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Removing Barriers to Breastfeeding for LGBTQ+ Parents

Portrait of a happy LGBT family. The young adult partners are spending time with their baby. The non-binary gendered adult is holding the baby boy. The parents are smiling.

This article is part 1 of a series on ways individuals have found to navigate breastfeeding.

Choosing how to feed your baby is a deeply personal choice. And there are a lot of reasons why breastfeeding might not be an option for a family. But sexual orientation, gender identity, and not being the birth parent shouldn’t be barriers to breastfeeding.

Breastfeeding medicine specialists are working hard to remove the barriers to breastfeeding that prevent LGBTQ+ parents from feeling enabled to make that choice.

“It doesn’t help anyone to say you should breastfeed and then not have the support and evidence-based best care that we know helps families reach their infant feeding goal,” says Ann Kellams, MD. But what that support looks like may be different for every parent.

Inducing Lactation for Non-Birthing Parents

When a person gives birth, biological processes trigger milk production. Usually within a couple days. But just because you weren’t the birthing parent doesn’t mean your feeding options are limited.

When Can Lactation Be Induced?

Inducing lactation can take more time than the hormonally charged process of giving birth. So, many non-birthing parents elect to start months before the baby’s due date.

“We offer prenatal visits for both birthing and non-birthing parents,” shares Amanda Rosenblatt, a lactation consultant at UVA Health. “There are published protocols we can use to help guide parents in their journey.” Protocols are techniques and timelines that have worked for others. These provide a roadmap.

Worried About Breastfeeding?

Lactation consultants can help talk through barriers and figure out options for your family.

At these prenatal visits, a lactation consultant can show you how to use a breast pump to begin stimulating milk production. This can start about 6 weeks before the anticipated birth. Some non-birth parents can even build up a store of milk for when their baby arrives.

But other parents don’t feel a need to breastfeed until they first hear their baby’s cries. And that’s a good time to start as well! Basically, it’s never too late or too soon to start breastfeeding.

The Joys of Co-Nursing

Sometimes, it’s not only about the non-birth parent breastfeeding. It’s about both parents sharing nursing. When more than one parent breastfeeds, it’s called co-nursing.

Breastfeeding reduces the risk of:

Breast cancer
Ovarian cancer
Uterine cancer
Type 2 diabetes
High blood pressure

Co-nursing means both parents benefit.

Co-nursing allows parents to share the burden of breastfeeding as well as the joy. If one partner is unable to produce enough milk, this can be a huge relief. It can also mean letting both partners share what little sleep there is to have.

It's also a remarkably special experience for parents to be able to share with each other.

“It was pure magic to have my partner going through the exact same, highly emotional, journey as me. Not to mention, it was super helpful to not be the sole producer of milk and the only parent who could soothe children with breastfeeding,” shares Haley Stephens.

Her wife, Sara, agrees. “Being able to breastfeed the twins was magical and it allowed me to experience that part of motherhood.”

Breastfeeding After Top Surgery

Sometimes, it’s the birth parent who worries about milk production. This can be an especially hard mental burden for trans and non-binary parents who have had top surgery.

But there’s no way to know without trying. Some trans parents who have had top surgery are surprised when their body begins to produce milk from their chest. And for some, that’s the thing that makes them want to try chestfeeding.

It’s likely that after top surgery you won’t be able to produce enough to exclusively breastfeed. But even some breastmilk can provide benefit. And it can still be a valuable bonding experience, even if it’s not an every-feeding-time activity.

 Breastfeeding Through Gender Bias

For people who are non-binary or trans, breastfeeding can present additional challenges. A lot of pro-breastfeeding language comes with a generous helping of prescriptive gender roles.

And yet, despite this, a study showed that 33.5% of non-binary and trans parents exclusively breastfed. And of those, 41.3% kept exclusively breastfeeding until 6 months. This huge accomplishment represents nearly 1,000 hours of breastfeeding.

But many more said they wanted to breastfeed but felt they couldn’t continue. And for many, they listed not receiving feeding-related education or experiencing healthcare discrimination as big reasons why they stopped.

And that’s why having lactation consultants with an international board certification, experienced doctors specialized in Breastfeeding and Lactation Medicine, and education on helping people of all backgrounds achieve their feeding goals is so important at UVA Health.

Can Breastfeeding Help with Gender Dysphoria?

Evan Joy knew they were non-binary well before they became pregnant. And through pregnancy, the changes to and focus on their breasts “felt like a karmic slap.”

Then the baby was born. And, just like it has for so many other new parents, everything changed. Suddenly, their breasts served a purpose.

“For me, personally, my breasts have everything to do with who I am as a parent and nothing to do with my gender. I expect the memory of nursing will forever be a part of how I define love,” they share.

But ultimately, this will vary from person to person. What everyone agrees can help, though, is having medical professionals who respect them, their choice of language, and their feelings.

Won’t Milk Production Be Limited?

One concern that holds parents back from trying breastfeeding in these situations is worrying that they won’t be able to produce enough milk. When inducing lactation, overcoming chest surgery, or handling feelings of dysphoria, supply is often affected. But lactation consultants don’t think that should be a reason to hold back if it’s something you want to do.

Kellams says, “What we don’t know in these situations is how much milk your body will be able to produce, or what percent of the baby’s intake. That does not mean that you cannot have the experience of breastfeeding and bonding with your baby in that way, and that any milk you make is not helpful or important.”

Some parents get discouraged when they find they aren’t producing enough to feed their baby. But with breastmilk, getting some is better than none. Many of the benefits of breastfeeding, like improved immunity, aren’t dependent on breastmilk being the only source of nutrition.

Combination feeding (giving breastmilk and formula) ends up being the most workable option for some families. “Every drop counts, and we always say that any breastmilk is better than no breastmilk.  Some of the studies that show health benefits look at ever breastfeeding vs. never breastfeeding,” says Kellams.

But just because studies only looked at all or none doesn’t mean those are the only options for you.

Lactation Support for All

If your family has decided breastfeeding is something you want to try, then lactation consultants want to help you however they can. Whether that’s inducing lactation or talking through the barriers to breastfeeding that you encounter.

“Our goal is to help all families achieve their personal infant feeding goals and for them to be happy and comfortable with their individualized feeding plans. We are here to support anyone and everyone,” says Kellams.

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