Surrogacy and Breastfeeding: What Are the Options?

Breastfeeding, for some women, can seem like a natural and logical choice, while other feel ambivalent or even conflicted about it, while some at the outset know that nursing is not for them. Some women decide to wait until their baby is born to make a decision about how they want to feed. How to feed your baby is always a very personal decision.

When many, if not most, people hear about a surrogacy arrangement, they assume that the option of breastfeeding is off the table, which is understandable. If the intended mother isn’t giving birth herself, how can she breastfeed? And certainly a gestational carrier wouldn’t breastfeed the baby, would she?

Well, she might, just as an intended mother might choose to breastfeed the baby her gestational carrier has just delivered for her. Neither of the nursing arrangements is very common by any means, nor are they unheard of, either. And of course a third option is that both women nurse the baby, but this is rare.

An intended mother who hasn’t been pregnant can in fact breastfeed her baby, though it does take a fair amount of preparation and more than likely, herbal and/or pharmaceutical support, and most likely some supplementation with formula, at least immediately following the baby’s birth. An intended mother may be able to bring in a full supply of breast milk to feed her baby, though patience and diligence is required. In a future blog post I’ll offer more information on the specifics of induced lactation for intended mothers and how they can prepare to breastfeed their baby.

A gestational carrier, however, is able to nurse the baby she delivers from the moment of the birth, because her body has spent the last months and weeks of the pregnancy preparing for it. In fact, the milk that her body is getting ready to produce is formulated specifically for the baby she’s pregnant with, as is the colostrum that she produces for the first few days, before her milk supply comes in. The colostrum is particularly beneficial for babies because it’s full of antibodies, concentrated nutrients, laxative properties that help the baby pass its first stool, and it offers the baby immunity from viruses and bacteria.

Intended parents and gestational carriers should talk about their thoughts and feelings on nursing early in the pregnancy, so everyone can prepare accordingly.  If an intended mother wants to breastfeed her baby (which is a wonderful way to bond, since she didn’t get to carry the baby herself), she should prepare to feed the baby exclusively at her breast. In this case, it’s probably best that the baby not nurse from the gestational carrier, so the mother-baby pair can begin to establish their own breastfeeding rhythm and routine right away. In this situation, the gestational carrier can pump her milk and provide it to the intended parents to supplement the baby with, whether through at-the-breast supplementation or by bottle.

Pumping milk is by far the most common way gestational carriers provide breastmilk to their surrogate babies. Some see exclusively pumping (rather than putting the baby to breast) as a way for the gestational carrier to avoid feeling too attached to the baby (though surrogates themselves rarely report this being the case – they are chiefly motivated by helping the intended parents). The concern,  though perhaps mostly unfounded, is understandable from the intended parents’ perspective, and any responsible and sensitive surrogate mother wants to respect her intended parents’ wishes.

When a gestational carrier pumps milk for her surrogate baby, the intended parents should provide her with a hospital-grade breast pump, milk storage supplies, and reimbursement for any costs such as shipping.  She will pump her milk and store it in her freezer and then send (or deliver, if she lives close enough) the milk in batches. It’s important to note that if the surrogate is exclusively pumping, the amount of colostrum the baby will receive is minimal, because it’s produced in such limited amounts over the first few days. This should not discourage intended parents from accepting pumped milk from their gestational carrier though, it’s just something to keep in mind.

The last option (which I have done twice) is for the gestational carrier to nurse the baby upon birth and through the first day or few days, as long as they’re together in the hospital or birthing center (following this she may continue to pump for the baby). This arrangement is certainly not for everyone, and it takes a certain amount of trust and confidence on the part of the intended parents, because I imagine at a time they are most overjoyed with the arrival of their baby via surrogacy, it can stretch their feelings of hospitality (even if they’re in favor of it).

The benefit of the gestational carrier nursing for a few days is three-fold – first, the baby is able to get the colostrum that’s ready and waiting for him in the breasts, which is an extremely healthy way to begin life. Second, the suckling action of the baby at the breast helps the surrogate’s uterus clamp down and contract, which minimizes her post-birth bleeding. And third, the initial stimulation from the early nursing helps the surrogate’s milk supply, allowing her to pump more milk than she typically would be able do had she not nursed.

The benefits of breast milk, whether provided at the breast or by bottle through pumping, are significant to the baby and can also be beneficial to the gestational carrier. Many gestational carriers who provide milk after the birth say that the experience is very rewarding for them and they enjoy the continued connection with the baby and intended parents. If it’s the right fit for the intended parents and the surrogate, the arrangement can be win-win, with the baby receiving the benefits.

There is no one right or wrong way to approach feeding your baby once he or she has arrived. And if you decide that breastmilk is what you’d like to provide to your baby, there are many different arrangements available. The most important element in your decision making is communication between your partner and your gestational carrier, to come up with a plan that works for everyone. And once you do come up with a plan, keep the lines of communication open as everyone adapts to their new roles, and try to flexible as different needs arise.  Breastmilk is a priceless gift to help a baby get a good start in life, but it’s not the only way to success – thoughtful consideration and happy, healthy parents go a very long way too!