Tuesday, February 19, 2013

Back Alley Milking


 

Remember when we were inundated with those "Got Milk?" commercials?


 



 
 

Well, my mind has been inundated with “How you gonna get that milk?” lately.

A family does have a few ways to provide breast milk even if they haven't had a pregnancy – either using someone else's breast milk, try to induce lactation, or just pass and use formula (which is what I am leaning towards.)

Option #1 - Purchasing breast milk or procuring donated breast milk

 

It can be difficult to find a milk bank that will sell directly to an individual. It is also cost prohibitive at $6 -$8 per ounce. Although typically this milk is donated to the bank, the bank passes along the cost associated with processing the milk.

 

Purchasing milk online is untested. Since diseases, alcohol, and many drugs can be passed in breast milk, there is considerable risk in choosing this more affordable option ($1 per ounce).

 

Option #2 - Induced lactation

 

The plus is that this option provides all the healthy immune-boosting elements you want because it is after all breast milk, but it is a difficult time commitment with no guarantee it will work. Domperidone, the drug commonly used to increase prolactin (hormone), has been taken off the market by the FDA due to cardiac risks associated with its use. Proponents of the drug are very quick to point out that these unfortunate events only occurred after the drug was given intravenously and if one is inducing lactation, the drug would typically be taken in pill form.  We do know that the drug is passed through milk, but I couldn’t find any study that addressed infant risks.  Also just a little FYI - I have been informed by one of the  lactation consultants that this option is not just for the ladies, and my husband could attempt to induce as well.   (SIDE NOTE: He is not responsive to the idea.)

 

I have met with two lactation consultants, each with a different plan of attack if you will.

 

Consultant 1: Recommends the Goldfarb Neman protocol with Domperidone.  This plan requires you to take birth control pills along with Domperidone for six months, and then begin pumping with a hospital grade pump. Domperidone is a drug which has lost its FDA approval, and cannot be purchased at non-compounding pharmacies in the U.S. From what I understand, the drug itself is illegal but the ingredients to make the drug are not. So a compounding pharmacy can legally make the drug for you. If my doctor refused to write a prescription, the lactation consultant told me not to worry because “she knows a guy”.  The entire conversation sounded more like an encounter from Breaking Bad than an appointment with a lactation consultant.  Although this plan has a 90 percent success rate, I felt I needed a second opinion.

 

Consultant 2 - Plan A: Recommends Goldfarb Newman protocol with Reglan.

Again you take the birth control pills along with a drug called Reglan. Reglan has been notoriously associated with depression.  Although it is FDA approved, there has been a great deal of backlash against this drug. I think I had Consultant #1's disdain for Reglan in the back of my mind because I evidently seemed rather discouraged and Consultant 2 suggested we could try a more “natural approach”.

 

Consultant 2 - Plan B: Modified version of Goldfarb Newman taking a combination birth control pill (in my case Necon 1/35) It is important to take the active pills only and continuously for 5 months in an attempt to mimic pregnancy. After the 5th month, you rent a hospital grade breast pump and then use it rigorously. Or she went on to say: “If money is tight, you could dry feed your partner 8 times a day until milk arrives.  I did turn quite red as the 7th grader inside couldn’t help but be a tad embarrassed.   The success rate with this option is not as high as the others, but the consultant refused to give any kind of estimation. She did say that I have a better chance of success because I have breast fed before.  (In an effort to honor Parker's memory, I pumped my milk after he passed and was fortunate to be able to donate it to his NICU.)  Therefore, my milk ducts are developed, and my body does not need to undergo all the changes necessary for breast feeding. She felt confident that if we chose this more natural option we could be successful.

 

There's a lot to think about, but the reason I am leaning towards formula is because we are considering trying for a third child in July.  Time isn’t doing anything but acting against us, and if we chose to do another IVF cycle I would be unable to induce. But whatever we decide we need to do it quickly because no matter which plan I choose the longer the time frame you have to try to bring in milk, the higher chance of success you have for it to work. Ideally, one would have 6 months +, so since our Yankee Doodle is due July 4th the clock is ticking.

 

 I wanted to share what I have learned in my research undertaking and although I appreciated the lactation consultants meeting with me, there was not a whole lot of insight beyond what one could find on asklenore.com.  If this is something you are considering, I bow to your awesomeness so best of luck

7 comments:

  1. I breastfed both of my older kids (so the breasts have been activated before) and now am trying the pump only method - i figured maybe I just need to wake the ladies up ;-) I can't take birth control so that option was out for me. I tend to get a little granola about things so before I start the drugs I figured I would start to pump and see what happens. I am giving it a month and if nothing happens I am starting the Domperidone. (Reglan was completely out as an option because of the side effects). I have been at it for 3 weeks. I can feel the changes so we shall see.... Even if I have to start with formula it would be nice to be able to supplement with breast milk eventually. I hate cleaning bottles! Good luck - whatever you choose!!

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    1. Thanks Joann- You have my support 100%! Best of luck, and please keep us posted on how it goes. I was thinking after IVF trying to "just pump" and see what happens

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  2. I have been lurking from Cyclesista, after 4 failed IVF attempts I have been following your story intently. I always thought that surrogacy was just something celebritys could afford to do. It is interesting because the hormones from IVF are intense and the fall in estrogen should be almost as dramatic as in a pregnancy has anyone tried pumping after IVF and been succesful?
    Anyway this is interesting please keep us posted!

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    1. Anonymous, I am really sorry - 4 failed IVF rounds is rough. Although surrogacy in India is not inexpensive, it is within reach for the middle class. If this is something you are interested in doing, research, research, research, and then do a little more research. Talk to as many references as you can. You will find that people in this community are very giving with their time and information. As far as clinics, SCI was by far the most transparent with processes, information, and communication. If you email them at info@surrogacycentreindia.com, they will send you more information. Natural inducing like what Joann is doing has been successful with many women who have breastfed before, so I think I should have as good a chance as any with or without IVF. But I'll keep you guys posted. Thanks for the support!

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  3. Hey girl - if you do go with the induced lactation route I can tell you that the hospital grade pump is the ONLY way to go. If only every woman that has tried to breastfeed would have used this kind they probably would have done it with success. It literally forces the ladies to produce. LOL. Trying not to be too blunt, but you know what I mean. :) Praying for your decisions you are facing for your sweet baby to be.

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    1. Thanks for the prayers and support!

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  4. For anyone interested in inducing, the generic domperidone in India (Vomistop is one brand) works very well and is a fraction of the price I've found elsewhere. I came home with literally a couple thousand pills. My son was born in November in Mumbai and I'm nursing him. Best of luck everyone!

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