Trans and adoptive parents are breastfeeding without giving birth: 'It made me feel more like a mom'

• Induced lactation is a medication-and-pumping regimen allowing parents to nurse without a pregnancy.
• Women and trans people unable to bear children say it's made them more confident in their bodies.

Jackie Kent will never forget the moment her son Everett latched onto her breast for the first time.

Giving birth and breastfeeding a child were things she'd always longed to do, but after some failed intrauterine-insemination procedures, an examination led to the discovery that Kent's uterus had a congenital defect. Kent, 35, and her wife, Megan, were told Kent would never be able to carry a baby.

The couple, who live in Chico, California, decided to switch roles, with Kent giving her eggs but Megan carrying their child. Kent resigned herself to the dream of breastfeeding being over.

But after a friend adopted a baby, the couple learned of a process called induced lactation, a regimen of medication and pumping meant to "trick" the body into thinking it is pregnant and encourage it to produce milk. Kent knew it was something she wanted.

The day Megan gave birth to Everett, Kent was there to breastfeed him. She and Megan later went on to co-feed their second child, Sutton, for the first six weeks of her life.

"Breastfeeding felt so normal and natural, and it felt like I finally had space to step into the role of being a mom in the way I had envisioned it," Kent told Insider. "I felt like my body had failed me related to pregnancy, and this gave me a new way to feel about my body."

Induced lactation can confer all the benefits of breastfeeding

The social changes of recent decades have redefined what it means to become a parent. Queer couples are now able to pursue their dreams of starting a family, and adoption and surrogacy remain pathways for many parents as well.

Dr. Sharon Silberstein, an OB-GYN and lactation consultant in London, says she has seen increased demand for assistance with induced lactation in the past few years.

"Due to the use of social media, induced lactation is becoming more widely known," Silberstein said. "More people have access to guidance via remote support, and more literature has been published on the topic. I do believe it's more common now."

Silberstein said many parents who couldn't or hadn't given birth were seeking ways to confer the health benefits of breastfeeding to their children — like reduced infections and a lower risk of sudden infant death syndrome — as well as bond with them.

"Inducing lactation can be beneficial in lots of situations," Silberstein said. "It helps with bonding and has the same nutritional benefits as breastfeeding after pregnancy."

Whether they're welcoming a baby via adoption, through surrogacy, or as the non-gestational partner in a queer relationship, Silberstein said most parents follow the Newman-Goldfarb protocols, developed by Dr. Jack Newman and Lenore Goldfarb in Canada in 2000. In a 2011 interview, Goldfarb said that about 31% of people developed a full milk supply using the protocols; while the practice is accepted within medicine, it remains understudied.

The protocols begin six months before birth, when the parent is encouraged to take a combination birth-control pill containing progesterone and estrogen along with a daily dose of domperidone, an anti-nausea medication that has the side effect of causing the breasts to swell.

The birth control serves to suppress a parent's milk supply until six weeks before birth. The parent then ceases to take the birth control but continues with the domperidone. This encourages a rapid decrease in serum progesterone levels and increase in serum prolactin levels, mimicking the chemical reactions caused by giving birth and having one's milk come in.

From there, blessed thistle and fenugreek seed, herbs that are thought to promote milk production, are introduced. (While the pair have been used as folk remedies for centuries, there is very little research on their effectiveness.)

An intense pumping schedule begins to build up the supply. Parents are encouraged to pump for five to seven minutes every three hours, including during the night.

Both the pumping and medication must continue even after the baby is born and starts feeding. This encourages the body to produce more milk and prevents the supply from drying up.

Inducing lactation can help with the trauma of infertility

Many parents who induce lactation have experienced infertility. Some who've built families through adoption or surrogacy say the process has allowed them to feel more connected to the physical side of childbirth.

Chrissy Fleishman, 36, from Maryland, has a condition called Mayer-Rokitansky-Küster-Hauser syndrome, meaning she was born without a cervix or uterus and is unable to carry a child. Instead, she has had two children through surrogacy: Bram, born in 2015, and Wilder, born in January of this year. She's successfully induced lactation for both.

"Infertility is traumatic and has a grieving process," Fleishman told Insider. "There is the loss of what you thought your life would look like, and feeling like your body is somehow broken, it can't do what it was 'meant' to do."

"With inducing lactation, I felt, if I can't grow him in my body, at least I can help him grow once he's out and with me," she continued. "It was incredibly healing, even with its challenges."

Bekki Hockman, 48, from Suffolk, Virginia, spent 25 years trying to conceive before turning to surrogacy, with her goddaughter offering to carry her baby. Her daughter, Mia, turned 3 in May, and Hockman is still breastfeeding her through induced lactation.

"I had always wanted to breastfeed my children; obviously, I never thought I would have infertility issues," Hockman said. "With having a surrogate, it was even more important to me. I wanted to really bond with my daughter, and nursing made me feel more like a mom."

Induced lactation can help trans parents affirm their gender identity

Induced lactation is also popular with trans parents, both those who have transitioned from female to male and those who have from male to female. Silberstein said she recently worked with a trans woman whose wife was pregnant. Using the Newman-Goldfarb protocol, the woman has been able to produce some milk.

Christina Avery, 40, from Ontario, Canada, was already a mother of two teenagers when she fell in love with her future husband, Radford Cowan. A year into their relationship, Cowan told Avery he planned to transition from female to male but still wanted to have biological children. He gave birth to their first baby, Wilder, in April.

Since Cowan had his breast tissue removed as part of his transition, he's unable to feed from his chest. So Avery decided she would try to induce lactation instead.

"Having nursed my first two children well into toddlerhood, I was familiar with the benefits in terms of health and attachment," Avery said. "It seemed like a nice way to split the parental load. My partner is extraordinarily supportive and was my number-one cheerleader."

Unfortunately, Wilder had a tongue tie and spent time in the hospital with jaundice, which compromised the regularity of Avery's milk supply. She still nurses a few times a day but has to supplement with donor milk from a bottle.

"I'm still pro-induced lactation," she said. "It has been lovely to be able to feed my baby and give them some of the benefits of breastfeeding. It's also nice to still be able to bond with them in that way."

Inducing lactation comes with challenges

The process of inducing lactation isn't easy, especially for patients in the US. Domperidone, the drug required, isn't approved for use in the US because it can cause cardiac side effects. The Food and Drug Administration issued a warning against the drug in 2004. It is available in the UK and Canada, but with restrictions.

"There is a small increased risk of cardiac side effects," the UK-based Silberstein said. "When inducing lactation, we ensure that the patient has no heart problems and monitor them throughout. It is also a low dose of the drug."

Parents who want to take domperidone in the US cannot get a prescription; the only option is to import it from abroad, following FDA guidelines.

"Obtaining domperidone in the US is not easy," Fleishman said. "I had to purchase from an overseas pharmacy, which is costly and takes a long time to receive."

Even if they can obtain medication, parents inducing lactation have to establish a time-consuming pumping regimen that can leave them exhausted before their baby even arrives.

"One of the biggest challenges was definitely pumping," Kent said. "It is completely consuming, and after the baby is born, it is hard to figure out how many times to nurse and how many times to pump to maintain supply. At times, I felt like it was all I could think about."

Typically, people who induce lactation produce less milk than those who have carried a baby. After Mia's birth, Hockman learned she had insufficient glandular tissue, a disorder in which the milk-making tissue of the breast doesn't develop as expected. She could only produce a limited supply of milk.

"The hardest part was knowing that I flat-out wouldn't be able to make more," Hockman said. "I only made 5, 6 ounces a day, and that's being generous. We supplemented with donor milk for two full years."

But despite the challenges, Hockman and other parents who have induced lactation say they wouldn't change a thing.

"I'd do it a hundred times over," Hockman said. "This is one of the best things I've ever done."