News

No, the CDC Hasn't Endorsed the Use of Powerful Drugs by 'Men Who Want to Breastfeed'

Both cisgender and transgender women have used domperidone, a drug not approved in the U.S., to induce lactation.

Published July 20, 2023

 (Tim Clayton - Corbis/Contributor, Getty Images)
Image Via Tim Clayton - Corbis/Contributor, Getty Images

In July 2023, claims began to spread online that infants were consuming drugs endorsed by the Centers for Disease Control and Prevention (CDC) that were being used by "men who claimed they could breastfeed."

"I woke up today to learn @CDCgov endorses using powerful drugs to induce nipple discharges in men who then claim they can "breastfeed," a Twitter post said on July 6, 2023. "PS: some of the drugs are then consumed by the infant. Yes, the CDC. Our tax dollars."

We found posts repeating these claims on other social media platforms, like TikTok, Facebook, and Reddit. Tabloid and conservative publications like the Daily Mail and The Post Millennial published articles making the same assertions, stating that guidelines for "men who want to breastfeed infants" had been "newly released" by the CDC. (Phrases like "men who claim they can breastfeed," "men who want to breastfeed infants," and "men who want to masquerade as women" were used in these articles and posts to sarcastically describe transgender women.) 

We found that several case studies have been published on trans women successfully inducing lactation, including a 2018 study (considered to be the first to focus on induced lactation in trans women), a 2021 study, and a 2023 study.

According to Them, both cisgender and transgender women have used domperidone, a drug not approved in the U.S., to induce lactation. According to the National Library of Medicine, no adverse effects have been found in a limited number of published cases of breastfed infants whose mothers were taking domperidone, which we will discuss in more detail below. 

We also learned that, at the time of this writing, the CDC doesn't endorse using powerful drugs to induce lactation. We found no mentions of domperidone on its website. The CDC does mention transgender people breastfeeding or chestfeeding on its website, but it's not new information. We found it had been on the website for years. 

How Do People Induce Lactation?

The articles promoting the claim that trans women used powerful drugs to induce lactation mainly focused on one medical protocol: the Newman-Goldfarb protocol. According to reputable publications like Them, both cisgender and transgender women have used the protocol to successfully induce milk and feed their infants. We reached out to experts to learn more about the procedure and will update this article if we hear back.

In the Newman-Goldfarb protocol, a birth control pill containing the steroid hormones progesterone and estrogen is taken by the person inducing lactation at the same time as domperidone, which is known to increase prolactin, the hormone involved in milk production. 

According to the International Breastfeeding Centre, it is recommended that a person inducing lactation stay on domperidone until the baby is born, and it is likely the person will need to continue taking domperidone until done with breastfeeding. The International Breastfeeding Centre's website says the person inducing lactation should be on the birth control pill for at least 16 weeks and continue until 6-8 weeks before the baby is born.

According to the Mayo Clinic, domperidone is generally used to increase the movements or contractions of the stomach and bowel. In the U.K., the NHS web page for the drug said that a doctor may prescribe it for people having trouble breastfeeding, but only if other options haven't worked. The Canadian Press wrote that domperidone had been marketed in Canada since 1985 for managing symptoms of gastrointestinal disorders. 

(On Health Canada's website, we found a safety and effectiveness review had been initiated for the drug in December 2022 for "withdrawal symptoms after stopping or reducing the dose of domperidone used to stimulate lactation." We reached out to Health Canada about the review, which told us that it is in the final stages of the safety review, and that domperidone products had not been authorized by Health Canada to use in lactation promotion.)

The FDA had not approved domperidone for use in the United States for any reason, as of this writing. This is due to potential serious health risks associated with the medication, specifically an increased risk of heart failure for at least some patients, according to Slate

As for any effect domperidone might have on infants, at the time of this writing, the National Library of Medicine stated in its entry about the drug:

Data available from 4 small studies on the excretion of domperidone into breastmilk are somewhat inconsistent, but infants would probably receive less than 0.1% of the maternal weight-adjusted dosage. No adverse effects have been found in a limited number of published cases of breastfed infants whose mothers were taking domperidone. 

Have Transgender Women Successfully Induced Lactation?

Several case studies have been published in which trans women were found to have successfully induced lactation, including a 2018 study considered to be the first case study to focus on transgender women, a 2021 study, and a 2023 study. We reached out to hormone experts about the claims and will update this article if we hear back.

The Newman-Goldfarb protocol wasn't mentioned at all in the 2018 or 2021 case studies, although domperidone was discussed in all three studies as a drug used to induce lactation. In addition to finding the transgender woman in question successfully induced lactation for her infant, the 2023 case study also found the participant's milk had "values of protein, fact, lactose, and calorie content at or above those of standard term milk."

All three case studies mentioned various future research into transgender women inducing lactation, including confirming robust macronutrient content in the 2023 case study and determining an optimal hormonal regimen in the 2021 case study.

There were also differences among the transgender women inducing lactation in the case studies. For example, the 2018 and 2021 case studies said transgender women needing androgen blockers was a difference between transgender and cisgender women inducing lactation. (According to Verywell Health, anti-androgen drugs are also known as testosterone blockers and are commonly prescribed to transgender women to block the effects of testosterone.) 

However, the 2023 case study said antiandrogen therapy wasn't indicated because of the participant's history of orchiectomy (surgical removal of the testicles, which can eliminate the need for testosterone blockers, according to Verywell Health).

What Is Listed On the CDC's Web Pages About Transgender People and Breastfeeding/Chestfeeding?

As for the claims about the CDC, we found no mentions of the Newman-Goldfarb protocol or domperidone on its web pages that discuss breastfeeding or chestfeeding. 

Many of the claims referred to two different pages on the CDC's website that are focused on breastfeeding. One page was titled "Breast Surgery," while the other was titled "Health Equity Considerations." 

On the CDC page titled "Breast Surgery," a section was dedicated to transgender and nonbinary parents who wanted to breastfeed or chestfeed their children. It said:

Can transgender parents who have had breast surgery breastfeed or chestfeed their infants?

If you have questions about infant nutrition or medications before and while breastfeeding, please consult with your healthcare provider. You can find more information on  medications and breastfeeding here and on the National Institutes of Health's Drugs and Lactation Database (LactMed®).

Yes. Some transgender parents who have had breast/top surgery may wish to breastfeed, or chestfeed (a term used by some transgender and non-binary parents), their infants. Healthcare providers working with these families should be familiar with medical, emotional, and social aspects of gender transitions to provide optimal family-centered care and meet the nutritional needs of the infant. These families may need help with the following:

  • Maximizing milk production
  • Supplementing with pasteurized donor human milk or formula
  • Medication to induce lactation or avoiding medications that inhibit lactation
  • Suppressing lactation (for those choosing not to breastfeed or chestfeed)
  • Finding appropriate lactation management support, peer support, and/or emotional support

Learn more about how to support transgender persons.

Benjamin N. Haynes, director of the Division of Media Relations at the CDC, said the information listed on the page was for informational purposes only in an email to Snopes. 

The other page titled "Health Equity Considerations" included a section on pronoun usage, as well as information about transgender or nonbinary people who give birth:

Pronoun Use

  • Ask which terms, names and pronouns are preferred by the individuals being supported.
  • When introducing oneself, announcing one's own pronouns may make it easier for others to share their pronouns.
  • If an individual corrects your pronoun use, it's best to briefly acknowledge the mistake and correct the pronoun going forward. Spending too much time apologizing for the error can bring more attention and discomfort to the simple mistake.

Remember that:

If you have questions about infant nutrition or medications before and while breastfeeding, please consult with your healthcare provider. You can find more information on  medications and breastfeeding here and on the National Institutes of Health's Drugs and Lactation Database (LactMed®).

  • Transgender and nonbinary-gendered individuals may give birth and breastfeed or feed at the chest (chestfeed). The gender identity or expression of transgender individuals is different from their sex at birth. The gender identity of nonbinary-gendered individuals does not fit neatly into either man or woman.
  • An individual does not need to have given birth to breastfeed or chestfeed.
  • Some families may have other preferred terminology for how they feed their babies, such as nursing, chestfeeding, or bodyfeeding.

According to the Internet Archive, the "Breast Surgery" page on the CDC website included the section for transgender and nonbinary parents since June 2018. The archive also showed the "Health Equity Considerations" page included information about pronoun usage as well as transgender and nonbinary people breastfeeding or chestfeeding since June 2022. 

There was no evidence the information on these pages was about any other group of parents besides transgender and nonbinary parents.

The Bottom Line

Several case studies have been published on transgender women successfully inducing lactation, including a 2018 case study considered to be the first to do so, a 2021 case study, and a 2023 case study.

Generally, the FDA has not approved the drug domperidone in the U.S. for any purposes, including inducing lactation, due to potential serious health risks associated with the drug. According to the National Library of Medicine, no adverse effects have been found in a limited number of published cases of breastfed infants whose mothers were taking domperidone. 

The CDC includes information about transgender people breastfeeding or chestfeeding on its web pages about breastfeeding/chestfeeding, but not any specific information about inducing lactation. The information contained on the CDC's website that addressed transgender and nonbinary parents breastfeeding or chestfeeding was not recently added. The CDC did not endorse using powerful drugs to induce lactation.

Sources

"About Domperidone." Nhs.Uk, 12 Apr. 2023, https://www.nhs.uk/medicines/domperidone/about-domperidone/.

Breast Surgery | Breastfeeding | CDC. 26 June 2018, http://web.archive.org/web/20180626032955/https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/breast-surgery.html.

CDC. "Breast Surgery." Centers for Disease Control and Prevention, 9 July 2023, https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/breast-surgery.html.

---. "CDC and Breastfeeding." Centers for Disease Control and Prevention, 13 Apr. 2023, https://www.cdc.gov/breastfeeding/index.htm.

---. "Health Equity Considerations." Centers for Disease Control and Prevention, 9 July 2023, https://www.cdc.gov/nutrition/emergencies-infant-feeding/health-equity.html.

"Domperidone." Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, 2006. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK501371/.

Domperidone (Oral Route) Side Effects - Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/domperidone-oral-route/side-effects/drg-20063481?p=1#:~:text=Descriptions,immediate%20supervision%20of%20your%20doctor. Accessed 19 July 2023.

Health Equity Considerations | Nutrition | CDC. 28 June 2022, http://web.archive.org/web/20220628150432/https://www.cdc.gov/nutrition/emergencies-infant-feeding/health-equity.html.

Inducing Lactation – International BreastFeeding Centre. https://ibconline.ca/induction/. Accessed 19 July 2023.

Nast, Condé. "Yes, Trans Women Can Breastfeed — Here's How." Them, 9 May 2018, https://www.them.us/story/trans-women-breastfeed.

"Orchiectomy: Definition & Recovery." Cleveland Clinic, https://my.clevelandclinic.org/health/treatments/21467-orchiectomy. Accessed 19 July 2023.

Reisman, Tamar, and Zil Goldstein. "Case Report: Induced Lactation in a Transgender Woman." Transgender Health, vol. 3, no. 1, Jan. 2018, pp. 24–26. PubMed Central, https://doi.org/10.1089/trgh.2017.0044.

Urquhart, Evan. "What the Freakout Over Trans Women Breastfeeding Is Really About." Slate, 17 July 2023. slate.com, https://slate.com/technology/2023/07/trans-women-breastfeeding-safe-mumsnet.html.

Wamboldt, Rachel, et al. "Lactation Induction in a Transgender Woman Wanting to Breastfeed: Case Report ." The Journal of Clinical Endocrinology & Metabolism, vol. 106, no. 5, Jan. 2021, pp. e2047–52, https://academic.oup.com/jcem/article/106/5/e2047/6123860.

"What to Know About Testosterone Blockers for Transgender Women." Verywell Health, https://www.verywellhealth.com/testosterone-blockers-for-transgender-women-4582221. Accessed 19 July 2023.

Izz Scott LaMagdeleine is a fact-checker for Snopes.