Surrogacy and Breastfeeding: Inducing Lactation

The benefits of breastfeeding newborns are widely recognized. Breastfeeding not only provides a newborn baby with proper nutrition, but also helps maintain health and ward off illness during infancy as well as in the future. But there is also a bonding experience that takes place between a breastfeeding mother and her baby during these early stages following birth. For intended mothers whose baby is born by surrogacy as well as adoptive mothers, inducing lactation offers an opportunity to experience the physical and emotional bond of breastfeeding with her newborn.


The Benefits of Breastfeeding

Breastfeeding fosters a unique closeness that is comforting to both mother and baby. In terms of health benefits, breastfeeding has been linked with protection against the following:


  • leukemia
  • obesity
  • diarrhea
  • ear infections
  • respiratory problems such as asthma
  • high blood pressure in the future

Breast milk contains a protein known as CD14 that helps the development of immune system cells known as B cells in newborns. In addition, colostrum - breast milk that is produced in late pregnancy and during the first few days following birth - has a high concentration of antibodies and helps early digestion.


How Inducing Lactation Works

Lactation involves two hormones. Prolactin is considered the milk-making hormone while oxytocin is the hormone responsible for releasing breast milk. Both of these hormones are controlled by the pituitary gland and are therefore not ovarian hormones. This means that even a woman who has undergone a hysterectomy can induce lactation.

The hormones involved in inducing lactation both respond to nipple stimulation, and thus respond to manual stimulation such as:


  • breast massage
  • nipple manipulation
  • sucking by baby
  • sucking by a hospital grade electric breast pump

While manual stimulation alone should be sufficient in inducing lactation, hormonal therapy to induce lactation is also available. This typically involves administering high levels of estrogen hormones in order to simulate pregnancy. This is followed by an abrupt withdrawal of estrogen to mimic the hormonal environment in a woman’s body after birth. Medication to enhance prolactin levels will then be administered, and sucking – whether by baby or a pump – will begin at this point.

Inducing lactation can take anywhere from 5 days to 4 months, so expecting mothers often begin to induce lactation during the third trimester of a surrogate pregnancy. Inducing lactation should only be attempted with the guidance of a pediatrician, lactation consultant and/or doctor.


Inducing Lactation Symptoms

Initially, it is common for the mother to produce only a few drops of breast milk. However, as the process of inducing lactation continues, she may begin to experience the following symptoms:


  • increased thirst
  • changes in nipple color
  • fuller and more tender breasts
  • changes in menstruation
  • changes in libido

Inducing lactation may also affect a woman’s appetite or breast tissue.


Inducing Lactation and Newborn Nutrition

There have been several studies conducted for the purpose of assessing the nutritional value of induced breast milk as compared to the breast milk of women who had just given birth. One study found that infants of mothers who had induced lactation were sufficiently nourished. However, most women who induce lactation find that it is not possible to produce enough breast milk to match the appetite as well as nutrition requirements of their baby.

Other studies have found that the composition of induced breast milk differs from postpartum breast milk; colostrum breast milk - which contains high levels of albumin and IgA during the early stages following birth - does not seem to be produced when inducing lactation.

Breastfeeding a baby delivered by a surrogate birth should thus be viewed as a bonding experience. Mothers should not worry about the amount of milk produced, but rather focus on the benefits of the closeness which breastfeeding brings.

There are ways for mothers to provide nutrition for their newborns, such as:


  • donor milk: some women use a feeding tube device worn on the mother’s chest to breastfeed using donor milk
  • using breast milk acquired through a milk bank
  • using the surrogate mother’s breast milk
  • using baby formula


Breastfeeding and Surrogacy

It is important for expecting parents to discuss the issue of breastfeeding with the surrogate mother prior to the birth of the baby. Many surrogate mothers breastfeed the newborns during the first few hours following birth. However, if parents are concerned about establishing an initial bond with the baby through breastfeeding, they should make arrangements with the surrogate mother.

Some women wish to breastfeed the baby through induced lactation and supplemental devices; others ask the surrogate mom to wear an article of their clothing in order for the baby to become familiar with their scent. Some intended mothers allow the surrogate mother to breastfeed the baby before they themselves begin nursing the child. This often helps minimize any difficulties with latching, as the baby becomes accustomed to breastfeeding early on.


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