Breast and Chest Feeding Considerations for Trans and Gender Diverse Parents

Benefits of Breast/ Chest Feeding

While the most important goal is ensuring your newborn receives all the nutrients they need to grow and thrive, there are many benefits feeding your baby nothing but human milk for the first  6 months of their life. Human milk transfers antibodies from parent to child and helps the baby’s immune system develop. Studies show that breast/chest feeding reduces the risks of common childhood illnesses like diarrhea and respiratory viruses. Long term, people who were breastfed as babies have lower odds of developing chronic diseases including asthma, type 1 diabetes, and obesity (CDC, 2025). Internationally, where there are fewer food safety regulations and limited access to clean drinking water, exclusive breastfeeding is an important way to limit an infant’s exposure to potentially life threatening diseases. The World Health Organization estimates that the lives of over 800,000 children could be saved each year if exclusive breastfeeding were universally adopted (WHO, 2018). 

Even if a parent needs to supplement the milk they produce with support of a nursing co-parent or formula, breast/chest feeding has important benefits for any parent. Breast/chest feeding facilitates a close emotional bond and can help the parents anticipate baby’s needs through body language cues. Benefits specific to the gestational parent (the person who carries and births the baby) include a reduced risk of postpartum depression, ovarian cancer, and cardiovascular disease (Cleveland Clinic, 2023). 

Considerations for Transmasculine People

Transgender men and transmasculine people who’ve started HRT or had top surgery may have difficulty time producing and maintaining a consistent supply of human milk. If you are the gestational parent, your body is hormonally prepared for chest feeding. However, resuming testosterone after giving birth may limit your milk supply and should be discussed with your doctor before delivery if you plan to chestfeed. Concerns about triggering gender dysphoria or other mental health conditions through chestfeeding should always be taken seriously; a happy, healthy parent is instrumental for a happy, healthy baby! You may feel more comfortable pumping your milk using a machine and bottle feeding your baby. If you are not the gestational parent, nursing your infant may be possible, but will require the support of medications, including estrogen and progesterone to start milk production, also known as lactation.

Top surgery can also affect the internal structures of the chest and make chestfeeding more difficult. While top surgery may remove many mammary glands, some will remain to prevent the chest from looking concave, or rounded inward.  Surgical techniques that preserve the nipple, such as keyhole and peri ariolar, are more likely to preserve nursing function than techniques that use free nipple grafts, like double incision. Because your chest is more muscular and less flexible after top surgery, your baby may also have trouble latching to the nipple. Trying different feeding positions, with or without the guidance of a lactation consultant, can help alleviate this problem. Additionally, binding while chestfeeding can increase the risk of an infection in the milk ducts, called mastitis (NHS, 2025). While mastitis can be very painful and interrupt feeding your baby, it’s easily treated, although sometimes requires antibiotics and rarely has long term complications (Blackmon et al., 2024). 

Considerations for Transfeminine People

Transgender women and transfeminine people can also play a key role in the early nourishment of their children. All people, regardless of gender identity or sex assigned at birth, have milk producing glands and estrogen can cause development of the ducts that move milk through the chest tissue and nipples. The hormones produced during pregnancy prepare the body to breast/chest feed. However, there has been a reliable method of inducing lactation and maximizing milk supply in cisgender women who adopt or use gestational surrogates for over 25 years. The Newman-Goldfarb Protocol is a schedule of medications to be started 6 months or more before the baby is due, so you’re prepared to nurse when the baby arrives. It uses hormones- including estrogen and progesterone, herbal supplements, mechanical breast stimulation through pumping, and a medication called domperidone (Goldfarb & Newman, 2000). Domperidone is an anti-nausea medication commonly used in Europe and other countries, but is not currently FDA approved in the US. It may also pose serious risks to your heart and mental health (FDA, 2023), as well as the risk of tardive dyskinesia or uncontrollable movements often of your neck or tongue. Discussing the potential risks to you and your baby with your doctor is essential if you’re considering this medication. While more research is needed on inducing lactation in trans women, small studies and case reports have shown the Newman-Goldfarb Protocol is effective (Amesfoort, Mello, & Genugten, 2024).

Much like with cisgender women who use this protocol, there is no way to be certain that it will make enough milk to meet your baby’s nutritional needs. You may need to provide supplemental nutrition for your baby- such as through formula, a partner or co-parent who nurses the baby, or pumped milk from a milk bank- such as the Human Milk Banking Association of North America.

Regardless of gender identity or sex assigned at birth, it’s important for all TGD parents to know that HIV can be transmitted through human milk. If you are HIV positive, taking your HIV medication, maintaining viral suppression, and regular consultation with your doctor are necessary to protect the health of your child.