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Delgado D, Stellwagen L, McCune S, Sejane K, Bode L. Experience of Induced Lactation in a Transgender Woman: Analysis of Human Milk and a Suggested Protocol. Breastfeed Med 2023; 18:888-893. [PMID: 37910800 DOI: 10.1089/bfm.2023.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Background: A growing number of diverse familial structures wish to colactate their infant. For transgender and gender diverse (TGD) individuals, chestfeeding or breastfeeding may be within their goals of parenthood. There is limited evidence on how to induce lactation for a nongestational parent on gender affirming estrogen treatment. Case Presentation: We report the case of a transgender woman who successfully underwent lactation induction following a protocol using the galactogue domperidone plus use of a breast pump. The patient had modifications to her hormone therapy with estrogen and progesterone while remaining on antiandrogen therapy with spironolactone. A description of the protocol, medications, laboratory monitoring, human milk analysis including macronutrients, oligosaccharides, and hormones is presented. Discussion: This is the fourth case to date known in the literature of a transgender woman with successful lactation induction, and the third case to remain on antiandrogen therapy during this process. Our report is the second to demonstrate comparable macronutrients, and the first to report on human milk oligosaccharides and hormones in induced milk compared with term human milk of a gestational parent. Conclusions: The opportunity to chestfeed or breastfeed an infant can be profound for many parents. Further research is needed to meet the needs of TGD individuals who wish to induce lactation as part of their parental goals.
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Affiliation(s)
- Daniela Delgado
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Lisa Stellwagen
- University of California Health Milk Bank, San Diego, California, USA
- Human Milk Institute (HMI), University of California, San Diego, La Jolla, California, USA
| | - Sydney McCune
- Human Milk Institute (HMI), University of California, San Diego, La Jolla, California, USA
- Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego, La Jolla, California, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Kristija Sejane
- Human Milk Institute (HMI), University of California, San Diego, La Jolla, California, USA
- Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego, La Jolla, California, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Lars Bode
- Human Milk Institute (HMI), University of California, San Diego, La Jolla, California, USA
- Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego, La Jolla, California, USA
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
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Samuel TM, De Castro CA, Dubascoux S, Affolter M, Giuffrida F, Billeaud C, Picaud JC, Agosti M, Al-Jashi I, Pereira AB, Costeira MJ, Silva MG, Marchini G, Rakza T, Haaland K, Stiris T, Stoicescu SM, Martínez-Costa C, Vanpee M, Domellöf M, Castañeda-Gutiérrez E, Thakkar SK, Silva-Zolezzi I. Subclinical Mastitis in a European Multicenter Cohort: Prevalence, Impact on Human Milk (HM) Composition, and Association with Infant HM Intake and Growth. Nutrients 2019; 12:nu12010105. [PMID: 31905959 PMCID: PMC7019749 DOI: 10.3390/nu12010105] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 02/01/2023] Open
Abstract
Background: Subclinical mastitis (SCM) is an inflammatory condition of the mammary gland. We examined the effects of SCM on human milk (HM) composition, infant growth, and HM intake in a mother–infant cohort from seven European countries. Methods: HM samples were obtained from 305 mothers at 2, 17, 30, 60, 90, and 120 days postpartum. SCM status was assessed using HM Sodium (Na): Potassium (K) ratio >0.6. Levels of different macro- and micronutrients were analyzed in HM. Results: SCM prevalence in the first month of lactation was 35.4%. Mean gestational age at delivery was lower and birth by C-section higher in SCM mothers (p ≤ 0.001). HM concentrations of lactose, DHA, linolenic acid, calcium, and phosphorous (p < 0.05 for all) was lower, while total protein, alpha-lactalbumin, lactoferrin, albumin, arachidonic acid to DHA ratio, n-6 to n-3 ratio and minerals (iron, selenium, manganese, zinc, and copper) were higher (p < 0.001 for all) in mothers with SCM. There were no differences in infant growth and HM intake between non-SCM and SCM groups. Conclusion: We document, for the first time, in a large European standardized and longitudinal study, a high prevalence of SCM in early lactation and demonstrate that SCM is associated with significant changes in the macro- and micronutrient composition of HM. Future studies exploring the relation of SCM with breastfeeding behaviors and developmental outcomes are warranted.
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Affiliation(s)
- Tinu Mary Samuel
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
- Correspondence:
| | | | - Stephane Dubascoux
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Michael Affolter
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Francesca Giuffrida
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | | | - Jean-Charles Picaud
- Hospices Civils de Lyon, Neonatal intensive care unit, Hôpital Croix Rousse, 69004 Lyon, France;
- Univ. Lyon, CarMeN Laboratory, INSERM U1060, INRA U1397, INSA Lyon, Universite Claude Bernard, 69221 Lyon 1, France
| | | | - Isam Al-Jashi
- Medical School, Department of Obstetrics and Gynecology, Titu Maiorescu Medicine University, 031593 Bucharest, Romania;
| | | | - Maria Jose Costeira
- Instituto de Investigação em Ciências da Vida e Saúde, 4720-011 Braga, Portugal;
| | | | - Giovanna Marchini
- Karolinska University Hospital, 141 86 Stockholm, Sweden; (G.M.); (M.V.)
| | - Thameur Rakza
- Centre d’Investigation Clinique de Lille, Hôpital Jeanne de Flandre, 59777 Lille, France;
| | - Kirsti Haaland
- Oslo University Hospital, 0372 Oslo, Norway; (K.H.); (T.S.)
| | - Tom Stiris
- Oslo University Hospital, 0372 Oslo, Norway; (K.H.); (T.S.)
| | | | | | - Mireilla Vanpee
- Karolinska University Hospital, 141 86 Stockholm, Sweden; (G.M.); (M.V.)
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umea University, 901 87 Umeå, Sweden;
| | - Eurídice Castañeda-Gutiérrez
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Sagar Kiran Thakkar
- Nestle Research, Singapore 618802, Singapore; (C.A.D.C.); (S.K.T.); (I.S.-Z.)
| | - Irma Silva-Zolezzi
- Nestle Research, Singapore 618802, Singapore; (C.A.D.C.); (S.K.T.); (I.S.-Z.)
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