Saturday, December 21, 2013

Checking in: Week 21

I did some more investigations on surrogacy options in India today, and I'm starting to get a much clearer picture of things. I wish I had acquired all this knowledge months ago, but that is not how it works. Sometimes, even the less than ideal choices we make can lead us someplace good, and sometimes, doing everything correctly and logically will still not garner success.

Still, others will benefit from what I have learnt, and that makes me pretty happy.

One thing I did learn today--finding a human milk source in India will be extremely difficult. Everybody knowledgeable in this area is telling me that getting the surrogate to do this is a bad idea. I atleast want the colostrum, and I hope to god I can get that.  

Now, I have to seriously consider induced lactation. People who started this....what was your timeline? How long were you on the pregnancy hormones and domperidone before you stopped the hormones and the milk production began? I totally want the crash course and not the long drawn out process.

Finally: a question about the final stretch in the 3rd trimester: what gets done in each appointment? From my conversation with the surrogate handler, every checkup, all we can get done is the doppler to hear the heartbeat. That is it. There seems like there should be more, right?


  1. No advice from me but I look forward to reading about the induced lactation process!

  2. I took domperidone to increase my milk supply when my daughter was 8 months old. (Easily got it from an international pharmacy). I had gone on a strict elimination diet looking for the cause of my daughter's allergies (milk was it) and in the process lost weight quickly and my supply dropped dramatically. My daughter was still exclusively breastfeeding (refused solids until 10 months) so I needed the supply. Domperidone worked very well, but about 10 months later I had routine bloodwork done and they discovered my liver enzymes were too high. So I had to stop domperidone and immediately lost my supply. So just a heads-up to watch your liver enzymes - I read this is not all that unusual. I also took Reglan for a bit with my first daughter, and that drug also worked well with no known side effects for me. If you can make it work, I think the induced lactation would be a great option. Babies go through A LOT of breastmilk! Plus the convenience, and control with knowing what you are putting into your own body. And would you get some of the same benefits as any woman who breastfeeds in terms of reduced cancer risks?

  3. I don't have any advice to offer about induced lactation, but regarding the 3rd trimester appointments - honestly, I was really surprised the whole way through my pregnancy (including the 3rd tri) at the lack of examination that is apparently done. And that was even with a perinatologist who monitored me very closely. After going through so much invasive stuff with IF, I was honestly expecting the peri to be examining me constantly, but it barely happened at all. In the 3rd tri, I think she measured fundal height once or twice, and at my 37 and 38 week appointments, she checked to see if my cervix was dilated at all, and literally that was it in terms of physical exam. I remember being really bummed at the 38-week appointment that I was only slightly soft and 1 cm, so it didn't look like I was going to go into labor any time soon. And then the next day my water broke and Miss A arrived. So don't be too disappointed if the surrogate isn't softening and dilating a lot at the end - it's still possible that delivery could be just around the corner!

    1. And note that there is a large contingent that believes cervix checks are totally unnecessary, and simply serve to increase risk of infection. Your cervix can sit at several cm open for weeks, or can go from zero to 60 (so to speak) overnight. I personally refused all cervix checks until I was 40 weeks and had been in prodromal labor for over a week. I'd say, at this point, minimize anything remotely invasive and just monitor urine, fundal height, and how well the surro is feeling.

  4. I hate to break to ya, but if things are going smoothly (which is obviously the ideal), prenatal appointments really ARE pretty routine and boring the last few months! Mine included: doppler heart rate check, fundal height measurement, weight ck / swelling ck, urinary analysis. That's it! They'd ask questions about any headaches, sleeping patterns, exercise, etc.... but really it's pretty routine and boring. That's a GOOD thing, remember!

    I'm curious how the induced lactation process works - I look forward to reading more about it!

  5. Ditto, fundal height, weight, blood pressure, temperature, urinalisis and Doppler. The last week for me (week 33) I also had an amniotic fluid index (AFI) and monitored heartbeat after fetal kicks (I can't remember what this is called) and these were only done due to my gestational diabetes. I never had a cervical check after 20 weeks when they did it with transvaginal ultrasound.

    Definitely boring, in fact my husband stopped coming to the appointments because they were so boring.

  6. I induced lactation for my son (born via gestational surrogacy). I was terrified he was going to die in utero, so I couldn't convince myself to start the process until we were 19 weeks along (which is late to begin the protocol). I was on the hormones + Domperidone for 3 months before I started pumping. Ended up pumping every 2-3 hours around the clock for 2 months before he was born and was only able to work my way up to 5oz (150ml)/day. My son is now 6 months old and I'm still breastfeeding, albeit with the aid of the Lact-aid supplemental nursing system filled with breast milk from our surrogate. I'm now able to produce 10 oz (300ml)/day, but that's the maximum. To be brutally honest, inducing lactation is HARD. Despite what you read, MOST women are never able to reach a full supply (unless they've previously breastfed their children). I will also say though that it's worth it for the bonding experience alone. I love breastfeeding my son, even though I need a little help in doing so. --- If you're going to attempt the process, start NOW.

  7. With Smudgie, we had a marker for potential growth restriction, so they did a growth scan every month and biophysical profiles in the last 6 weeks (he was fine, there was nothing to worry about). With Nu-nu, just heartbeat scans measuring the fundus, and palpating the uterus to check position and estimate size. Plus bloodwork for GD and group B strep. That was it until 38 weeks when I had my first cervix check and found out I was in labor. Really anticlimactic appointments. My husband also skipped most of them until the 38 week one, which he thankfully attended!

  8. Our surrogate's doctor was at Hiranandani and we had at least one ultrasound in the third trimester, maybe we even had two. Personally, I was happy to see our baby (the technology is just amazing!) but I didn't understand why it was necessary. When I was pregnant with our daughter, I don't think I had any in the last trimester.We also got reports on her cervical length and regular blood reports in the last tri.

    I'm looking through my notes to comment about inducing (will get to that soon), but I agree with Meg, start now. The more pumping the better. My supply was doubling every couple of days while I was pumping.

  9. I would recommend intensive monitoring from 32 weeks. We sadly lost our child a week before the due date and it was diagnosed as sudden intrauterine death with no evident reasons. It was a perfectly healthy pregnancy as far as we know. I am biased towards being paranoid because the pain is heart wrenching. You waited for so many years... Please assume that every pregnancy is high-risk and go for continuous monitoring.

  10. Thinking of you & your babe as you enter the final stretch.