IntroductionBreastfeeding has many benefits for both mother and baby, but not all mothers can have their own babies. Here we used an induced lactation protocol to breastfeed adopted babies.Materials and MethodWe implement and describe an induced lactation protocol for adoptive breastfeeding dyads at Kemang Medical Care (KMC) Women and Children Hospital and Permata Depok Hospital, Greater Jakarta, Indonesia. Participants included 32 of 48 breastfeeding dyads or subjects undergoing induced lactation protocols and fulfilling the inclusion criteria. The induced lactation protocol included the Praborini Method (hospitalization for nipple confusion) to promote latching, pharmacologically induced lactation, and at-breast supplementation.ResultsNineteen babies (59.4%) were aged <1 month and nine (28.1%) were aged 1–3 months at protocol initiation. Almost all (31 babies, 96.8%) were adopted after birth. At first examination, 20 babies (62.5%) could not latch, but all dyads could breastfeed after hospitalization for <1–2 days. Breast milk was induced after one cycle of Yasmin in 24 cases (75%). All mothers took domperidone and no side-effects were reported. Average breastfeeding duration was 8.5 months, with weaning at 2–25 months of age, with working mothers weaning at ≤4 months. At-breast supplementation was used until weaning.ConclusionsAdopted babies can achieve long-term breastfeeding through this multimodal protocol. Further prospective studies are warranted.

Although there is evidence to suggest that frenotomy improves breastfeeding outcomes for tongue-tied (ankyloglossic) infants, less is known about the optimal timing of treatment. In this retrospective cohort study, the timing of frenotomy and its impact on infant and maternal factors were examined in 31 tongue-tied babies with breastfeeding difficulties in a hospital in Jakarta, Indonesia. After frenotomy, all infants improved latching and mothers experienced a subjective improvement in nipple pain and breast engorgement. Frenotomy improved weight gain in infants regardless of type of tongue-tie (p = .001), but greater mean weight gains were achieved in tongue-tied babies who underwent early frenotomy (prior to Day 8) compared to babies who underwent late frenotomy (after Day 8; p = 0.002). Tongue-tie and frenotomy issues need to be addressed during the very first few days of an infant’s life to ensure optimal breastfeeding outcomes.

Breastfeeding is the best way to feed infants, but optimal milk transfer and weight gain depend on good latching. Tongue- and lip-tie can prevent successful latching and prevent adequate nutrition. Tongue- and lip-tied babies can either have slow weight gain (SWG) or failure to thrive (FTT). We examine the effect of a holistic supplementation regimen on tongue-tied babies with SWG and FTT. This was a descriptive, cross-sectional study of 55 tongue- and lip-tied babies with SWG and FTT at KMC Hospital, Jakarta, Indonesia. All babies underwent frenotomy and received supplementation with formula (64%) or pasteurized donor breast milk, using either a modified lactation aid (78%) or the Medela Supplemental Nursing System (22%). All mothers received domperidone and acupuncture to improve milk supply. A majority of babies had type 3 tongue-tie (46%) and class 3 upper lip-tie. Twenty-five subjects (45%) had SWG, and 30 subjects (55%) had FTT. All mothers had low milk supply. At-the-breast supplementation improved the nutritional status of 44/55 subjects (80%,p< .001), whereas 11 subjects received early complementary feeding at 4 months of age. By the end of the study, all subjects were solely breastfed without at-the-breast supplementation. The holistic management of tongue- and lip-tied babies with SWG or FTT consisting of frenotomy, at-the-breast supplementation, domperidone, and acupuncture improved infant nutritional status and the mother’s milk supply. Babies could breastfeed without supplementation after treatment and gained weight.

Background: The World Health Organization has encouraged all facilities providing maternity services and care for newborn infants to adopt the “10 steps” of successful breastfeeding. This includes not giving artificial teats to breastfeeding infants because they may cause nipple confusion. We present a multimodal hospitalization protocol for infants with nipple confusion, a multimodal relactation method that supports breastfeeding couplets.Purpose: To investigate the effectiveness of hospitalization as an intervention for nipple confusion.Method: Data related to nipple confusion in patients hospitalized between January and December 2012 at Kemang Medical Care, Jakarta, Indonesia, was reviewed. Survival analysis was performed to evaluate the relationship between infant age and intervention outcomes.Results: There were 58 cases of nipple confusion during the study period. Most subjects (96.6%) totally rejected breast contact. Forty-six cases (79.3%) used bottles because of tongue-tie. The length of hospitalization varied from 1 (56.9%) to 5 days (3.4%). Fifty-three cases (91.4%) were able to successfully breastfeed using our protocol. Younger babies had greater breastfeeding success.Conclusion: Hospitalization for nipple confusion with multimodal management is effective for treating nipple confusion. Tongue-tie can lead to difficulties in initiating breastfeeding, and early introduction to artificial teats can lead to nipple confusion. Early detection and treatment is desirable.