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How can mothers who welcome babies via surrogate breastfeed?

Kim Kardashian (Photo: Getty Images)

As Kim Kardashian showed fans all the products she has ready for the arrival of her third baby, one particular item raised eyebrows: her My Brest Friend nursing pillow. Why would she need that for a baby being delivered via surrogacy? Because if she chooses to (and some sources say she will), she really can try to breastfeed her daughter, even without having been pregnant with her.

Induced lactation, in which a woman can trick her body into producing milk, is a practice women have been doing forever to keep orphaned or malnourished babies alive. In modern times, induced lactation is an option for women who adopt, have babies via surrogacy, or are in a same-sex relationship and didn’t carry their baby. With so much hype around the benefits of breastmilk to children, many don’t want to miss out on the chance to provide their own.

“If women want to go into the induced lactation process, some feel like there’s a greater chance if you’ve breastfed before,” Diane Asbill, RN, IBCLC, the Lactation Services coordinator for UNC Healthcare, tells Yahoo Lifestyle. “That doesn’t mean you necessarily will be able to fully nourish your baby just with your milk, but you at least have the option of nursing the baby with some of your milk.”

Since Kardashian did breastfeed North and Saint, she may be able to stimulate lactation just by pumping regularly before the baby’s arrival. If that’s not enough, her doctor may prescribe hormones, such as birth control pills, which mimic what a pregnant woman’s body would be doing anyway. Then she can also take galactagogues — herbs and medicines to promote milk production.

“There are no good randomized control trials of which galactagogues really work, which ones are most likely to bring in some milk production,” Asbill said. Some commonly used herbs include fenugreek, blessed thistle, alfalfa, and goat’s rue.

A much-talked-about recipe for inducing lactation, known as the Newman-Goldfarb Protocol (developed by Canadian pediatrician Jack Newman and lactation consultant Lenore Goldfarb), suggests starting birth control six months before the baby is due, then stopping six weeks before the due date. At that point, the protocol advises pumping every three hours. It also suggests that women take the drug domperidone, which is where things get questionable. The drug, which is approved in Canada for gastrointestinal problems, is not approved by the FDA for any use in the U.S. When used intravenously (not how mothers and mothers-to-be would take it), it has been linked to cardiac arrest, arrhythmias, and sudden death.

“We certainly are aware of physicians who prescribe it and women who have used domperidone very successfully without a negative medical history that made it more risky for them,” Asbill said, but her hospital and most American doctors are not about to take that risk. Women who decide breastfeeding is that important to them have to find ways to buy it online or across the border.

Even after doing all this, milk may still not come. Asbill says she’s seen women able to produce a nearly full supply of milk, and she’s seen others come up with just a few drops. That doesn’t, however, mean they can’t still experience the joy of nursing. With the use of a supplemental nursing system (SNS), a tube that one attaches from a bottle to the breast, parents and babies can get the benefit of skin-to-skin bonding during feeding.

“I’ve worked with several women who for a full year fed their baby at their breast every single feeding and the baby never got one drop of milk that came out of her body, but they had a full nursing relationship,” Asbill said. “Breastfeeding is not just food, it’s nurturing and care for your baby.”

Though there’s nonstop “breast is best” messaging out there, some studies have suggested that the benefits of breast milk may have been overblown, due to the fact that it’s really difficult to conduct a randomized control trial on mothers and babies.

Asbill tries to guide parents to understand what their goal is in breastfeeding, especially if the emotional cost of achieving it is too high.

“Many of us would do anything to make [breastfeeding] work,” she says. “But at some point you have to say, ‘Is this really healthy and safe for me and my baby, or are we missing out on the nurturing and loving part of being with our baby because we’re trying to get another teaspoon of milk?’”

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