When Natasha Baird learned that she was to become a mother through adoption, she immediately bought a breast pump.
The 32-year-old municipal engineer started a rigorous pumping routine - every three hours, around the clock - even darting home from work on a sewage project to keep up the routine.
After four weeks, with the help of a drug to promote lactation and some supplemental formula bottles, Ms. Baird was able to breastfeed her newly adopted daughter.
Ms. Baird, who lives in Montreal, is one of an increasing number of mothers who are nursing babies they did not carry. With breastfeeding so heavily championed by medical authorities, adoptive parents - who tend to be older and well-educated - don't want their children to miss out.
As more couples face infertility and look to build families through adoption or gestational surrogacy, interest in induced lactation is growing.
"People are hearing about a friend of a friend who breastfed, and they are calling with questions," says Leigh Baetz-Craft, a lactation consultant at Mount Sinai Hospital in Toronto.
The practice has been given a big boost by Jack Newman, a Toronto family physician and internationally known breastfeeding advocate. Dr. Newman worked with a determined Montreal mother to develop an improved drug regimen for induced lactation.
For years, doctors had been prescribing birth-control pills to adoptive mothers in an effort to mimic the surges and drops in estrogen and progesterone that prepare a mother's body for lactation. But few adoptive mothers breastfed successfully, experts say.
Lenore Goldfarb approached Dr. Newman before the birth of her first child by gestational surrogate in 2000, determined to breastfeed. Dr. Newman worked with the Montreal mother to develop a blend of birth-control pills and domperidone, an anti-nausea drug that raises levels of the lactation hormone prolactin.
By pumping rigorously in the months before her son's birth, Ms. Goldfarb was able to breastfeed Adam, with some formula supplementation, for eight months. By her second son's birth, also via surrogate, the regimen had been refined and she dispensed with bottles.
Ms. Goldfarb, who is now doing a PhD in human lactation and reproductive technology, has documented her experience on a website, Asklenore.info, that receives 29,000 hits a day. The Newman-Goldfarb Protocols for Induced Lactation are now published in two major textbooks on human lactation.
Getting the milk to flow remains a demanding process for mothers who haven't given birth. In addition to the hormones and the domperidone, mothers-to-be must pump around the clock - all the while knowing that the adoption could fall through. Some even begin pumping before they have been selected by a birth mother, and some continue even if the adoption falls through.
Adoptive mothers who want to breastfeed say they often face resistance from many of the players involved in the adoption process, including doctors, social workers, foster families and even the birth mother.
Ms. Baird, whose daughter is native, had to wait a week without her husband or her mother in Thunder Bay, Ont., while the band office decided whether the adoption should proceed. She had to convince her daughter's skeptical foster mother that she was producing milk. After Ms. Baird nursed the baby in front of the foster mother, the woman invited her to move in with her to facilitate breastfeeding while awaiting approval of the adoption.
Ms. Baird, whose daughter is now approaching her second birthday, says all of the hard work paid off. "I couldn't get pregnant but I could breastfeed," she says. "My body was finally doing what it was supposed to do."