In February, a 30-year-old woman in New York City became the first male-to-female transgender person to breastfeed a baby.
When the transgender woman told doctors at the Mount Sinai Center for Transgender Medicine and Surgery in New York that she wanted to breastfeed her pregnant partner’s baby, they put her on a regimen of drugs that included an anti-nausea medication licensed for use in Britain and Canada but banned in the United States.
Within a month, she was producing droplets of milk. And within three months — two weeks before the baby’s due date — she had increased her production to eight ounces of milk a day.
Ultimately, after undergoing a three-and-a-half month experimental treatment regimen, she was able to rely exclusively on her breast milk for the baby’s first six weeks. At week six, she was still producing a maximum of 227 grams per day. This number represents about half of the number of grams of milk that a newborn requires daily after five days of age, but the baby developed normally and in good health. After six weeks, the mom supplemented with formula.
How Did She Do This?
The couple worked with Dr. Tamar Reisman and Zil Goldstein, a nurse practitioner, at the Mount Sinai Center for Transgender Medicine and Surgery in New York City.
As reported in Volume 3.1, 2018 of Transgender Health, “the patient’s medical history was significant for gender incongruence for which she initiated a feminizing hormone regimen in 2011. At the time of our first visit, she was taking spironolactone 50 mg po bid, estradiol 2 mg po bid, and micronized progesterone 100 mg po bid.”
In essence, the recipe for this mother’s milk was years in the making. Long before her partner became pregnant, she had been taking female-enhancing hormones. At five-and-a-half months through the pregnancy, a combination of breast stimulation, oral hormones and nausea medication was introduced. Prolactin, the hormone produced organically in breastfeeding women, is not available as a lab-made alternative. Instead, the new mother used an anti-nausea drug called Domperidone as a prolactin replacement. Along with the Domperidone, she used three hormones: estrogen, progesterone and spironolactone (this last hormone blocks the production of testosterone).
At the woman’s one-month follow-up doctor visit, she was able to produce just a few droplets of milk. But at her three-month follow-up visit, just two weeks before the baby’s due date, she was able to produce eight ounces.
The report in Transgender Health continues: “Three-and-a-half months after she had started the mentioned regimen, the baby was born weighing 6 lbs., 13 oz. The patient breastfed exclusively for 6 weeks. During that time the child’s pediatrician reported that the child’s growth, feeding, and bowel habits were developmentally appropriate. At 6 weeks, the patient began supplementing breastfeedings with 4–8 oz of Similac brand formula daily due to concerns about insufficient milk volume.”