Key Messages

• No standardized protocol for inducing lactation currently exists.

• A standardized protocol for inducing lactation may not reflect the diversity of parents’ health, fertility,
or lactation histories; circumstances and timing of babies’ arrivals; and parents’ goals and values.

• The Three Step Framework for Inducing LactationTM is flexible and customizable for the individual needs of each family. The International Board Certified Lactation Consultant® (IBCLC)
can use this model to develop an individualized inducing lactation protocol for each client.

Introduction: With cultural and social evolution and improvements in reproductive technology, an increasing number of babies are born to lesbian, gay, bisexual, transgender, intersex, queer and/or questioning, and asexual and/or ally parents. As parental roles and gender expression become more expansive, the role of breastfeeding a baby must naturally also expand to include the option of sharing of breastfeeding among parents, called co-lactation (Bamberger & Farrow, 2021). In most cases, co-lactation involves a gestational parent and a non-gestational parent. If a non-gestational parent desires to produce milk for the purpose of breastfeeding, they do so by inducing lactation. While interest in and research about induced lactation are developing quickly, little information is currently available about co-lactation.

Main Issue: A couple identifying as queer presented with concerns about inducing lactation in the non-gestational parent, as well as seeking assistance in managing a successful sharing of the breastfeeding relationship.

Management: Breast massage, milk expression, acupuncture, hormone therapy, and galactagogues, including domperidone, goat’s rue, and malunggay (moringa oleifera) were used to initiate and establish lactation by the non-gestational parent. Parents shared the breastfeeding relationship equally and carefully managed milk expression when the other parent was breastfeeding to maintain or increase lactation.

Conclusion: With professional lactation support, commitment to a lactation plan, responsive parenting, and strong communication and cooperation between parents, two parents were able to successfully co-lactate for more than a year. Breastfeeding was shared equally and supplementation of breastfeeds was rarely needed.