Chestfeeding

If you are a transgender or gender nonbinary parent or an adoptive parent, you may be wondering if you will be able to chestfeed your baby.

Each person’s situation is different. But it is often possible to produce milk, even if you are not the birth parent. You may also be able to chestfeed at least partly, even if you have had certain types of chest (top) surgery.

The process to create a milk supply is called inducing lactation. It’s important to have healthcare providers to guide you through this. Talk with your provider. And talk with a lactation consultant who has worked with trans and gender nonbinary people to support chestfeeding. They can help you and advise you.

Why might I want to chestfeed?

Chestfeeding may be an option in many situations. These can include:

• You are transgender or gender nonbinary and not the birth parent

• You are in a same-sex relationship and not the birth parent

• You are adopting a baby

• Your baby is being born by surrogacy

Can I chestfeed even if I haven't given birth?

Yes. A person does not need to be pregnant or give birth to be able to have a milk supply and to chestfeed. Everyone has mammary glands and the hormones (prolactin and oxytocin) that are needed to make milk. But each person’s ability to produce milk is different.

How much milk you can make may depend on any chest or nipple surgeries you have had. And on any hormone treatments you have had. You won’t know how much milk you can make until you try. This is why it’s important to talk with a lactation consultant. They can review your health history, answer your questions, and advise you on a plan to help you create a milk supply.

Creating a milk supply: inducing lactation

Inducing lactation is done by stimulating and emptying the breasts. It will take some work and some effort to build up a milk supply. Your lactation consultant will work closely with you. You will likely need to try a combination of:

• Breast stimulation. Breast stimulation triggers the hormones that affect milk production. This may be done by using a breast pump or stimulating your nipples by hand. Your lactation consultant will advise you on how often and for how long to pump. They will also show you how to express milk by hand. Once your baby is here, you can have them suckle at your breast.

• Hormone therapy. This often means taking estrogen and progesterone supplements. Trans women may be advised to take androgen suppressant therapy.

• Medicines and herbs (galactagogues). Certain medicines and herbs can help start and maintain milk production. Your lactation will advise you on this.

Induced lactation takes planning, commitment, and support. Your lactation consultant can talk with you about your options. It is helpful to start the process a few months before the baby arrives.

What are some issues that may affect my milk supply?

Your personal history impacts your ability to chestfeed. Each person’s history as a trans or gender nonbinary person is different. So it’s important to work with a lactation consultant who understands your personal situation and the issues that may affect you.

Things that may affect milk supply for trans men include:

• Having chest or nipple surgery. If you are a trans man and have had chest surgery, some of your mammary glands were removed. This means your milk supply may be reduced. But you may still be able to produce some milk. This will depend on the type of chest or nipple procedure you had.

• Taking testosterone. Taking the male hormone testosterone may reduce your milk supply.

Trans women may also be able to create a milk supply. They may need to take androgen suppressant therapy to stop testosterone from working. They may also need to take female hormones.

What are some other options if I don't produce enough milk?

If you have a low milk supply but still want to feed your baby by chestfeeding, you can try:

• Using a supplemental nursing system (SNS). A nursing supplementer is a small bag or bottle that holds milk. The milk flows from the bag or bottle through a tiny feeding tube that is placed by your nipple. Your baby suckles at your nipple and receives milk through the feeding tube. This can also help increase your milk supply.

• Using donor milk. Donor milk is available from human milk banks. Your lactation consultant can help you learn more about finding and using donor milk. You can feed this to your baby using an SNS or by bottle feeding.

• Using formula. Supplementing with formula is also an option. This can be done by using an SNS or by bottle feeding.

Beyond nutrition: The many benefits of chestfeeding

Even if your milk supply is low, you and your baby can still enjoy many benefits from chestfeeding. After all, chestfeeding is not only about nutrition. The time you spend snuggling together with skin-to-skin contact is special and can:

• Help you bond with your baby

• Help your baby go to sleep

• Help ease your baby’s pain

• Promote your baby’s sucking reflex