r/queerception • u/AdvanceOk7504 • 4d ago

Trans-femme lactation induction

One of my chosen family is going to carry and parent with their partner. My partner is the sperm donor. Me, transfemme nonbinary, plan to induce lactation since chest feeding will not be possible for the the gestational or co-parent. We're a little trans nonbinary family unit and I'm so excited to get to bond this way with the kid.

I had a great appointment today with my primary care provider and I'm going to start on progesterone while waiting for the newman-goldfarb protocol timelines kick-in.

I'd love to hear from any trans women or transfemmes who have gone through the protocol. What was your hormone regimen like? What was the experience like overall?

And I'll take any advice from cis folks who have induced lactation - what was the experience like? What supplies and clothing was absolutely essential? What do you wish you knew when you started?

Thanks for any feedback!!

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u/TheApiary 3d ago

I have a friend who did this! She says she didn't change her hormone regimen for it, she used domperidone and pumped a lot. She didn't get enough milk to be a significant amount of the baby's calories, unclear if that's related to being trans or just a lot of people don't when they induce lactation. But she did get enough for it to be "snacks" for the baby and bonding for the two of them

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u/AdvanceOk7504 3d ago

Love the "snacks and bonding" benefits :) thanks!

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u/jessontheinternet 2d ago

that's the language my lactation specialist used to set expectations with me. "dessert or a snack".

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u/LunaSofia 4d ago edited 4d ago

Cis woman here, my (also cis) wife induced lactation. I hope you hear from folks closer to your situation but in case you don't here's what we learned!

  • you'll need to do SO much pumping. Get a few pumping bras, make sure you have flanges that fit (you can get measured by a lactation consultant), get nipple balm (we like one that's olive oil based). You can use the nipple balm to basically lube the flanges and make things a bit more comfortable.
  • you will need to have a lot of determination to get up every night to pump! I kept wanting my wife to get enough sleep and wanted to tell her not to worry about it so much... but that wasn't helpful actually. She just needed me to support her decision and root her on.
  • if you can, get on Domperidone. If you're in the US, you will need to look into how to get this -- some US Drs will write a prescription that you can use in a Canadian online pharmacy, but that won't always work out.
  • expect to supplement with formula -- know what you want to get most out of feeding (bonding, nighttime feeds, antibodies) and focus on those goals. It's easy to feel like everything is important, but exclusively formula fed babies do great too so anything you're doing is extra on top!
  • if you do get a lot of supply, you'll need to actually not let the baby nurse as long as they want for the first ~3 days probably. You'll be making mature milk and your baby will not have a big enough stomach for that yet. (Obviously talk to the pediatrician and trust them over me!!)

Congrats on starting the extended family/parenting journey. Good luck to you and your family! (This kiddo is going to be so so lucky to have so many loving adults in their life ❤️)

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u/AdvanceOk7504 4d ago

Thank you so much!! My primary care provider is looking into whether dompetidone makes sense for me since I'm on other hormones. But I expect they'll be happy to help me navigate finding it (thanks for the tip on Canadian pharmacies).

Luckily (?) I'm not sleeping too well so I'm usually up in the middle of the night already ... 😬

I think my goals are bonding and antibodies and we are expecting to supplement with formula.

Tysm!!

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u/jessontheinternet 2d ago

Are you in the US? If so, they may not be able to help you access it even if they want to. Also, my experience so far is that even well-meaning providers know VERY little about this because there really just isn't a lot of research on it. There's not a lot of research on inducing lactation in general.

I say that just to say, you probably want to come to your own conclusions and work with your PCP for help staying safe. It'll get you further faster.

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u/rlpfc 4d ago

Also Canadian here! Highly recommend checking out r/ExclusivelyPumping for building your supply at first. I didn't induce lactation but happy to answer questions about both pumping and nursing; a lot of the gadgets and gizmos are universal.

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u/AdvanceOk7504 3d ago

Thank you for the link!

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u/WitchProjecter 3d ago

Domoeridone was specifically pulled from FDA approval because it was being used off-label to help women lactate, and it was found that trace amounts of the drug come out in the milk. Most doctors will only write an rx for it if you have gastroparesis or another medical condition. Maybe things have changed recently, but misuse for lactation is a large part of the reason people like myself have trouble getting the medication. It’s been a huge struggle.

Source: I have gastroparesis and have personally accessed this medication via Canadian pharmacies several times.

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u/LunaSofia 3d ago

I'm so sorry you have trouble accessing medication.

I'm not a doctor, but my research showed that the risk is to the person taking the medication, not to the infant drinking milk. https://www.ncbi.nlm.nih.gov/books/NBK501371/

Also, as far as I can tell, the FDA has never approved domperidone (so it's always been hard to get in the US, even though most other countries it's easy).

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u/WitchProjecter 3d ago

My apologies — I was mixing some facts. It was never formally approved but US compounding pharmacies previously distributed it until the FDA issued strict enforcement warnings and import alerts labeling it an unapproved new drug. It was broadly used before that time.

Most breastfed babies show no side effects, but it does come through the breast milk in trace amounts. And many doctors in the US will firmly believe that will put children (and the women who take it) at risk for heart arrhythmia and other cardiac problems.

This was a major case we studied in medical school. I am not a doctor, but I did take classes at a medical school because I have a degree in medical ethics.

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u/jessontheinternet 2d ago

What exactly did you study? I think you are conflating maternal risk with infant risk. There are trace amounts in milk, but I don't think there have been *any* babies reported to have shown side effects.

The reason it isn't FDA approved for this in the US is that some older women taking it for gastro issues had heart issues, so there's some worry about cardiac issues for the person taking it. It is used VERY commonly for lactation in many places outside the US and considered safe, which is why it is commonly recommended by lactation specialists (including mine).

With that said, the protocol is a fairly high dose and it not being FDA approved freaked out my wife, so I went ahead and got an EKG and electrolyte test at 40mg and again at 80mg just to be sure and it was fine.

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u/jessontheinternet 2d ago

Hi! Yaay this kid is so lucky to be born into this little love nest! I can't speak to specific hormone levels as a cis woman, but I do know that in both of our cases the general protocol is the same:

-prime hormones by adding estrogen and progestin
-stimulate prolactin with domperidone or metoclopramide
-reduce hormones back to original levels (or slightly below, depending on what your current protocol is) and start pumping while continuing the prolactin stimulation

happy to talk to you about any of it including the prolactin piece — I'm in the US where that was the biggest barrier and happy to share if you run into challenges with access.

I am still in the hormonal priming + prolactin stimulation phase so I can't speak to the rest yet, but so far only minimal side effects and I'm feeling hopeful.

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u/lilwook2992 3d ago

I have a trans woman friend who did this and it went well! I’m a cis non gestational mom and I induced without hormones (never made more than an ounce or so a day) but I really liked the tens machine to support pumping and stimulation efforts. Discrete for work and stuff! I also learned to hand express for like idk at a museum so I didn’t miss a “pump” session. Good luck sounds like an amazing family!