Multiple informational pages on the official Centers for Disease Control and Prevention (CDC) website give guidance on “chestfeeding,” a term used to describe transgender and nonbinary-gendered individuals feeding an infant from their chest.
Several doctors have accused the national public health agency of not taking into account the possible health risks that could result from children drinking “milk” that has been produced by pharmaceutical intervention and gender-reassignment hormonal treatments, according to the Daily Mail.
The CDC guidance received renewed scrutiny this week after a transgender woman posted a photo of herself purporting to chestfeed an infant.
After the tweet went viral, an online debate ensued over whether people who have not developed natural mammary glands can produce breast milk.
One CDC handout entitled “Health Equity Considerations” from June of 2022 states that “Transgender and nonbinary-gendered individuals may give birth and breastfeed or feed at the chest (chestfeed).”
“An individual does not need to have given birth to breastfeed or chestfeed,” the CDC claims.
The handout states that some families may use their own preferred terminology for feeding infants, such as nursing, chestfeeding, or “bodyfeeding.”
Another CDC webpage, updated in April of 2023, contains a question and answer section on breast surgery, and advises that transgender parents who have had breast surgery can breastfeed or chestfeed their infants.
“Some transgender parents who have had breast/top surgery may wish to breastfeed, or chest feed (a term used by some transgender and non-binary parents), their infants,” the agency wrote.
“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,” they wrote.
The CDC says that families may need help with “Medication to induce lactation.”
Biological males who undergo gender-reassignment are able to take a cocktail of hormone drugs in order to mimic the changes a woman’s body goes through during the late stages of pregnancy and shortly after the birth of a baby.
Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, told the Daily Mail that “we have no idea what the long-term effects on the child will be” from a breastfeeding trans woman using “all kinds of off-label hormones.”
“A lot of people are pushing for off-label use of a drug…it’s become to politicized that you can do all kinds of things for a politically approved purpose,” Orient told the outlet.
Off-label means to use a drug for a purpose other than the one for which it had been approved.
“The CDC has a responsibility to talk about the health risks, but they have been derelict in doing that,” Orient said.
Dr. Stuart Fischer, an internal medicine physician in New York, told the Daily Mail that he finds it “very hard to believe” that the milk produced by trans women is comparable to the breastmilk made by biological women in terms of nutritional value.
“Because it’s induced. You can’t fool Mother Nature,” he told the outlet.
Dr. Fischer explained that it is hard to know the impact trans women feeding babies would have due to a lack of research.
“If it’s been tested a handful of times, how would we know the long-range effect? The short-term is one thing, but the long-term in terms of physical and mental illness… who knows?” Fischer said. “It’s an emerging field, to put it mildly.”
“This is the kind of thing where politics and science are uncomfortably put together,” he added.
The method that trans women can use in order to make themselves lactate is called the Newman-Goldfarb protocol, and involves several drugs, some of which are not approved for the purpose of inducing lactation and which carry significant risks.
The protocol was initially developed in order to help induce breastmilk production in adoptive mothers, and utilizes a contraceptive pill to boost estrogen, physical stimulation with a breast pump, and the anti-nausea drug domperidone to mimic the hormonal changes women go through during pregnancy and birth.
The combination of drugs also includes the heartburn medication metoclopramide, the heart medication digitalis, the anti-psychotic drug chlorpromazine and sedative medications to produce prolactin, the hormone which stimulates milk production in biological women.
In 2004, the FDA warned against women using the anti-nausea drug domperidone to increase milk production due to potential health risks, citing published reports and case studies of cardiac arrhythmias, cardiac arrest and sudden death in patients receiving an intravenous form of domperidone.
The FDA stated that the drug, when excreted in breastmilk, could “expose a breastfeeding infant to unknown risks.”
“Because of the possibility of severe adverse effects, FDA recommends that breastfeeding women not use domperidone to increase milk production,” they wrote.
Professor Jenny Gamble, a midwifery expert at the Coventry University in the United Kingdom, told the Daily Mail that the latest research suggests that the composition of the pharmaceutically produced milk of trans women resembles that of “mature” breastmilk.
“The milk is the same composition as for women who re-lactate or induce lactation,” Gamble told the outlet. “It’s the composition of mature breastmilk.”
Mature breastmilk is a thinner and more watery milk that is produced after the first few weeks of breastfeeding, and lacks colostrum, the yellowish ‘liquid-gold’ that is high in proteins, sugars, fats, vitamins and antibodies that provide nutrition to the baby.
In May, a trans woman who goes by “Nominal Naomi” went viral on Twitter for announcing that they had successfully produced breastmilk.
The peer-reviewed journal articles about lactation in trans women cited by Naomi include three individual case studies, and one survey which gauged healthcare professionals’ interest in breastfeeding protocols for trans women.
The studies cited did not include an analysis of the long-term health effects on infants of consuming drug-induced breastmilk, or case studies with a sample size of more than one individual.
The first documented case of induced lactation in a transgender woman was published in the journal “Transgender Health” in 2018, and described the case of a 30-year-old trans woman who underwent hormone therapy and a drug regimen including domperidone to achieve “modest but functional lactation” for a period of six weeks.