CDC releases guidance for males who want to breastfeed infants

"Can transgender parents who have had breast surgery breastfeed or chestfeed their infants?"

The Centers for Disease Control and Prevention has published on its website guidance for people who identify as trans and non-binary on how to "chestfeed" infants.

The CDC’s website now has information on how to feed children for biological women who had their breasts removed as part of gender-reassignment surgeries and for biological men taking hormones in order to grow breasts.

In the CDC website’s section "Infant and Young Child Feeding Toolkit" under "Health Equity Considerations," it stated that "Transgender and nonbinary-gendered individuals may give birth and breastfeed or feed at the chest (chestfeed)."

The agency added that "The gender identity or expression of transgender individuals is different from their sex at birth," noting that "the gender identity of nonbinary-gendered individuals does not fit neatly into either man or woman."

Under the website’s "Breast Feeding" section discussing breastfeeding for those who have undergone surgeries, the agency used the term "chestfeeding." 

Additionally, the health agency wrote, "Can transgender parents who have had breast surgery breastfeed or chestfeed their infants?"

The response was “yes,” adding an explanation that "Some transgender parents who have had breast/top surgery may wish to breastfeed, or chestfeed (a term used by some transgender and non-binary parents), their infants."

"Healthcare providers working with these families should be familiar with medical, emotional, and social aspects of gender transitions to provide optimal family-centered care and meet the nutritional needs of the infant."

The CDC also stated that transgender parents "may need help with" "maximizing milk production, supplementing with pasteurized donor human milk or formula, medication to induce lactation or avoiding medications that inhibit lactation, suppressing lactation (for those choosing not to breastfeed or chestfeed)" and "Finding appropriate lactation management support, peer support, and/or emotional support."

The Daily Mail reported that the recommendations apply to biological men who, after taking hormone drugs, can produce their own breastmilk, and that the FDA has warned that one of these drugs domperidone, "can pass into breast milk in small amounts and can sometimes give babies an irregular heartbeat as a result."

Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, told the outlet, "The CDC has a responsibility to talk about the health risks, but they have been derelict in doing that."

She added, "We have no idea what the long-term effects on the child will be" if trans parents are using "all kinds of off-label hormones."

The idea behind "off-label" means that a drug is being used for a different purpose than what it was approved for. The report noted that there are some medications necessary to induce lactation in trans women that have not been approved for boosting milk production in the US.

A 2004 advisory stated: "In response to reports that women may be using an unapproved drug, domperidone, to increase milk production (lactation), the Food and Drug Administration (FDA) is warning breastfeeding women not to use this product because of safety concerns."

The Daily Mail also reported that experts have cautioned trans women from using what's known as the Newman-Goldfarb protocol, which includes consuming a cocktail of drugs to allow one to lactate. The long-term health implications of such a treatment is not known, neither for adults nor babies.
New York-based physician Dr. Stuart Fischer told the Daily Mail that it is "very hard to believe" that the breast milk which naturally occurs in a biological female is the same as the breast milk created by hormone medication in a biological man noting that "If it's been tested a handful of times, how would we know the long-range effect?”
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