A pilot study on the protein composition of induced nonpuerperal human milk

Successful Co-Lactation by a Queer Couple: A Case Study

INTRODUCTION

With cultural and social evolution and improvements in reproductive technology, an increasing number of babies are born to lesbian, gay, bisexual, transgender, intersex, queer and/or questioning, and asexual and/or ally parents. As parental roles and gender expression become more expansive, the role of breastfeeding a baby must naturally also expand to include the option of sharing of breastfeeding among parents, called co-lactation (Bamberger & Farrow, 2021). In most cases, co-lactation involves a gestational parent and a non-gestational parent. If a non-gestational parent desires to produce milk for the purpose of breastfeeding, they do so by inducing lactation. While interest in and research about induced lactation are developing quickly, little information is currently available about co-lactation.

MAIN ISSUE

A couple identifying as queer presented with concerns about inducing lactation in the non-gestational parent, as well as seeking assistance in managing a successful sharing of the breastfeeding relationship.

MANAGEMENT

Breast massage, milk expression, acupuncture, hormone therapy, and galactagogues, including domperidone, goat's rue, and malunggay (moringa oleifera) were used to initiate and establish lactation by the non-gestational parent. Parents shared the breastfeeding relationship equally and carefully managed milk expression when the other parent was breastfeeding to maintain or increase lactation.

CONCLUSION

With professional lactation support, commitment to a lactation plan, responsive parenting, and strong communication and cooperation between parents, two parents were able to successfully co-lactate for more than a year. Breastfeeding was shared equally and supplementation of breastfeeds was rarely needed.

Three Continents, Two Fathers, One Donor: A Non-Puerperal Relactation Case Study

INTRODUCTION

A woman was able to relactate 7 years after breastfeeding her children. She donated her expressed milk to her friends, a same-sex male couple, who had a child through surrogacy in the United States. She lived in London and shipped her milk to Hong Kong, where they lived. The infant thrived on the donated expressed milk received during the first 3 months of his life.

MAIN ISSUE

This case is unusual because the woman was not breastfeeding at the time, which would have made expressing easier, and she was not adopting. She consulted a National Childbirth Trust Breastfeeding Counsellor and an International Board Certified Lactation Consultant^® who helped her explore non-puerperal relactation protocols.

MANAGEMENT

Her plan started 6 months before the birth and included the use of domperidone, frequent expressing by hand and with a hospital-grade pump. A breastfeeding specialist physician made suggestions on the dosage of domperidone. She donated a total of 35.06 L. She had the full support of her partner and family.

CONCLUSION

Non-puerperal induced lactation and relactation offer ways to make human milk accessible to all infants, particularly those from LGBTQ+ families in which no parent is lactating, as was the case with the same-sex male couple participating in this study. It is essential to disseminate the knowledge and skills needed to support non-puerperal induced lactation and relactation among all healthcare professionals involved.

Lactation Induction in a Transgender Woman Wanting to Breastfeed: Case Report

CONTEXT

Breastfeeding is known to have many health and wellness benefits to the mother and infant; however, breastfeeding in trans women has been greatly under-researched.

OBJECTIVE

To review potential methods of lactation induction in trans women wishing to breastfeed and to review the embryological basis for breastfeeding in trans women.

DESIGN

This article summarizes a case of successful lactation in a trans woman, in which milk production was achieved in just over 1 month.

SETTING

This patient was followed in an outpatient endocrinology clinic.

PARTICIPANT

A single trans woman was followed in our endocrinology clinic for a period of 9 months while she took hormone therapy to help with lactation.

INTERVENTIONS

Readily available lactation induction protocols for nonpuerpural mothers were reviewed and used to guide hormone therapy selection. Daily dose of progesterone was increased from 100 mg to 200 mg daily. The galactogogue domperidone was started at 10 mg 3 times daily and titrated up to effect. She was encouraged to use an electric pump and to increase her frequency of pumping.

MAIN OUTCOME MEASURE

Lactation induction.

RESULTS

At one month, she had noticed a significant increase in her breast size and fullness. Her milk supply had increased rapidly, and she was producing up to 3 to 5 ounces of milk per day with manual expression alone.

CONCLUSIONS

We report the second case in the medical literature to demonstrate successful breastfeeding in a trans woman through use of hormonal augmentation.

Tandem Breastfeeding: A Descriptive Analysis of the Nutritional Value of Milk When Feeding a Younger and Older Child

Breastfeeding is a gold standard of feeding of newborns and infants. Tandem breastfeeding (TBF) is feeding two children of different ages at the same time. The knowledge about the composition of human milk in prolonged lactation is still scarce. Milk from tandem breastfeeding women and after weaning was examined. Milk samples were collected from 13 TBF mothers. A 24-h milk collection was done. Analyses of fat, protein, carbohydrate and energy content were performed using MIRIS. Sociodemographic characteristics of TBF mothers was done. Higher fat content, energy value and total protein concentration was found in TBFM milk during tandem breastfeeding, than in milk after weaning the older child. The carbohydrate content remained stable. The composition of breastmilk, in terms of macronutrients, changes after weaning, taking into account the nutritional requirements of the younger child. The milk of nursing mothers in tandem did not show diurnal variability in individual components. These findings suggest an adaptive role of human milk to nutrient requirements of newborn and older children. The results may support the promotion of long breastfeeding, including tandem breastfeeding.

Induced Lactation in a Mother Through Surrogacy With Complete Androgen Insensitivity Syndrome (CAIS)

INTRODUCTION

Breastfeeding offers the optimal feeding option for newborns in terms of nutritional content and reinforces mother-infant bonding. As a physiological process intrinsically linked to parturition, breastfeeding is no longer reserved for puerperal mothers. Progress in understanding the intricacies of lactogenesis and breastfeeding has further paved the way for artificially induced lactation in recent years.

MAIN ISSUES

We describe the case of a mother through surrogacy with XY karyotype and complete androgen insensitivity syndrome who wished to breastfeed her child.

MANAGEMENT

Through a combination of estrogen therapy, galactagogues, and mechanical breast stimulation she was able to partially breastfeed her child for one month.

CONCLUSION

This case further shifts the concept that breastfeeding is a physiological process confined to only puerperal mothers and offers an opportunity to a wider group of nontraditional mothers to take part in the unique experience of breastfeeding.

Induction of Lactation in the Biological Mother After Gestational Surrogacy of Twins: A Novel Approach and Review of Literature

One of the important challenges in surrogate pregnancies is the early bonding of genetic mother with her infant and the establishment of breastfeeding. A combination of pharmacological and nonpharmacological methods is often used for the induction of lactation. Reports of induced lactation in surrogacy are limited and scattered. In this report, we present a case of induced lactation and initiation of breastfeeding in preterm twins by the genetic mother, through her novel approach after a gestational surrogate pregnancy. Thematic approach of maternal account is summarized with context and rigor. We reviewed the reported literature of induced lactation in similar cases with an aim to address the various methods adopted.