Tuesday 26 April 2016

Adoption, Bonding and Breastfeeding

We are celebrating the recent arrival of our fifth child, who joined us about a week ago. To us, adoption is a really beautiful thing, which communicates some of the heart of the gospel. Adoption is always going to involve some kind of loss somewhere along the line - the most obvious of which being that the child is not with their biological family. (There may be other losses too, depending on the circumstances of both child and adoptive family). It is not 'ideal', but to me in many ways that reflects the fallen world we live in. Many things are not ideal. One does not look far to see pain and brokenness. Yet our glorious hope in Christ is for redemption, and one day restoration and resurrection.

You might wonder about the title of the post! However, I like to write about the abundance of life, and right now one of those enjoyable challenges surrounds relactation.

Quick tutorial:

1) Relactation is when a woman who has previously breastfed a child is able to establish and maintain a milk supply to breastfeed again, often after a period of many years. This is something which has been known and accepted in many societies for years. In Africa, it is not uncommon for a grandmother to breastfeed an infant whose mother died in childbirth. There aren't many other feeding options for the children here. Relactation can be supported by medication which enhances the production of prolactin from the pituitary gland. It just so happens that I was on such a medication for years for a gastrointestinal problem, and so had a large supply to hand. There are also herbal supplements and some dietary choices which are supposed to increase milk supply although I am unsure as to whether there is good scientific evidence for these.

2) Induced lactation refers to a woman who has never carried a pregnancy or breastfed but who wishes to breastfeed. This is a little bit more tricky, since breastfeeding required two things: the development of glandular breast tissue and the production of prolactin. It can be achieved in these mothers, but may require a combination of hormonal medication to 'mimic' a pregnancy before stopping these and starting drugs which can stimulate lactation.

But you might ask, why would anybody want to do this if a child is healthy and well established on bottle feeding? For me, the benefits are vast. I will not attempt to describe in full the benefits of breastfeeding - there are many resources that already do this. My quick summary is this:

1) Breastmilk is designed perfectly for an infant. As well as nutrition, it contains all kinds of helpful antibodies and proteins which can help protect against infection. There are often new discoveries regarding the nutritional and immunological benefits of breast milk which can continue well into adult life

2) Breasfeeding provides an amazing time of bonding. There is nothing much nicer than to cuddle a perfectly relaxed child who is half sleeping and half feeding.

3) Perhaps part of the bonding is also that breastfeeding takes time. It is necessary to create that time to be close with your child, no matter what else is going on around you.

4) Breastfeeding gives that time just to gaze at your child, to sing to them, to pray for them, to study them and to really focus on them. Perhaps this becomes more important as the family grows and there are always so many competing demands on time

For us, with a seven month baby who is starting to eat increasing amounts of solids, the benefits may relate more to bonding than to nutrition. However, there is evidence that even a small amount of breast milk is beneficial, even if it is difficult to be scientifically precise about this.

There are a number of helpful resources which provide more detail if this was something you wished to do - for example here, here, here and here.

Some of my own reflections:

1) It is possible. With our first adopted child, I was already breastfeeding and he was a bit younger, so it was a very straightforward (in fact immediate) transition. It has been a bit more work this time, and I would not say that 'feeding is established' yet by any stretch

2) It takes patience. It is one thing to get the mother to lactate. It is a different issue to get the infant to take to the breast, especially if they have no previous experience of breastfeeding. There are supplemental nursing systems designed specifically with this in mind. But can you imagine trying to use this with three lively and curious boys that you are homeschooling, and a cleaner who doesn't always give much personal space, as well as various other people coming and going? For me, that is the biggest challenge of all - to get space and time.

3) It takes space and time! I am completely comfortable breastfeeding anywhere, including in professional meetings, on public transport or even walking along the road with the child in a sling. But I am less comfortable using a supplemental nursing system or a breast pump anywhere. A week before the child came home to us, I  had to make a long distance work-related trip. Trying to find somewhere to express milk in an airport is interesting. Similarly, to do so whilst working a busy shift in a teaching hospital can be challenging (and if nobody knows you are expecting a child or that you are lactating, explaining the need to access a private room is interesting). Most of the resources recommend pumping each side for 15 minutes, 8-10 times a day. For me, that really hasn't been possible. 3-4 times a day perhaps but not more. Now we are all together, I need time with the baby so she can work out how to latch on. She is making progress, but we don't have the luxury of hours and hours alone together to really focus on this.

4) Most of the resources seem to assume that it is just you and your adopted baby and you have all the time in the world to work on this. Like I said, I am not able to spend as much time as might be ideal. But I think it is important to remember that anything is worthwhile! I might not be able to exclusively breastfeed her the way I did with my other adopted child, but indeed she is older and if we can aim for one or two feeds a day as well as other nutrition, I would be delighted. Sometimes there needs to be an adjustment of expectations, to avoid frustration and disillusionment

5) It is important not to get obsessed. I do not want my relationship with my daughter to be all about breastfeeding, and its important not to start thinking it is the most important thing. I sometimes feel a bit like a failure for feeding with a bottle (we have literally never used a bottle before with any of our other four children). But that's not the point. Parenthood isn't about 'success' or 'failure' anyway. It is interesting because I remember hearing other mums telling me they felt a 'failure' for not being able to breastfeed - maybe now I actually understand a little bit of that feeling, and that must be helpful for me to be able to encourage others in the future.

So, there you go. A bit different from my usual posts, but hopefully will bring encouragement to some of you!

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