Thursday, August 1, 2013

Adoptive Breastfeeding

I have decided to share my story in honor of World Breastfeeding Week ( stick with me it will be long)

Adoptive breastfeeding is such a beautiful, bonding, heart healing experience for babies and mama's. It surprises me how many people don't know that its possible and how many people still feel it's taboo or weird. So here is my confession. Scratch that declaration. I am proud and not ashamed I BREASTFEED MY ADOPTED BABY.

It has been a journey that has required patience, love, creativity, and support (seriously without the people who have cheered me on we may not have succeeded).

If this is the first entry you have read on my blog here is a recap for you. My husband and I adopted our daughter from an orphanage in Eastern Europe and got home April of 2013. She was 9 months old and she has Down Syndrome. I knew there was a chance that breastfeeding may not happen for us. being 9 months old and used to formula and used to a bottle with a large hole. Plus having Down syndrome presented some unique what if's. Down Syndrome causes low muscle tone and larger tongues. We didn't know if her tongue would be strong enough so suck efficiently and transfer milk. Also having spent her life thus far in an orphanage and not having much human interaction, we didn't know if she would reject breastfeeding since it is an intimate act of trust and love. Neither of which she had known. My one advantage was that i was and still am breastfeeding my biological babe who is 2 months older than my adopted daughter. That meant i only had to increase my milk supply instead of having to induce lactation. (mama's who induce lactation are my hero's. Such hard work, though so worth it!)

So i started to do my research. There was some literature on adoptive breastfeeding and some very helpful online support groups bit it is unbelievably hard to find literature out there on breastfeeding babies with Down Syndrome. And impossible to find anything about breastfeeding an adopted child with Down Syndrome. I was lucky enough to find a group that is very small and confidential  full of mama's adopting or who had already adopted kids with special needs and breastfeeding. They were a God send. I also found a local IBCLC to help me out. We met before i left to get my daughter. We talked about the lack of info that matched my situation to use as precedent or for guidance and the potential challenges. She was so encouraging though and cheered me on and told me she believed in me and that even if breastfeeding didn't happen for us pumping was a great back up plan. So she helped me with pumping tips to increase my supply and during the months of paperwork i filled 3/4 of my chest freezer with my milk. I was confident in my supply i knew i could make enough to breastfeed my daughter too. the rest would depend on whether or not she could suck and transfer milk efficiently.

In the weeks i spent visiting my daughter at the orphanage bonding became my number one goal. I knew that she would need to feel close to me, safe with me, and loved by me for us to have any hope at breastfeeding. ( i thought it may be months home before she would latch and i was prepared for that but hoping it would happen sooner). During my visits i would give her massages, sing lullabies to her, wear her in my Ergobaby carrier, and repeat mantra's to her ex: kind hands, soft touch, mama loves you, you are safe etc. When i would wear her in my Ergobaby i would wear a tank top that could be pushed down so that her face was against my bare skin so she could get used to the feel, smell, sound etc of me. When they let me feed her her bottle i would hold her in as close to a breastfeeding position as i could. I worked on eye contact and touch. Neither of which she was used to.

When gotcha day arrived i took her back to the apartment we were staying in and thought well here goes might as well try. I started by taking a warm bath with her. I washed her head to toe and cooed at her and sang to her and held her skin to skin. afterward I massaged her with lotion and then brought her to my breast.

To my amazement she latched on! She didn't stay on for more than a few seconds, but she had latched and suckled! We stayed like that for awhile and i let her try a few more times. Even though she didn't stay on long enough to make my milk flow, she had tried. It was a huge moment for us. If you have ever had a baby and can remember that hormone rush , that over the moon in love, mam bear protectiveness you feel when you first put your babe to your breast. Well it was exactly the same the first time my daughter latched on. It was amazing and so encouraging. I knew then that we definitely had a shot at making this work.

I pumped bottles for her and started out by alternating. One feeding of formula next feeding breast milk. She was starving and malnourished and i worried about re-feeding syndrome or making her belly hurt. After three days of that she refused the formula and would only take breast milk. By the 5th day i had her she had finally nursed long enough to make my milk let down and had emptied my breast. I couldn't believe it. she only breastfed the whole way home (36 hours of traveling and flying).

Once we got home it became a different story. She was getting frustrated at the breast and would cry and give up before the milk started to flow. Now that her tummy was filled and she wasn't worried about whether she would get another meal she was wanting instant gratification. So i started to use my freezer stash of pumped milk and bottle feed it to her. This went on for about 2 weeks . She had pretty much stopped nursing. i would try to nurse her but she would usually refuse.It was tough to keep trying and be rejected over and over. But I wasn't ready to give up yet. I called our IBCLC and got some advice from her and some encouragement. We decided to try an SNS (supplemental nursing system) like this . I hoped that i could put an ounce or two in it to give her the instant flow she wanted until my milk let down. Unfortunately she refused to latch on with SNS in place. Some children with Down Syndrome are more likely to have sensory issues or issues with textures in their mouth. My daughter hated the feel of that teeny tiny tube against her tongue. So we continued with bottle feedings.

At this point I decided to try breastfeeding her first thing in the morning when my breasts were over full and I decided getting her to tandem nurse with her brother was a top priority. He could do the work to get milk flowing for her if they nursed together plus while nursing two my milk would let down faster.I had tried to tandem nurse the two of them before and she wouldn't have it, it totally freaked her out. I'm guessing it had to do with trauma from the orphanage. I think she thought she would have to compete with him for food. I started by trying to work on their bond as brother and sister. I let him cuddle her and he would bring her little toys to show her. She had been afraid of the bath so I always bathed with her, now I brought Levi in too. I rigged up pillows and such so I could bottle fed her while nursing Levi so she could see they could eat at the same time and didn't have to compete. The morning nursing session went great. She would nurse when my breasts were over full so we had at least one feeding a day guaranteed to be at the breast.

After a few days she decided that tandem nursing was okay. Victory!! This did not totally solve our dilemma though because Levi also eats solid food and does not Breastfeed as often as she does. But we now had quite a few feedings a day at the breast. Next light bulb idea for me was hey why don't i just use my pump for the other feedings, just to get milk flowing and then latch her on. Genius. I don't know why i hadn't done this earlier. It worked like charm. I would use my double pump at first and latch her once flow had started. then I started pumping one breast while she nursed at the other breast in hopes she would learn that flow took a little time. Eventually she started to breast feed again without the pump and even when not tandem nursing with brother.

We are now almost 4 months home and have been bottle free since June 1st!! Every once in awhile i still have to get out the pump to help her. If she slept longer than usual so is very hungry, or if she has just finished therapy and is tired, or when we are in public she sometimes gets nervous etc She will still need a little help. But i am totally ok with that. And i am so proud that we worked through all that we did together as a team. Our bond is deep and she knew i was mommy very quickly. I feel i can credit a lot of that to our breastfeeding relationship. when we brought Stef home she was malnourished and underweight and had a gray color to her skin along with excema and terrible constipation. She has put on 5 pounds and is is glowing pink. Excema is completely gone. And she no longer has hard painful bowel movements. I know that those are all a credit to my breast milk.

There were moments i was ready to throw in the towel and just bottle feed. There was frustration and tears. But i am so glad we stuck it out and didn't give up. Breastfeeding was the right decision for us and is a special bond we share.

I am taking part in Mothering magazines blog about breastfeeding event. to read stories from other mama's visit here

Gotcha day!!

Finally the 10 day wait was up and all my paperwork was in hand and i could set Stefanya free!

I was nervous because i had asked our facilitator  early on in our process if there was any info to contact Stefanya's birth parents. There was a phone number and a street address.  I had asked her to contact them and she agreed to do it after the 10 day wait was up and Stefanya was legally ours since we had no way of knowing if her birth family would be friendly, or would be upset at being contacted, or if they would end up not liking us and not wanting us to adopt her.

The night before gotcha day she telephoned Stefanya's birth mother. She answered the phone and our facilitator told her " your daughter Stefanya has been adopted by an American family and she leaves the orphanage tomorrow. Her new mother has invited you to come and say goodbye. " Her birth mother said thank you and that she would be there. I was so nervous , i really hoped she would show up but i was also so scared to meet her and was praying all would go well. I knew it was a risk contacting her birth family but since day one i felt God telling me that i needed to do it. I knew that if Stefanya could know them and know where she came from and why she was placed for adoption it would be better than carrying unanswered questions the rest of her life. I also felt strongly that there was a good chance that her birth parents loved her and didn't place her for adoption due to shame or not wanting the hardship of a child with special needs but instead because they were backed into a corner. There isn't access to therapy and help for families who choose to keep their children with special needs in their country. They have no special education. Society does not accept people with special needs. I also knew that their medical system is far behind ours, and getting her the medical care she needed would be difficult if not impossible for them.

We went into the office of the orphanage director and she told me through our facilitator that the birth parents were there and were waiting for me. i was so nervous i think my heart was beating out of my chest and i thought i was going to be sick. The director said don't worry they are very positive and are glad to meet you. that made me feel somewhat better.

They brought in her birth mother and father. Such a surreal moment . They are very close in age to Josh and I. My first thought was oh my goodness Stefanya is the exact image of her birth mother but with her birth father's eyes. When they came in they were speaking in Russian to the director and facilitator. Our facilitator said her mother would like to talk to you. And to my surprise her birth mother (we will call her O to protect her privacy and her birth father D)  O spoke to me in English! she told me how thankful they were that we adopted Stef and she began to cry so i got up and sat next to her and held her hand ( i dunno what came over me i am not usually that brave with strangers) i told her about how much we loved stef already and about our home and all we could offer Stef. I asked if we could use the visiting room to talk for a bit , they said yes. I asked O and D if they would like to see stef. I remember O's eyes lighting up her saying are you sure, can i really? So we had stef brought in and i told O how much she looked like stef and let her hold her.

I felt such an instant closeness to O. I wanted to know more about her and D and Stefanya. I had 3 days left in Kharkiv before we had to head back to Kiev and then home to the states. I told O that i would love to see her again and asked if that would be ok. She said yes she would love to so we made plans to meet in front of the dolphinarium the next morning. I packed Stef up and we said goodbye forever to the orphanage.

Asher and Levi and my mom were all anxiously waiting at our apartment for me to bring Stef home. Well Levi really had no idea what was happening, I think Asher had stopped believing that baby sister was coming home at that point, but my mom couldn't wait to meet her. I came in the door and laid her on the couch for everyone to admire. they all fell in love instantly :)