Breastfeeding and Surrogacy: Options for Intended Parents

Breastfeeding has many benefits for babies, including providing a baby with ideal nutrition, helping to protect against illnesses and diseases, and sharing antibodies from the mother with the baby.  Breastfeeding also creates a bonding experience for both mother and baby, which may help infants trust caregivers and help the mother learn to read the infant’s behavior.  If a gestational surrogate is carrying your baby, there are still options for breastfeeding or using breast milk from a donor or the surrogate.

Inducing Lactation

Intended parents who want to breastfeed without having been pregnant will need to work closely with a doctor months before the baby is born.  The process of inducing lactation involves taking hormones, usually birth control pills, to simulate pregnancy.  Before the baby arrives, your doctor will tell you to stop taking the hormones and will prescribe medications and supplements that promote milk production.  At this point, the intended parent will start breast pumping, gradually increasing the duration and the number of times per day until she starts producing milk.  The milk supply should gradually increase. Most people who are able to induce lactation will not produce enough milk to fully sustain a baby.  Many intended mothers use a supplemental nursing system (SNS).  While the baby is latched at the breast, a thin tube is placed alongside the nipple and a controlled flow of supplemental milk is released from a container as the baby feeds.  Supplemental milk may be your own that you have pumped and stored, the surrogate’s breastmilk, donated breastmilk, or formula, to ensure the baby gets enough nutrition for healthy growth.  You can also simply bottle feed in addition to breast feeding.

Using the Surrogate’s Breastmilk

Surrogates are not required to pump for their intended family, so if this is something you want to ask for, it should be discussed and agreed to as part of the surrogacy contract.  You will have to compensate the surrogate for her time, plus pumping supplies and shipping costs.  Pumping is time-consuming and tiring, so many surrogates are not willing to do it.  Some will pump for six weeks to help get the baby off to a good start.

Donor Breastmilk

The FDA recommends against feeding your baby breastmilk acquired directly from individuals or from the internet.  Donor milk obtained this way is unlikely to have been screened for infectious disease or contamination risk.  The FDA advises you should only use milk from a source that has screened its milk donors and taken precautions to ensure the safety of the milk.  There are human milk banks that screen milk donors and safely collect, process, and store the breastmilk.  Your state health department may have information on human milk banks in your area.  Another source of information is is the Human Milk Banking Association of North America (HMBANA), a voluntary professional association for human milk banks ( Link Disclaimer).

Baby Formula

There are lots of parents who are not able to breastfeed, even if they gave birth to the baby themselves.  If the intended parents can’t breastfeed, formula feeding is a perfectly acceptable way to nourish an infant and is designed to imitate breast milk as closely as possible.  Your pediatrician can advise you on the best formula for your baby, whether as a supplement to breastfeeding or as the sole source of nutrition in your baby’s first year.  

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