therefore, once you have worked out how frequently you need to pump and it works for you, don’t worry if someone else does it differently.

Expressing breast milk is hard and can be very emotional. You may need to grieve not being able to nurse your baby at the breast. While expressing milk can help you connect with your baby, it also is a symbol of the disconnection. 4 Realizing that grieving is not only important but normal is critical to dealing with one’s feelings and healing. Also realize that no matter how long a mother has been exclusively pumping, transitioning back to breastfeeding is an option.

When the time comes to wean from expressing there are ways to do this both safely and comfortably.