The word is getting out!  Appreciation of the importance of breastfeeding is increasing while at the same time families are growing in more diverse ways.  While adoption has been around for a very long time, more families are growing via gestational surrogacy.  The number of LGBTQIA+ parents is also growing.  The result is more non-birthing parents with various gender identities and diverse hormonal and anatomical characteristics are interested in inducing lactation…and in some cases co-breastfeeding. Creating lactation without pregnancy and birth for a diverse population can pose some new challenges for lactation professionals. Fortunately, for each of the obstacles we may face supporting these extraordinary parents, there are solutions – many of them drawing from the skills we already have to support the wide variety of birthing parents we regularly encounter.

Are you an inclusive lactation provider?  Co-nursing — also called co-breastfeeding or co-lactation — involves sharing lactation and/or breastfeeding relationship between two or more LGBTQIA+ parents.  This presentation explains why parents might choose to co-nurse … although if you’ve ever been the only nursing parent in a family with a baby waking up multiple times during the night you probably already have some idea! But when research and general knowledge about lactation revolve around one person breastfeeding a baby, it can be difficult to know how to navigate a shared breastfeeding relationship.  How to establish sufficient lactation between parents?  How to balance parental roles when both breastfeed?  Will baby develop a preference for breastfeeding with one parent over another?  This presentation draws on the experiences of many co-nursing couples to serve as a guide for successful co-nursing for queer families.

Exclusive feeding directly from the breast or chest is not always available.  Common reasons for this include a baby who is unable to effectively remove milk from the breast/chest or a parent who is not producing enough milk to meet baby’s needs.  A nursing supplementer – or supplemental feeding tube device as it is often referred to in journals – can serve as an “external milk duct” providing plenty of extra flow when baby needs an easier flow or parents need an increased flow.  A nursing supplementer can help preserve the breastfeeding relationship and increase milk production.  So why isn’t it used more often?  It can be challenging to use, especially at first.  As a lactation consultant who specializes in working with parents inducing lactation, Alyssa has seen the struggles and successes using a nursing supplementer first-hand.  In this presentation she shares her professional experience and the wisdom of the research to help other lactation professionals support clients with this incredible tool for supporting long-term breastfeeding outcomes.

Too much supplementation means baby is getting less of the parent’s own milk, and eventually less milk production for the parent.  Too little supplementation means baby is not fed enough.  So how to find that juuuuust right amount?  Or even to determine whether supplementation is really necessary?   And, when necessary, how to supplement in a way that preserves long-term breast/chestfeeding outcomes?  This presentation can serve a guide for if, when, how and how much to supplement direct breast/chestfeeding with additional human milk or infant formula.

Inducing lactation for adoptive, intended (via surrogacy) or non-gestational LGBTQIA+ parents – just like any other lactation issue we support – should not be approached with a “one size fits all” protocol.    Parents vary in their need or preference to avoid certain methods, present with diverse hormonal and anatomical characteristics (think PCOS, post-menopause, trans woman, or intersex), may have irregular time or unknown timelines for their babies’ arrival (almost always the case with adoption), and usually have a long-term need for supplementation.  We can offer a flexible and customizable approach to inducing lactation that meets the needs of the individual.  Sound complicated?  Actually, when broken into three basic steps, inducing lactation has much in common with some familiar lactation issues facing the gestational parents we already regularly support.

Every parent deserves the opportunity to breastfeed – even if that parent did not birth their baby.  And as professionals, it is important to recognize that these parents will come to us with some unique needs and circumstances.  They are likely to have health histories that are different than gestational parents.  They may have difficult feelings about their path to parenthood or a non-conforming gender identity. The timing of their baby’s arrival may be unknown until weeks or days beforehand.  They may be sharing the breastfeeding/chestfeeding relationship with a partner.  They can expect to need to supplement their milk production.  And of course, they won’t have the hormones of pregnancy to initiate lactation.  Understanding as best we can the unique needs of these extraordinary parents can go a long way towards being an inclusive lactation practice.

Many lactating parents rely on a breast pump to help provide milk for their babies when they are separated or not feeding directly from the breast/chest for other reasons. Some of these parents may find pumping uncomfortable. Many others have difficulty expressing enough milk to meet their babies’ needs. There are also those who produce an overabundance of milk while pumping. This session addresses all of these parents by providing ideas for making pumping as effective, efficient, and comfortable as possible.

When is it too late to breastfeed a baby? Sometimes parents regret the decision not to breastfeed. Sometimes they discontinue breastfeeding and feel it was too soon. For various reasons, parents may wish to resume lactation.  Although it isn’t as easy to make milk without the hormones of pregnancy kicking things off, it is very possible for parents who haven’t lactated for days, weeks, or months to begin to produce milk once again.  This presentation was developed to help the listener understand when and why a parent may wish to relactate, what to expect, and the specific tools and techniques to resume milk production.

Newborn babies are hardwired for breastfeeding:  their newborn instincts direct them to latching at the breast/chest.  But what about older babies who are currently exclusively bottle-feeding – can they learn to breastfeed too?  A birthing parent may wish to initiate or resume breastfeeding after choosing not to breastfeed or discontinuing breastfeeding.  An adoptive or foster parent may be placed with an older baby or toddler whom they wish to nurse.  With patience, persistence, support, and some tools and tricks, it can be possible.  This presentation discusses how to know if baby is ready to breastfeed, setting the stage for success, and the process of gentle transitioning from bottle to breast/chest.

When a parent is unable to meet her baby’s needs with her own milk, milk donated by another nursing parent may be an option. Parents have always quietly, informally received donated milk from family members and friends. Recently, parents are connecting via the internet with nursing parents they have never met who are willing to donate their surplus milk to another baby in need. Milk donors are not screened, the milk is not pasteurized, and the handling and storage of the milk is not monitored. As a result, it is essential that parents take precautions whenever accepting donated milk. This session takes a close look at the concerns regarding milk sharing and how parents can minimize the risks involved.

According to research collected by the U.S. Surgeon General, the support of the breastfeeding partner is one of the most important factors for breastfeeding success. Dads and other breastfeeding partners can support breastfeeding success by providing emotional support, gathering resources, helping the nursing parent get comfortable, provide nurturing, and more.  This session also addresses common concerns of the breastfeeding partner, including suggesting ways the partner can bond with the baby without bottle-feeding so as not to disrupt breastfeeding in the early days.