Inclusive Lactation Care: Supporting All Parents in Their Lactation Journey

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August is National Breastfeeding Month and this year the United States Breastfeeding Committee has announced the theme to be “Together We Do Great Things!” With this theme in mind, we hope to spend the month not only celebrating the health care providers (doctors, nurses, midwives, lactation counselors) who support parents in their lactation journey, but also every parent who makes the choice to provide human milk for their child.

A key part of celebrating all lactating parents is to acknowledge that as our community continues to grow more diverse, so does the image of families and that of lactating parents. The most recent update to the American Academy of Pediatrics (AAP) Policy Statement on Breastfeeding and the Use of Human Milk (July 2022), for the first time begins to address the specific disparity in providing human milk among the gender diverse population.

In the state of Ohio 4.3% of the adult population (aged 18+) identify as a member of the LGBT community with 30% of these individuals currently raising children. Additionally, the largest demographic of LGBT-identifying individuals is 18-24, well within the reproductive age. When looking at individuals who identify as transgender, while a smaller percentage there is still a significant presence with 46,500 transgender Ohioans. Like the greater LGBT community, most of these individuals are either adolescent or within reproductive age with nearly 1 in 5 transgender individuals aged between 13-17 years, and 36% are transmen meaning that they could have preserved reproductive capability.

For these transgender or gender diverse individuals who maintain their ability to carry a child, many of the terms that are intrinsic within the lactation and human milk feeding environment can be seen as very cis-normative and female engendered, which can feel exclusionary or even triggering of feelings of gender dysphoria. This added stress can lead to poorer birthing experiences, less sense of bonding with the newborn, and increased mental health strain due to an apparent lack of support.

Fortunately, this can be alleviated by being aware of the words we use, particularly around lactation and human milk feeding when interacting with gender diverse parents. While the term “breast” may be anatomically correct regardless of biological sex, the genderfication of this term may have a negative connotation for transmasculine individuals who refer to that area of their body as their “chest” and therefore use the term “chestfeeding” to describe the act of directly feeding their infant from their body.

Other alternatives to common terms used in lactation and human milk feeding include:

• Parents instead of mother/father
• Human milk instead of breastmilk
• Milk pump instead of breast pump
• Non-nutritive suckling instead of non-nutritive breastfeeding

If unsure of what terms to use, the simplest thing to do is to ask:

• What do you expect your new baby to call you? your partner?
• How do you intend to feed your baby?

By making these small changes we can ensure that gender diverse parents feel welcome, seen, and respected as they navigate their lactation and human milk feeding journey.