[diannadawn]

Hello all,
I have 3 biological children (ages 9, 6, and 3) and 2 weeks ago we met an expectant mother (and her family) with severe emotional and developmental delays. She is due any day, and they are giving us temporary custody with the plan to adopt so that mom has time to process (as best she can) and prepare for the adoption.
Anyway, I am nursing my 3 year old, but not much, and I know I will need to supplement with formula while I increase my supply. My kiddos were all out of hospital births, no meds, no vax, no anything. Besides erithromycine (which is necessary in this case, I am trying to figure out if I should look at any othe interventions or vaccines since she will not have the benefits of exclusive breastfeeding.

Thanks for any thoughts!
Dianna

 

[queenjane]

My baby came to me via foster care at three weeks old, because he was a foster child i was supposed to get him the mandatory vaxes...he got the hep B in the hospital, and then when two months old i took him for the two month vaxes, then i never took him back. So, at 15 months old he is almost completely unvaxed. Other than a bout with whooping cough when he was about seven months old, he has not been sick. (My older totally unvaxed son who was 11 at the time got WC first, then the baby, then my adult sister who was presumably vaxed for it...she was the sickest, then the baby, then my son...which made me think that not being vaxed was a benefit. and the WC was not the nightmare that all the doctors warned it would be.)

My older son was breastfed for 3.5 yrs and unvaxed, my baby was formula fed and minimally vaxed. So far, he has been just as healthy as my bio son. So, personally i wouldnt vax an adopted baby thinking they are more at risk or anything.

If you're nursing then it sounds like you'll be able to provide mostly breastmilk eventually....you can find more info about adoptive nursing at asklenore.com ...other people might have better advice about that than me. I know many people use the organic formula at the health food store, but my baby has done well on the generic store brand (most stores carry their own brand, and its pretty much exactly the same as enfamil, i compared ingrediants.) Its half the price of name brand.

Congrats on your new baby!

Katherine

 

[Whistler]

congrats on your new baby!

As far as breastfeeding, there is quite a bit of info out there on adoptive breasfeeding and relactation. I have been reading because I'd like to do the same thing. I did read on an adoptive message board that some birth moms were against it though. I hope this is not the case in your situation but you might tread carefully.

For vaxing, I'd check with the caseworker or whoever did your homestudy. I would think it would be just the same as with your bio kids but I would definitely check.

I hope all works out great for you! Keep us posted.

 

[SundayCrepes]

I am adoptive nursing my baby. My bio-son was 31 months when my adopted baby was born. I'd been nursing him 8 times a day and pumping daily in prep for the adoption. I'd also started taking domperidone a couple months before she was born which helped my supply greatly. (I found the dom from canada worked better than the stuff you order online. My nurse-midwife gave me the prescription. Ordering from canada is easy. See www.asklenore.com for more details.)

You can get donor breastmilk at www.milkshare.com. You can also use a lactaid nursing supplementer so that your baby gets the benefits of the physical act of nursing while you get stimulated. http://www.lact-aid.com/ You can use the lactaid with formula so if you can't get enough donor milk, at least your baby can "nurse" and get even a few drops of fresh milk along with the formula.

Here is an adoptive nursing tribe.http://www.mothering.com/discussions...d.php?t=952031 Towards the end most other moms drop out, but there may be some good info for you. Another good source of info on adoptive nursing is www.asklenore.com.

One of the hardest things for me was another mom who wasn't able to rebuild her supply being really negative about my experience. Even though I was only supplementing an ounce or two a day, she threw around terms like "failure to thrive" and "dehydration." So, be positive about this. However, trying to build a supply when you are so far into the weaning process is challenging. If you are not as successful as you want to be, be prepared for all the emotional baggage that goes along with it. It's innate in women to be devastated if they can't produce all the milk their baby needs. Afterall, in the old days, if a woman couldn't make enough nurse for her baby, the baby died (without a wetnurse.) Those emotions are hard so be forewarned. Here is a link to my emotional dredges:http://mothering.com/discussions/sho...optive+nursing

Right now you need to start pumping every couple hours and probably at night too. Get a hospital grade pump. Our local hospital rents them for $35 a month. It's hard to do with other kids at home, but it's what will help you be as prepared as possible. Also, check into domperidone. If you read the tribe, you'll see my dom journey. I am at 120 mg a day and have pretty much stopped needing donor milk. When I tried to wean to 110 mg a day I was supplementing up to 3 ounces a day. I am also taking motherloves more milk special blend. I haven't tried weaning that yet (my baby is 8.5 months and eats as much solids as a truck driver.)

Also check out http://www.makingmoremilk.com/
You can also buy the book at http://www.amazon.com/Breastfeeding-...0460114&sr=8-1

I think I'm the most outspoken adoptive nursing mom around here with some of the greatest success I've read about in this forum (others at asklenore.com did even better than me,) so feel free to pm me.

As an aside, I am tandem nursing my baby and my 3 year old. They have never shared a cold. One will get sick, but not the other. Thank you breastmilk.

Good luck and congratulations

 

[SundayCrepes]

Quote:

Originally Posted by queenjane If you're nursing then it sounds like you'll be able to provide mostly breastmilk eventually....

I don't want to be a naysayer, but that may not be true. You are in the natural weaning phase and that can be hard to overcome. I prepared for a year by pumping and nursing ALOT and I needed to supplement. I don't want to talk you down because you may do really well with making a lot of milk. I just don't want you to go through the horrible emotions if you don't make as much milk as you fantasize. Remember, there is more to adoptive nursing than the milk. Using the lactaid is a major benefit to your baby. All the bonding and touch and dental shaping is huge. The brain develops better with that skin to skin contact. (Ok, I'm preaching to the choir here, but I want to encourage you so you will use the lactaid.)

Even if you can only make an ounce or two of fresh breastmilk a day, that is providing a HUGE benefit to your baby. It is even better than any donated milk you get (and donated milk is better than formula.) The fresh milk you make will give your baby antibodies to whatever diseases it is exposed to. I guess that was the point of my comment in my pp about my tandem nursed kids never sharing colds. Even if you only make a small amount each day, your baby will benefit from the antibodies you provide.

 

[Polliwog]

I don't have a clue about nursing (adoptive or otherwise,) so I'm no help there. But if you do end up going the formula route (and aren't WIC eligible,) I agree with queenjane about the store brand formula. It's federally regulated and must meet the same standards as the big names. But is much less money. My first foster daughter reacted to the name brands and used the ready to feed liquid formula from Walmart.

 

[diannadawn]

Thanks for the info - I am okay with the fact that there is a good chance I will be unable to breastfeed exclusively. Thanks mybabysmama, I totally agree that mothering and parenting are so much bigger, and I don't think I will feel badly in the least (unless of course there are allergy/sensitivity issues to formula). I have had a couple of people offer milk, too, so who knows how much formula we will have actually use?

At this point, I am trying to look at considerations that should be made if the baby is not exclusively breastfed.

We actually all had whooping cough in January (even my DTAP-cut her foot really badly last year- vaccinated daughter), and we found we were not nearly as sick as people said we should have been. We just coughed for a while.

Since this is happening so fast (we were not even looking to adopt - this unique situation fell into our lap!) just open to the possibility, I am feeling overwhelmed at the thought that we will be bringing a new little one home in the next few days. I don't have anything except cloth diapers from my last baby! I am going to order a Lact-aid (that is clearly the fave), but I keep thinking about the practical differences - having to get up at night to prepare the SNS instead of just rolling over and nursing, going out during the day (that sounds really hard with an SNS) etc. I am trying to relax and just not worry about it. As a childbirth educator and doula, I have seen many of my moms' babies have bottles/pacifiers from the get-go with still very successful nursing relationships. For me, I have always just avoided both completely.

The other practical considerations are things like how long does baby need to stay home before going out into the "real" world? In birth/parenting situations, mom and baby recover from birth together. In this case, what is the best lifestyle to plan for the weeks after the birth? We are fortunate in that we homeschool and my husband is a college professor, so we have a lot more flexibility than most.

Thanks for listening to my ramblings! I am new to my community, and I don't really have anyone to talk about these kind of specific concerns with. Another ultra cool thing about our situation is that I am the birth doula (that is how I met these wonderful people), so I will get to be at our daughter's birth! It will be hard to leave her there for a couple of days, but hopefully everything will go smoothly.

A separate, but related concern is that we actually have an au pair moving in right now who also has a newborn (and has offered to help supplement which is a wonderful blessing!). However, she is also planning to completely vax her baby. I have carefully suggested the possibility of delaying and that she do more reading on the subject, but how worried should I be about this? We are really excited that she is moving in, and I think it will be great fun for the babies (and our older children), but I have always kept my kiddos at arm's length from freshly vaxed kids, and that is going to be hard in this situation. Any thoughts?

Thanks again,
Di

 

[Polliwog]

A lot of people here have bottle nursed, so you might look in the sticky if you aren't familiar with that.

With adoptive placements, just go with the flow. If the baby seems healthy, there's no reason not to take her out and about. I'd avoid crowded, germy, places but there's no reason not to go for long walks, the park, etc. Although, I know people who've taken brand new babies to the mall.

My kids are fully vaxed, but I know lots of people who have unvaxed kids but are foster parents. Foster kids have to be fully vaxed so their bio children are around newly vaccinated children all the time. I haven't heard it to be an issue, but of course, they are the experts.

 

[RedOakMomma]

...Just wanted to say that bottle nursing has been incredible.

I breastfed our other children, but when we adopted I couldn't get my supply up (I was in that weaning phase someone else mentioned...my son was 2 at the time).

Bottle nursing, especially skin to skin, is incredibly sweet. The eye contact, the touch, it's all wonderful.

Definitely look into it.

Best of luck to you!

 

[SundayCrepes]

Quote:

Originally Posted by diannadawn I am going to order a Lact-aid (that is clearly the fave), but I keep thinking about the practical differences - having to get up at night to prepare the SNS instead of just rolling over and nursing, going out during the day (that sounds really hard with an SNS) etc. I am trying to relax and just not worry about it.

IF you buy enough lactaids to get you through the day rather than reusing one or two, your life will go easily. You can keep the bags in the fridge and just pull them out to use. I don't warm the milk but then I rarely empty a bag so I need to keep it cool for reuse. Another advantage of cool milk is sometimes I can feel it moving in the tube or in her mouth and I know all is going well. (though you won't always feel it. You'll tell more if she's swallowing.)

Nighttime can be easy as well. Keep a small cooler with however many bags you will use at your bedside. Even a small cloth cooler that can be in bed with you would work well. You can use the lactaid in a side lying position. My baby's weren't ready for sidelying until a few weeks. When you do try to do the lactaid sidelying, practice during the day, not at night. You'll lose less milk that way.

For going out and about, lactaid.com sells a little cooler with a bag holder-tree. I didn't use that. I put each bag of milk in a ziplock bag (they can leak) then put them in a small lunch bag shaped softsided cooler I got at Target with a freezer pack. Then I put that it this diaperbag http://www.landsend.com/pp/DoItAllDi...&origin=search The bag is great because the top opens wide. I was able to carry the cooler, all the stuff I needed for two kids, and my wallet/personal stuff in it.

You may want to either buy the lace bag lactaid makes or, if you or someone sews, make a small pouch you can hang around your neck. It's much easier and faster than using the hook on strap lactaid sends.

I had enough milk for the first few days that I didn't need to supplement then. If you can do that until the baby sort of figures out what's going on, great. You may also want to tape the tube to your breast so you've got that hand free (there should be instructions with the lactaid.) However, I found the tape to tear up my skin and the baby didn't like having the tube in her mouth while latching on (she eventually got over that.) I found it easier during the early days to get her latched on then slip the tube in her mouth. You may need to experiment. Also, when they get older, the suck gets stronger, and they pull the tube way into their mouth. At that point I just held onto the tube tightly.

Regarding getting milk from friends. I chose to make sure all my donors had the bloodwork as recommended by milkshare.com. Some of the tests would be routinely done during prenatal care, but some would not. Some of the tests are for cancer causes viruses. My donor's insurance covered the tests. Their healthcare providers listed the reason for the tests as "Sexual exposure" or something like that since any sexually active person would fall into that category.

I know a lot of people here have had positive experiences with bottle nursing. You are in the rare position of getting a newborn while you have milk (even if it's only a little.) I'd like to encourage you to stay committed to the lactaid. It is the only way your baby will get any fresh milk and that is so important when it's possible.

By the way, don't do the SNS, I've done both, you'll like the lactaid better.

ALso check out the adoptive nursing forum at asklenore.com You'll get a lot of practical advice there.

 

[queencarr]

Things are so crazy at this last minute waiting stage, aren't they?

Breathe, relax, and realize that although adoption is a different process of joining your family, you can do this. I found the process not so different to bringing a biochild home as one might imagine. The not breastfeeding was way different, of course (especially at night!), but as many PP have said bottlenursing offers an alternative that provides the emotional and bonding experiences similar to bf. As far as going out and about, trust your gut. For us, my ff babies didn't really get sick either--everyone was amazed. I think that providing a healthy environment with fresh air and sunshine, not letting them chew on things like shopping carts and restricting others peoples' touching were a huge help. The general "adoption community and professional" recommendation is to avoid holding by other people for a (varied, depending on who you are talking to) period of time to promote parental bonding--unlike with bio children who had the advantage of womb time, they don't know who you are and have to learn. So this will reduce their exposure to germies anyway.

As far as vax/non vax, here is the situation we are facing. I do delayed/selective, basically limiting the number given at a time and avoiding those that are for what I consider reasonably treatable or mild illnesses. However, my youngest is almost completely unvaxed--he has a few that he received in Korea, but we discovered a severe egg allergy that has his allergist and our ped preferring to avoid ALL vaxes until a potential future date IF he no longer reacts to the egg. My almost 4yo will be due for his MMR booster shortly and still hasn't had CP (which I don't get anyway). Because of the unvax status of my youngest, the ped recommendation is to not give them to the 3yo because of viral shedding. So live vaxes would present some risk to your unvax baby, but I am betting that could be minimized with decent hygeine protocols. However, depending on when you finalize and your agencies policies, you may be required to get vaxes up to a certain point.

One other thing--I am generally against hep B for babies, but if Mom's status is uknown or questionable (as in, a possibility of having it but being in the window where she would test neg) the recommendation is to do it within 48 hous of birth as it greatly reduces mother-baby transmission.

 

[heatherdeg]

Although we WERE licensed to adopt, we had given up on ever getting "the call" when we were called about stbad. We were called on a Friday night and she was home on Wednesday.

She was 2 weeks old and seriously, even if we GOT the call--we NEVER imagined it would be for a newborn. So yeah--I feel your... roller coaster I guess is the best way to say it!

Quote:

Originally Posted by BethNC My kids are fully vaxed, but I know lots of people who have unvaxed kids but are foster parents. Foster kids have to be fully vaxed so their bio children are around newly vaccinated children all the time. I haven't heard it to be an issue, but of course, they are the experts.

That was us. Ds is unvaxed (actually, he WAS vaxed through 6mo but was reacting--turns out he's now med exempt due to immune deficiency). We were worried because of the immune deficiency, but it hasn't been an issue. And he was in day care as an infant. Not daily, but 1-3x/week and then as a toddler he was in daily for 2 years (ages 2-4). Even with the immune deficiency, we never had an issue.

Our stbad is a ward of the state and should be fully vaxed, but the ped fills out her paperwork that he's delaying due to "neurological findings" (because stbad actually DOES have some neuro issues and absolutely NO parental medical history). We'll see what the judge says. At the moment, there is a case going on in my state to honor the parental religious exemption of selected adoptive parents of a foster child. We'll see how THAT plays out!

You need to find out what your rights actually are. If you have custody and not guardianship, you may not have the right to choose. Likewise, you may not even be able to cover the baby on your health insurance (this is the stickler with mine--which is by all accounts an incredible health plan).

Because I got mine at 2 weeks old, I honestly didn't think about the fact that mother and child recover together. As such, we DID keep home for a week or so and kept HER home more as she adjusted; but we didn't really keep in and snuggle/bond. I wore her as much as she would tolerate. Then again, she was drug-exposed and things you would do or want to do sometimes take a backseat to that which the baby will tolerate. I also have a really busy 5yo. So she came into the mix and we took it from there with not a TON of "down time". She's only 6mo right now, but she's a happy and healthy child. I'm not sure if that did any lasting "damage".

 

[diannadawn]

Thanks for all of the comments and suggestions, they have been extremely helpful. I have a couple more questions in case anyone has any thoughts:

Queencarr has a good point about the HepB, this mom has been a prostitute (during the preg even), so I am thinking that is fairly high risk for HepB. She has tested negative for everything so far, but the whole window thing is definitely of concern. Other thoughts on this issue specifically?

Expectant mom has many mental and emotional disorders (Bi-polar and PTSD from sexual trauma, as well as some cognitive delays and austistic tendencies), so we are trying to work out how much time is best for her to spend with the baby. The family is open to us having a say in this,and I don't really know what to think. There are so many possibilities - everything from bfing and rooming in until discharge to the opposite extreme of take baby from the room after birth and focus on mom's recovery. Everyone in this situation wants to make the most loving decision for mom, but I don't really know how to figure that out. Mom has no ability for empathy and there is the possibility (however remote) that she would actually hurt the baby to keep anyone else from taking her.
We will be talking to the social worker at the hospital tomorrow to see what her advice is, but I am at a loss as far as what I "want."

The last, but not least, what are some thoughts about visitation during the first 3-4 months. We will have temporary custody (6 months, I think). Some say limited visitation helps mom process grief and separation better. Others say a period of time is good (especially in a situation where mom is really physically and mentally unable to care for a child) with no visitation, maybe 3 months or so. Again, this situation is unique and maybe no one here will have any advice, but the family is allowing us to figure out what we think is best, and I am at a loss about what to say.
By the way, this is a completely private affair, the state is not involved at all - it is between our attorneys and the families, so we don't have to worry so much about what the requirements are. We can totally decide against vaccinating, the family is supportive of me bfing in the hospital, and they think our parenting style (ap, co-sleeping, extended bfing, and natural diet) are really great. So, except for expectant mom, everyone feels that this is the best situation for baby, and when mom is feeling clearest, she knows this too. It is just the rest of the time that is causing us some stress about her feelings when the actual adoption comes up.

Thanks again to all of you, your advice has been wonderful (especially the specifics on night nursing and going out as well as vax opinions).
-Di

 

[Smithie]

A birthmom with a psychological disorder that has left her without the capacity for empathy? No visitation EVER, if you can manage it. This is not a situation of a teenager who can't parent now but has the potential to grow up to have a mutually enjoyed relationship with your child. This baby is incredibly lucky that s/he won't have to suffer what the child typically suffers when left to be raised by/around a person with the problems you are describing. You really don't want to open to door to an occasional dose of that particular hell.

If the real issue is that you want the baby's extended family of origin (grandparents, etc.) to have some contact with the baby, then that's a very different thing. I can see how that would be a way to minimize the losses inherent in adoption.

 

[diannadawn]

Thanks for your comments, Smithie. Yes, we are open to extended family contact. The family is quite loving and is also very respectful of us as the parents of this baby. While I believe your advice is valid, I think the birthmom's family would really like for her to feel like she is making this choice. If she feels trapped and decides that we are the enemy, the state will have to step in and terminate her rights. If that happens, we will have no say in what happens to baby (this according to our lawyer).
Part of the complication (and why this happened so late and why we are the tentative adoptive parents is because mom was so adamantly against any mention of the word adoption. With us, her family started with temporary custody and now is moving toward this as permanent. My gut says that a waiting period is a good thing, but it can't be too far or mom will feel like it is forever and will flip. She has run away before and of course fear is that she will run with baby if they are together.
This family has really struggled with mom and they want more than anything for this baby to be adopted by us. We have been taking this whole thing very slowly with no strong intention, just an openness to be available and loving parents if this is what we are supposed to do.
di

 

[Polliwog]

Quote:

Mom has no ability for empathy

Can you describe this to us (as best as you can.) How does that manifest itself? I know that would help me make a decision.

 

[tiffani]

no advice, really just

s -- sounds like it will be a pretty emotional situation any way you look at it...

oh, I kind of forgot the title of your thread... and I managed to relactate over 2 years after weaning, though our adoption plans fell through and I gave up, but was off to a good start!! mybabysmama suggested all the same things I would suggest... good luck!!

 

[SundayCrepes]

No idea what to suggest regarding contact with birthmom. Is there any legal reason she can't make these decisions herself?

Regarding the Hep B vaccine. My bio son is not vaccinated. Especially not with Hep B. I tell everyone that the only reason this vaccine is part of the childhood routine is to vaccinate the future prostitutes and drug addicts.

My adopted daughter's birthmom did not receive prenatal care so my daughter was vaccinated for Hep B within an hour of birth. When we met the baby at 6 hours of age, the mom gave us the right to make all medical decisions. I signed for her to receive the hepatitis immunoglobulin at 24 hours of age. Vaccines do serve a purpose in the right circumstances. The baby of a prostitute is, in my mind, the baby that needs the vaccine and immunoglobulin. There is a real risk here that the baby could contract a potentially lethal disease that could be prevented with the vaccine. Most babies are unlikely to have serious problems with a single dose of Hep B. That's not a reason to give it to every baby and in the big picture of multiple vaccines starting at such a young age, I think it is wrong to vaccinate every newborn because they might grow up to be a drug addict. However, THIS baby is at real risk. Even if the mom is testing negative now, you don't know what she will do between now and the birth. So I suggest you get the vaccine and immunoglobulin.

 

[queencarr]

Quote:

Originally Posted by mybabysmama No idea what to suggest regarding contact with birthmom. Is there any legal reason she can't make these decisions herself? Regarding the Hep B vaccine. My bio son is not vaccinated. Especially not with Hep B. I tell everyone that the only reason this vaccine is part of the childhood routine is to vaccinate the future prostitutes and drug addicts. My adopted daughter's birthmom did not receive prenatal care so my daughter was vaccinated for Hep B within an hour of birth. When we met the baby at 6 hours of age, the mom gave us the right to make all medical decisions. I signed for her to receive the hepatitis immunoglobulin at 24 hours of age. Vaccines do serve a purpose in the right circumstances. The baby of a prostitute is, in my mind, the baby that needs the vaccine and immunoglobulin. There is a real risk here that the baby could contract a potentially lethal disease that could be prevented with the vaccine. Most babies are unlikely to have serious problems with a single dose of Hep B. That's not a reason to give it to every baby and in the big picture of multiple vaccines starting at such a young age, I think it is wrong to vaccinate every newborn because they might grow up to be a drug addict. However, THIS baby is at real risk. Even if the mom is testing negative now, you don't know what she will do between now and the birth. So I suggest you get the vaccine and immunoglobulin.

You beat me to it

Is the mother not able to legally make decisions? Otherwise, the fact that her family seems to be driving the direction of this birth and relinquishment, would concern me and make me wary of getting involved in this situation. I am guessing that there is probably a lot more behind this that you are not sharing. But if she has full legal rights, and there is an appearance of coercion that can negate a termination of rights, opening a legal nightmare for everyone. Just make sure you are getting good legal advice from a trusted source.

Regarding the Hep B, with the new info you posted, I absolutely would have the baby vax for that. And would do the immunoglobulin (forgot about that, thanks mybabysmama

) My bio child received 2 blood transfusions (with the possibility of more at the time) as an infant, and although the risk was low I chose to have him vax for it at that point. I still feel very confident that was the right decision; there is a time and place for them and your situation would meet that criteria for me.

 

[tiffani]

Our kids aren't vaxed for anything either, and I agree that in your case I would probably vax for Hep B.

I just wanted to also gently mention that it isn't only prostitutes and drug addicts that acquire Hep B (and that prostitution and drug addiction do often go hand in hand, but not always) and if it didn't have this stigma, it would be better for everyone living with the disease. It is definitely a disease *mostly* confined to the higher-risk behavior population, but those people sleep with people outside of that circle, and then those people sleep with other people, etc...

I'm not worried enough about it to vax my kids for it, but I just wanted to show a little empathy for people (some on this very board!) living with Hep B.