Understanding the Challenges of Induction of Lactation and Relactation for Non-Gestating Spanish Mothers

Abstract

Background: Induced lactation and relactation are the processes that enable breastfeeding in non-gestating mothers. Research aim: The aim of this study was to describe and interpret the challenges faced by mothers who undergo induced breastfeeding and relactation for adopted infants, infants born via surrogacy, and infants born to same-sex female partners. Methods: A qualitative study was performed using in-depth interviews conducted with Spanish women ( N = 9) who had decided to undergo induced lactation or relactation. The data were collected between October 2014 and May 2017. The length of the study was due to the difficulty in locating and recruiting the sample. Interviews were transcribed and coded with the ATLAS.ti v.7.5.7 software. We performed a deductive thematic analysis, creating categories based on the interview questions, which we developed on the basis of previous literature about induced lactation and relactation. Results: Participants described the following challenges: the physical hardships of the process; breastfeeding problems; difficulty with accessing information about induced lactation or relactation; and lack of support from health professionals. Breastfeeding periods lasted from 1.5 months to 4 years. Participants reported that breastfeeding increased the closeness between the mother and child and that this feeling of closeness tended to decrease after breastfeeding cessation. Conclusion: We offer data and analysis that can improve our understanding of the lived experiences of women undergoing the process of relactation or induced lactation and may help guide intervention strategies to support women in this situation.

Methods and Success Factors of Induced Lactation: A Scoping Review

“…One (33.3%) of the three participants combined breast stimulation with alfalfa, cinnamon tea, and an oxytocin nasal spray (Da Rocha et al, 2014). All participants included in this study combined stimulation with herbal galactagogues (Cazorla-Ortiz et al, 2020). In the case report about a mother whose baby was born through surrogacy with complete androgen insensitivity syndrome (CAIS), "the participant also took fenugreek and milk thistle as herbal supplements" (LeCain et al, 2020).…”

“…Successful induced lactation could be defined as achieving milk secretion, even if the quantity produced is insufficient for the exclusive breastfeeding of the child (Banapurmath et al, 1993;Shiva et al, 2010;LeCain et al, 2020). In this respect, success was more related to the mother's satisfaction and her sense of self-realization than to the amount of milk produced or the duration of breastfeeding (Cazorla-Ortiz et al, 2020;Cheales-Siebenaler, 1999;Zingler et al, 2017).…”

“…Health professionals played a key role in providing information, advising, and counseling women who had not been pregnant regarding the different methods to breastfeed their children. It was important to consider the woman's priorities and the particular family configuration Szucs et al, 2010;Wilson et al, 2015;Cazorla-Ortiz et al, 2020). This kind of support could be offered by an International Board Certified Lactation Consultants (Biervliet et al, 2001;Cazorla-Ortiz et al, 2020;Farhadi & Philip, 2017;Flores-Antón et al, 2017).…”

“…It was important to consider the woman's priorities and the particular family configuration Szucs et al, 2010;Wilson et al, 2015;Cazorla-Ortiz et al, 2020). This kind of support could be offered by an International Board Certified Lactation Consultants (Biervliet et al, 2001;Cazorla-Ortiz et al, 2020;Farhadi & Philip, 2017;Flores-Antón et al, 2017). In the report by Kirkman and Kirkman (2001) concerning a case of surrogate motherhood between two sisters, the support the sisters offered one another was what enabled them to continue with the induction process, despite the difficulties they encountered along the way.…”

“…Frequent Stimulation. Each breast had to be stimulated for 10-20 min, 4-10 times a day (including at night), and this could be done manually or by using a breast pump, or both (Banapurmath et al, 1993;Cazorla-Ortiz et al, 2020;Flores-Antón et al, 2017;LeCain et al, 2020;McGuire, 2018;Reisman & Goldstein, 2018;Szucs et al, 2010;Wilson et al, 2015). In the study by Lakhkar (2000), four (33.3%) of the 12 participants who began the process of induced lactation did not produce milk.…”