Induced Lactation: How to breastfeed without pregnancy.
One of my favourite facts about the human body is the ability to induce lactation, even if pregnancy has never occurred. This blew my mind when I first learned about it back in school!
With that in mind, I’ve asked Emily to put together a post on what it means to induce lactation (or re-lactation). It’s important to note that while I am a huge supporter of breast-feeding/chest-feeding, I also strongly believe that fed is best, so if you are not able or do not wish to breastfeed your baby, there is absolutely nothing wrong or shameful about using formula (or using both methods)! Ultimately, what works best for mom and baby without causing added stress is what is likely the best choice for you.
Written by Emily Stevens, BSc Dietetics
Reviewed by Rachel Hilts, RD
An interesting, less talked about topic in the world of pregnancy and breastfeeding is the practice of inducing lactation for a non-gestational parent to be able to breastfeed their baby. Contrary to popular belief, you do not have to be pregnant or give birth to breastfeed your baby! There are methods that can be used to cause the body to produce milk and make breastfeeding possible (1).
There are many reasons why someone may want to induce lactation, which may include (but are not limited to) adoption, having a gestational carrier for your biological baby, being in a same-sex relationship and wanting to share or take over breastfeeding, having a baby weaned earlier than you wanted, and many more!
Whatever the reason may be, breastfeeding can allow for bonding time with your baby and provides them with great nutritional benefits, including the intake of human milk oligosaccharides, which are short polymers of simple sugars that are not digestible or used for energy but play an important role in building your baby’s immune system and gut microbiota (2,3).
What causes lactation during pregnancy?
During pregnancy, hormonal changes in the body signal the mammary glands to begin producing milk. Initially, estrogen and progesterone rise, which triggers the milk ducts in the breast to grow both in number and size; allowing your mammary glands to begin to prepare for lactation (4). During pregnancy, your body will also be producing prolactin (the hormone responsible for milk production); however, the high estrogen and progesterone levels in the body at this stage of pregnancy suppress lactation (4).
Once the baby is delivered, there will be a sudden drop in estrogen and progesterone that makes way for prolactin to increase (4).
Lactation will typically continue if milk is being removed from the breast regularly (through pumping, a baby suckling at the breast, or both). In general, the more milk that is removed, the more that is produced (4). This is, for the most part, a supply and demand system.
How is lactation induced?
It is possible for those who are not giving birth to try to induce lactation if they want to! This process typically includes hormone therapy to make your body believe it is pregnant and pumping to encourage your body to release prolactin (4,5). This can be an option if you are adopting or in a same-sex couple and not carrying the pregnancy, and are still wanting the experience of breastfeeding.
Hormone therapy usually begins with a combination birth control bill which provides estrogen, progesterone, and domperidone. This combination pill will increase your prolactin levels to help initiate milk production and simulate pregnancy hormones in the body. Based on your circumstances, this hormonal intervention’s exact length and timing should be discussed with a professional but is typically recommended to be continued for at least 16 weeks (1).
About two months before you expect to breastfeed, you will likely stop hormone therapy and begin pumping to encourage the production and release of prolactin (1). The typical course of action is to start pumping three times per day, working up to pumping every four hours, including once during the night, and finally increasing to every 2 to 3 hours and continuing until the baby arrives (6). As the milk comes in, you can collect and freeze it to store once the baby arrives.
Milk production after birth
After all of your hard work to induce lactation, you might be wondering how to maintain your milk production.
As mentioned above, the more milk removed from the breast (by direct feeding or pumping/manual expression), the more that is produced. As a baby suckles at the breast, oxytocin is released in the mother, initiating the letdown reflex that causes milk to flow from the breast.
It is vital that the baby is getting enough milk at the breast during feeding sessions to encourage them to continue to feed. If you feel you aren’t producing enough, a supplementary feeding device can be used (7). This is typically a bottle or bag that is filled with expressed breastmilk or formula that is worn around the neck. Tubes lead from the bottle/bag and are attached to the breast. This ensures that the baby will continue to get enough milk at the breast, making it so that they will continue to suckle at the subsequent feedings, further initiating the letdown reflex and hopefully producing more milk (7).
Final thoughts
Although breastfeeding can be an incredibly rewarding experience, it can also be challenging for many parents – whether you’ve induced lactation or not! It’s important to ensure you have support through this journey. If you feel unsure or are experiencing any issues, reach out to your doctor, lactation consultant, or otherwise for support and guidance.
References
1. Newman J. International Breastfeeding Centre: Inducing Lactation. 2017. [cited 2022 June 6] Available from: https://ibconline.ca/induction/
2. Anderson GH, Atkinson SA, Bryan MH. Energy and macronutrient content of human milk
during early lactation from mothers giving birth prematurely and at term. Am J Clin Nutr. 1981;34(2):258–65
3. Fusch G, Kwan C, Fusch C. Rapid measurement of human milk energy and macronutrients in the clinical setting. In: Human Milk. Academic Press; 2021. p. 191–231.
4. Cleavland Clinic. Lactation. 2021. [cited 2022 June 6] Available from: https://my.clevelandclinic.org/health/body/22201-lactation
5. Schnell A. Le Leche Legue: Breastfeeding Without Giving Birth. 2020. [cited 2022 June 6] Available from: https://www.llli.org/breastfeeding-without-giving-birth-2/
6. Kurke MA. I’m adopting a newborn, and I’d like to breastfeed the baby when I bring him home. Can I produce breastmilk if I haven’t been pregnant? 2021. [cited 2022 June 6] Available from: https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/induced-lactation/faq-20058403
7. Goldfarb L, Newman J. The Protocols for Induced Lactation: A Guide for Maximizing Breastmilk Production. 2007. [cited 2022 June 6] Available from: https://www.asklenore.info/breastfeeding/induced_lactation/protocols4print.shtml
