Academy of Breastfeeding Medicine opts for ‘chestfeeding’ and ‘birthing parent’ in new guidelines

The ABM "recognizes that not all people who give birth and lactate identify as female, and that some of these individuals identify as neither female nor male." To that end, mothers will now be "lactating persons," breastfeeding will be "chestfeeding," and nursing infants will be "human milk-feeding individuals."

The ABM makes the distinction between sex and gender thusly "It should be clear that the term 'sex' refers to a bio- logical assignment of female and male, whereas 'gender' refers to one’s cultural roles, and includes personal and social identity."

In their justification of these changes, they say that they are "acting in accordance with the United Nations (UN) and World Health Organization," which have been protested by many women's rights groups both in the US and internationally.

However, the AMB won't insist on using this language that de-centers women in motherhood globally, noting that there are plenty of places around the world where this sort of language would do more harm than good. "Although we affirm and support gender-diverse lactating persons around the world," they write, "using desexed or gender-inclusive language in places where being LGBTQI+ is illegal may do more harm than good and prevent important information from reaching families."

They write that "...some terms may be distracting or difficult to understand for readers who come from cultures where there are no apparent nonfemale lactating people, as well as for people who have low literacy, and for people who are not reading in their native language."

They note that language, too, poses a problem as many languages implicitly center women when it comes to motherhood and the function of mothering. "In these circumstances, when a term such as 'lactating parent' is substituted for 'mother' or 'breast- feeding mother,' it may not be understood easily, and use of gender-neutral pronouns for these terms (e.g. 'they/them') create additional confusion." English, however, is ripe for alteration since it is a malleable language with more words by far than any other.

The ABM tracks through some scenarios where this new language could be used. "For example, a dyad in which a birthing transgender father who has had gender-affirming male contouring surgery feeds his infant artificial milk through a supplemental nutrition system at the breast may have some of the same health risks as a cisgender nonbreastfeeding mother and infant: for example, the infant will have an increased risk of otitis media, gastrointestinal infection, and formula intolerance. The father is also at risk for common complications of chestfeeding/breastfeeding such as engorgement, cracked nipples, and mastitis. Because the father likely has some residual lactating breast tissue, it is unclear how his risk of type 2 diabetes and cardiovascular disease compares with that of a cisgender nonbreastfeeding mother—it may be slightly lower (or higher), but data are lacking for people assigned female at birth who take male hormones and lactate with reduced mammary tissue."

All of this to make sure that motherhood is inclusive to everyone.

Another example is this one: "For instance, compared with a cis- gender nonbreastfeeding mother, breast cancer risk may be increased for a birthing father who feeds his infant artificial milk (due to the residual breast tissue and the lack of desire or ability to lactate), or decreased if he is able to partially lactate with the remaining mammary tissue. Similarly, because breast cancer risk is influenced by parity, the expected breast cancer risk in people assigned male at birth who take female hormones and lactate is unknown. Gender-affirming hormone therapy complicates this further, as these hormones may contribute to health conditions, most notably an increased risk of cardiovascular disease."

When in doubt, each person should be consulted as to how they wish their function and body to be referred, though not having standardized words with standardized meanings in medical and health setting may lead to confusion and complications. "A lactating person should be encouraged to choose whichever terms for milk and feeding with which they identify," the statement reads.

The ABM recognizes that these new provisions are primarily for the western, English speaking world, writing that "Appropriate circumstances where desexed or gender-inclusive terms can replace sex-specific terms may include a document with an audience of health care professionals in a country where openly transgender or nonbinary persons give birth and breastfeed or chestfeed, such as a hospital policy in the United Kingdom or United States."

In conclusion, the ABM affirms that their goal is "to create materials that are comprehensible, acceptable, and permissible in all countries, in any language, and by any reader."

The Biden administration has gone all in on removing the concept of female from the concept of mother, opting instead for the term "birthing person."

Midwives have already been instructed to similarly call breastfeeding "chestfeeding." Midwives at Brighton and Sussex University Hospitals (BSUH) NHS Trust have been told to use the term "chestfeeding" instead of "breastfeeding" to be inclusive of transgender people.

The hospitals made the change to "rapidly redress the historic exclusion of trans and non-binary service users, whilst honoring and representing all who use our services."

"What we are doing is adding to the language we use to make it as inclusive as possible and to ensure that people who may identify in a different way feel our services are accessible," said BSUH chief nurse Carolyn Morrice.

Under the new "gender inclusive language policy," hospital staff were also asked to use the term "human milk" or "breast/chest milk" instead of breastmilk and the term "birthing parent" instead of mother.