In general, men can't lactate or breastfeed. While people born as male do have the anatomy necessary for lactation (nipples, mammary glands, and pituitary glands), they don't have the hormone levels necessary to produce milk.
Both males and females develop similarly in the womb up to a certain point (until about 9 weeks pregnant, when sex differences develop). This includes nipple development. But at puberty – thanks to hormones – females develop breast tissue and an ability to produce milk, while males don't.
Advertisem*nt | page continues below
It is possible for some transgender and nonbinary parents to nurse their babies with the right support, according to theU.S. Centers for Disease Control and PreventionOpens a new window (CDC).
"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 says.
According to the CDC, transgender and nonbinary parents may need help maximizing milk production, supplementing with formula or donor milk, using medication to induce lactation, and finding support, among other things.
Some transgender men and nonbinary people use the term chestfeeding or bodyfeeding rather than breastfeeding. Chestfeeding can mean nursing at the breast, but it can also mean using a tube attached to the nipple to feed a baby formula or breast milk. Chestfeeding may also be used for non-nutritive sucking – in other words, for comfort rather than nutrition.
"There have been case reports of trans people successfully chestfeeding, and their babies gaining weight and developing without concern." says Kate Shand, a physician assistant, board-certified lactation consultant, and member of BabyCenter's Medical Advisory Board. "There is much-needed research to be done so we can have data to back any recommendations."
Can men produce milk?
Men born biologically male (also called cisgender) don't normally produce milk. In fact, very few male mammals lactate.
While men do produce some of the hormone prolactin, which stimulates the mammary glands to produce milk, women have much higher levels. Those levels rise even more during pregnancy and after delivery, in preparation for breastfeeding.
Advertisem*nt | page continues below
It's possible for male prolactin levels to surge, too. It might happen because of hypothyroidism, which affects the pituitary gland. There have also been instances of medications – such as the antipsychotic chlorpromazine (Thorazine), steroids, or the heart medication digoxin (Lanoxin) – causing increased prolactin levels in men.
It might be also possible for a man to be given enough supplemental hormones (estrogen and prolactin, for example) to induce lactation. It hasn't been well studied, though.
There's little research on whether the milk men produce would be similar, nutritionally and in immunity-boosting components, to the breast milk that women produce. One studyOpens a new window of a man who produced breast fluid concluded that the concentrations of lactose, proteins, and electrolytes were similar to the colostrum and milk from lactating women.
"There's no evidence to suggest that colostrum between cisgender women and other breastfeeding/chestfeeding parents would be different," says Dr. Chandani DeZure, a neonatal and pediatric hospitalist at Lucile Packard Children's Hospital/Stanford UniversityOpens a new window and member of BabyCenter's Medical Advisory Board.
Newborns (male and female) sometimes lactate because of an excess of hormones from their mom's body, though it's usually just a few drops. And children of both sexes sometimes lactate a bit when they go through puberty – thanks to a rush of hormones. But these conditions are temporary and rare.
Advertisem*nt | page continues below
Can transgender men lactate and breastfeed/chestfeed?
It depends. Trans men on hormone therapy typically need to stop taking testosterone in order to get pregnant, chestfeed, or both. They may also need to take estrogen and progesterone to induce lactation.
If you're trying to chestfeed without becoming pregnant, additional feminizing hormone therapy might be necessary. Talk to your doctor about any questions you have – they can help decide what's best for you and your baby.
While there are some medications that are unsafe to take while breastfeeding, there's no indication that the usual hormones trans people take can harm a baby.
According to Dr. DeZure: "The baby's health would not be at risk here, but rather the parent's. Transgender parents who are on a stable hormone regimen should discuss any and all hormonal changes to induce lactation with their healthcare team prior to changing a medication regimen."
Top surgery – a procedure many transgender men and nonbinary people get to alter or remove mammary tissue – affects the ability to breastfeed. It doesn't necessarily include removal of all of the mammary gland tissue, but if it does, lactation won't be possible.
Advertisem*nt | page continues below
Even if you still have your mammary glands, top surgery may make lactation more difficult. Too much breast tissue might be removed, or the surgery may damage nerves essential for lactation. If the nipples and areolas are reconstructed during top surgery, it can impact how much milk you're able to produce or whether you're able to produce milk at all. That damage may heal over time, though.
In addition to hormone therapy, nipple stimulation can help induce lactation. It's similar to the process of relactation for cisgender women. Chestfeeding your baby is the most obvious way to stimulate your nipples for lactation, but you can also pump and hand-express your milk.
Another thing to consider is that chestfeeding may trigger gender dysphoria for trans men and nonbinary people, since you need to stop taking male hormones and you may need to take female hormones to support lactation.
If you're a trans man and want to know more about your ability to become pregnant or chestfeed, talk to your doctor. They can connect you with a lactation specialist or other medical expert who can help.
Can transgender women lactate and breastfeed?
Again, it depends. Trans women have the necessary anatomy to breastfeed – mammary glands, nipples, and pituitary glands. But trans women usually don't naturally produce enough of the hormone prolactin, which induces lactation.
Advertisem*nt | page continues below
It's possible for hormone therapy to successfully trigger lactation in trans women, though research is limited – there's anecdotal evidence of success, but only one case report of lactation induction in a trans woman.
The hormone therapies trans women undergo typically spur breast tissue growth, and it's possible that there could be enough natural breast tissue to breastfeed.
If a trans woman has breast implants, it is possible to breastfeed with breast implants, though it can lead to challenges such as low milk supply and engorgement.
Like with trans men, trans women will likely need nipple stimulation to induce lactation. You can stimulate your nipples through breastfeeding, as well as pumping and hand-expressing milk.
If you're a trans woman and want to know more about your ability to lactate and breastfeed, talk to your doctor. Learn more about resources and options for LGBTQ+ parents-to-be.
Advertisem*nt | page continues below
Learn more:
