Have you struggled to find information on chest-feeding and lactation that isn’t gendered and geared exclusively to cisgender women? 

You’re not the only one! To tear down some of these barriers and tackle the most pervasive myths around chest-feeding, Family Equality sat down with International Board Certified Lactation Consultant and author, Jacob Engelsman, to talk about his book, Lactation for the Rest of Us: A Guide for Queer and Trans Parents and Helpers. 

Lactation for the Rest of Us sets out to do what no book has done before: Provide concrete, comprehensive information about lactation in a way that isn’t gendered or exclusionary. When Engelsman first got involved in lactation and postpartum work, he noticed that while there are a wealth of resources for chest-feeding parents and their partners, none are specifically geared towards the LGBTQ+ community at all. 

There were resources about lactating after chest reduction surgery that never mentioned the experiences of transmasculine people. There were resources about inducing lactation, that included lesbian parents but left out transfeminine people. Much of the information that did exist about the LGBTQ+ lactation experience was hidden in the jargon of academic journals. 

Engelsman’s book brings together those resources alongside stories from real parents and interviews with experts — and it’s a solid first step in accessing the resources LGBTQ+ families might need on this journey.

For anyone in need of more direct support, Engelsman tells us not to be afraid of seeking out telehealth care and to lean on the recommendations of their local LGBTQ+ community.

Much of Engelsman’s book is set up as a series of Frequently Asked Questions broken out by subject to help prevent the information overload that can be common for new and expecting parents. In the spirit of that work, we took time during our discussion to review the number one piece of advice he’d give to various people and partners involved in a lactation journey. 

“My number one piece of advice is that almost no babies are literally exclusively chest-fed or breast-fed. There’s this idea that there’s kind of an all or none thing, and that if your baby is ever given any formula at all, you’re doomed.” 

Engelsman goes on to emphasize that the most important thing for any baby is consuming the calories they need to stay alive. Too often, Engelsman notes, parents will lie about exclusively breastfeeding their babies because of the shame and stigma associated with using formula. He says, “If one of you would own up and say, ‘At some point my baby had some formula, and it wasn’t the end of the world,’ you would all be better off for it.” 

Regardless of whether your family is LGBTQ+, half of all parents are non-lactating. For those parents, Engelsman suggests simply asking what the other parent needs. 

“[Lactation] is only for a small percentage of a couple’s relationship and a child’s life…Just do whatever that person needs you to do.” 

“Decide what it is that you are willing to do to induce lactation,” Engelsman says. This might include taking herbs or medication or pumping for most of the day. He stresses that there is a serious time commitment to inducing lactation, so it’s good to do your research and jump in with your eyes wide open. 

In addition to smashing the myth that everyone is exclusively breastfeeding their babies, Engelsman acknowledges that one of the most pervasive myths for trans and nonbinary families is the idea that parents can’t take testosterone if they’re lactating. 

“[That] is just patently untrue,” he says. The research shows that taking testosterone might affect milk production — but it also might not. He points out that testosterone doesn’t affect milk quality at all because it’s a hormone that is not easily absorbed by the stomach. 

He allows for one small exception: “If you’re using gel, that’s a whole different story. Because you have testosterone on your hands and your chest [and you might get it on the baby].” 

Finally, he notes that if it does impact milk production, you can just stop. “It self regulates pretty quickly.” 

One of the biggest challenges for parents who are chest-feeding is navigating the highs and lows of the emotional journey. Parents are often staying up all hours of the day and night, sorting through reams of overwhelming and often conflicting information, and feeling pressure to do it all “right.” 

To navigate these challenges, Engelsman says, “No amount of milk makes up for having a clinically depressed parent. In the long run, it will be better for your baby for their parent to have good mental health than to be getting milk from them.” 

For some families, he notes, that’s a choice that needs to be made. 

Engelsman also advises parents to talk to each other about how they feel, to reach out to their community, and to do research. With lactation in particular, there’s a condition called Dysphoric Milk Ejection Reflex that might make a lactating parent depressed or nauseous during their let down. 

This is a hormonal shift, and simply knowing it exists is a crucial part of being able to work through it. 

FOR MORE: Watch the complete interview on Youtube, and don’t forget to purchase Lactation for the Rest of Us from your local bookstore today!