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International Breastfeeding Journal
Published in: International Breastfeeding Journal 1/2024

Open Access 01-12-2024 | Lactation | Case Report

Lactation induction in a transgender woman: case report and recommendations for clinical practice

Authors: Jojanneke E. van Amesfoort, Norah M. Van Mello, Renate van Genugten

Published in: International Breastfeeding Journal | Issue 1/2024

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Abstract

Background

We present a case of non-puerperal induced lactation in transgender woman. Medical literature on lactation induction for transgender women is scarce, and the majority of literature and protocols on lactation induction is based on research in cisgender women. Healthcare professionals may lack the precise knowledge about lactation induction and may therefore feel insecure when advice is requested. Subsequently, there is a rising demand for guidelines and support.

Methods

Patient medical record was consulted and a semi-structured interview was conducted to explore the motive for lactation induction, the experience of lactation induction, and to gather additional information about the timeline and course of events.

Case presentation

In this case a 37-year-old transgender woman, who was under the care of the centre of expertise on gender dysphoria in Amsterdam, and in 2020 started lactation induction because she had the wish to breastfeed her future infant. She was in a relationship with a cisgender woman and had been using gender affirming hormone therapy for 13 years. Prior to initiating gender affirming hormone therapy she had cryopreserved her semen. Her partner conceived through Intracytoplasmic Sperm Injection, using our patient’s cryopreserved sperm.
To induce lactation, we implemented a hormone-regimen to mimic pregnancy, using estradiol and progesterone, and a galactogogue; domperidone. Our patient started pumping during treatment. Dosage of progesterone and estradiol were significantly decreased approximately one month before childbirth to mimic delivery and pumping was increased. Our patient started lactating and although the production of milk was low, it was sufficient for supplementary feeding and a positive experience for our patient.
Two weeks after birth, lactation induction was discontinued due to suckling problems of the infant and low milk production.

Conclusions

This case report underlined that lactation induction protocols commonly used for cisgender women are also effective in transgender women. However, the amount of milk produced may not be sufficient for exclusive nursing. Nevertheless, success of induced lactation may be attributed to its importance for parent-infant bonding, rather than the possibility of exclusive chestfeeding.
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Metadata
Title
Lactation induction in a transgender woman: case report and recommendations for clinical practice
Authors
Jojanneke E. van Amesfoort
Norah M. Van Mello
Renate van Genugten
Publication date
01-12-2024
Publisher
BioMed Central
Published in
International Breastfeeding Journal / Issue 1/2024
Electronic ISSN: 1746-4358
DOI
https://doi.org/10.1186/s13006-024-00624-1

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