1. Speak with the staff at the hospital where the baby will be born and let the head nurse, lactation consultant, pediatrician, and surrogacy attorney know of your plan to breastfeed the baby. The goal is to be able to start breast feeding within the first 30 minutes after birth. This may not be possible, but the earlier you start, the better. If you cannot breastfeed the baby immediately after birth, request that he be fed by cup or finger feeding, rather than by bottle.
2. Weigh the advantages and disadvantages of selecting a gestational surrogate or traditional surrogate that is open to nursing the child at the very beginning to establish good latching techniques and to allow the baby to get the nutrient rich and immunity boosting colostrum. Some surrogates are willing to pump breast milk for the child after they leave the hospital.
3. Start early to establish your milk supply. Some protocols recommend starting 6 weeks in advance of the baby’s arrival and others recommend a couple of months in advance.
4. Use a high quality, electric, hospital grade breast pump with dual attachments so you can pump both breasts at once. Your health insurance may cover the cost. You may also rent these hospital grade machines. Start gradual with gentle massage, nipple stimulation, and pumping a couple of times a day for 3 to 5 minutes. Work up to pumping for 10 minutes 6-8 times per day. Follow a lactation induction protocol.
5. Don’t be discouraged by how much breast milk you are able to pump before the baby arrives. Pumping is never as good as a baby for building up milk supply. Pumping even without large milk production helps change the breast and increases the likelihood of success regardless how much milk you are producing.
6. Especially at the beginning, focus on skin to skin contact between mother and baby. Undress the baby, except for diaper, to maximize contact with the mom’s skin.
7. If child need supplemental milk, use a lactation aid rather than bottle, cup, or finger feeding.
8. If you do not have enough breast milk at the beginning, supplement with formula mixed with your breast milk or donated breast milk.
9. Have a board certified lactation specialist available to work with you when you are first trying to breastfeed your child born to a surrogate. It is very helpful if this person is knowledgeable about the specific issues the intended mother may face with breast feeding since she has not been pregnant. The lactation consultant at the hospital may not have this knowledge, so ask before the birth. Check with the International Lactation Consultant Association or the La Leche League or for someone near you.
10. Remember that the emphasis is on bonding first and feeding second. It is not a failure if you do not produce all the milk your child needs.