Transgender and Gender Queer Baby Feeding
Notes on Language - This page’s goal is to emphasize the importance of using gender neutral language and discuss baby feeding outside of the traditional cisgender-binary. As such, I will utilize gender neutral language when I can. I will also attempt to use breast/chestfeeding wherever possible, often shortened to b/cf. I choose to not exclusively use chestfeeding, because I believe it is less specific about the anatomy of b/cf. I also choose not to use breastfeeding exclusively because of the discomfort it could cause some readers when used in reference to their experiences and bodies. I also use multiple words to describe diversity of gender expression and I believe it is important to define those terms in this context. Cisgender is referring to people who identify with the gender identity assigned to them at birth. I will be using multiple terms to refer to people who are not cisgender, including gender queer, gender non-conforming, and trans as an umbrella term for any people who do not identify as cisgender, including transmen, transwomen, and non-binary people, amongst other gender identities.
Introduction
Typical B/CF in a Trans Context
Inducing Lactation
Top Surgery
Supplemental Nursing Systems
Updated May 2024
There is a significant lack of b/cf education for medical providers in general, but especially to help tailor specific plans to queer families looking for atypical ways to feed their children. For this reason, this page is attempting to serve as a guide for gender queer and trans parents, parents-to-be, or people considering being parents at some point in their lives to learn about the multitude of options that they deserve to have access to and to learn about from (or sometimes in this case alongside) their provider.
Babies need to be fed and the ways they can be fed is plentiful. However, rarely is baby feeding within a queer and LGBTQ+ context discussed as layered, complex, and incredibly beneficial to bonding and family building. The LGBTQ+ family and their baby can utilize multiple and varied forms of baby feeding, from traditional breast/chestfeeding from the birthing parent alone, bottle feeding of breastmilk, in-house or donated, or formula, SNS feeding by any and all parents, or even inducing lactation in a non-gestating parent to feed their child breast milk.
If you are a trans gestating parent who plans to b/cf without a surgically or hormonally altered chest with traditional tools and methods, you still deserve to have your feeding journey be affirmative of your identity both within your gender and as a parent to your child. Prioritize relationships with health care providers who can support all aspects of your identity and advocate for yourself where you feel comfortable.
Lactogenesis, or the production of breast milk, can present differently in the inducing parent because of the lack of typical progression due to pregnancy and the associated physiological changes. However, breast milk production is still possible regardless if you gestated or not.
There are several different methods to induce lactation including using medication, herbs, manual stimulation, and encouraging endogenous hormones such as oxytocin through things like skin to skin and other bonding activities with your baby. Often, these will need to be used in combination in order to be successful. Lactation induction has been found to be successful in both AFAB and AMAB people.
Breast surgery, whether enhancement or reduction, is an incredible source of care for transgender and gender queer people. These surgeries can save lives, and allow people to enjoy their lives in a way they hadn’t before. That emotional stability is incredibly important not only to you as a parent, but also to your children. That being said, breast surgery can majorly impact the ability to b/cf significantly.
If you have already had surgery and still have interest in feeding your children your own milk, try to figure out from your surgeon how exactly the surgery happened. If you can find that out, discuss with them and your provider if being able to produce milk is possible, even for a decreased supply. Some surgical methods and procedures can make b/cf very difficult or even impossible so if you are able, it is important to understand the present anatomy of your breasts and where challenges could arise.
If you have not had surgery yet, but would like to, and b/cf is something you would like to do/are considering, make your surgeon and your provider aware of your interest and discuss with them a surgical procedure that upholds your ability to produce and supply milk to an infant. Ask them about finding a balance between your desired aesthetic effect for your chest/breasts, and your breasts functionality as milk producers. Surgery, regardless of your teams approach can still carry risks to make b/cf very difficult, so keep an open mind that later on you still might not be able to b/cf, similar to how some people could not be able to b/cf regardless if they’ve had surgery, but for a multitude of other unpredictable reasons.
Some surgical factors that could interfere with b/cf include-
Damage to the IV, V, and VI intercostal nerves which help provide sensation to the nipple and breast
Milk ducts and other milk making tissues damaged, scarred, or removed
Surgical alterations to the nipples that could alter placement of the nipple
If producing your own breast milk is not possible and/or not of interest to you, but you still would like to feed your baby from your nipple for purposes of bonding or otherwise, a supplemental nursing system is a good way to go. These devices hold milk or formula in a bottle that can travel down thin tubes that are adhered onto the nipple. There, a baby will begin to feed typically from the nipple but while receiving the milk/formula from the bottle.
Sources -
Borucki, Lynne C. (2005). Breastfeeding Mother’s Experiences Using a Supplemental Feeding Tube Device: Finding an Alternative. Journal of Human Lactation, 21(4
Cazorla-Ortiz, Gemma, Noemí Obregón-Guitérrez, Maria Rosa Rozas-Garcia, & Josefina Goberna-Tricas. (2020). Methods and Success Factors of Induced Lactation: A Scoping Review. Journal of Human Lactation, 36(4)
CDC. (July 2023). Breast Surgery | Breastfeeding. CDC. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/breast-surgery.html#:~:text=Is%20it%20safe%20for%20a,mothers%20with%20silicone%20breast%20implants
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La Leche League International. (2024). Transgender & Non-binary Parents. La Leche League International. https://llli.org/breastfeeding-info/transgender-non-binary-parents/#:~:text=Trans%20men%2C%20trans%20women%2C%20and,of%20those%20nursing%20adopted%20babies
Macdonald, Trevor, Joy Neil-Weiss, Diana West, Michelle Walks, MaryLynne Biener, Alanna Kibbe, & Elizabeth Myler. (2016). Transmasculine individuals’ experiences with lactation, chestfeeding, and gender identity: a qualitative study. BMC Pregnancy and Childbirth, 16(106)
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NHS. (December 2021). Chestfeeding if you’re trans or non-binary. NHS. https://www.nhs.uk/pregnancy/having-a-baby-if-you-are-lgbt-plus/chestfeeding-if-youre-trans-or-non-binary/#:~:text=Chestfeeding%20if%20you%27ve%20had,offer%20your%20baby%20supplementary%20feeds
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