CHICAGO — With pregnancy comes the inevitable question: Will you breastfeed? But hardly anyone thinks to ask that question of a woman who is adopting.

Yet it's possible to induce lactation in order to nurse a nonbiological child. There are several ways to make this happen, including holding a baby to the breast, pumping, taking herbs, using a protocol of birth-control pills and other medicines.

Lactation consultant Mary Kay Smith said the success of breast-feeding an adopted baby "all depends on the situation."

Smith, a La Leche League leader and a lactation consultant at Henry Ford Hospital in Detroit (she was a leader in Illinois from 1982-2003), explained: If "a mom is adopting because of a fertility issue on her part, then the hormones that won't support a pregnancy may not support nursing. If the fertility issue is on her husband's part, then she may be able to use hormone medicine."

The first step is to talk with an obstetrician/gynecologist. There are several options.

Regardless of the situation, Smith offered the same advice she would give to postpartum moms: "Wear your baby, give baby skin-to-skin contact. ... Anything that escalates your hormone levels. That's part of the bonding."

WEIGHING OPTIONS

These are some methods for induced lactation. Keep in mind that the schedule may need to be adjusted to sync with often-unpredictable adoption time frames.

PUMPING: "Start four to six weeks beforehand," Smith suggested, adding that once the baby is in your custody, "put the baby to breast. Or try a nursing supplementer (such as Lact-Aid Nursing Trainer and Medela Supplemental Nursing System): This device has tubing that goes around the neck. A little bottle is attached with ... tubes that go from the bottle (of breast milk or formula) to the breast. The baby getting something from the breast entices the baby to stay there. And the longer the baby stays there, the quicker the (naturally occurring lactation hormone) prolactin is activated," Smith said.

MEDICATION: Smith said many adoptive moms use hormone medications to increase prolactin levels, including the anti-nausea drug Reglan and the stomach-paralysis drug Domperidone. Again, check with your doctor. Significantly, in 2004, the U.S. Food and Drug Administration warned against using Domperidone for breast-feeding because of the possible risk of drug transmission to infants through breast milk.

HERBS: For a more natural way to induce lactation, Smith suggests fenugreek, milk thistle and goat's rue. She noted you can find these and more herbs at motherlove.com. As for dosage, consult your doctor.

PROTOCOLS: Stimulate pregnancy hormones by following Toronto pediatrician Dr. Jack Newman's protocols for induced lactation, which Smith characterized as a combination of birth-control pills, Domperidone, pumping and herbs. The specifics can be found in Newman's book "The Ultimate Breastfeeding Book of Answers" (Prima Publishing, 2000), with a summary at www.asklenore.com.