Induced breastfeeding is an option for those who did not get pregnant – 08/18/2023 – Equilíbrio

Shortly after their wedding in 2017, writer Marcela Tiboni, 41, and his wife, real estate consultant Melanie Graille, 34, began the process of in vitro fertilization. In the first attempt, which took place in January 2018, they were successful and more: they were twins, a boy and a girl.

“Since we work autonomously and would not be entitled to maternity leave, we thought about the possibility of both breastfeeding, which would give us more freedom and make us more relaxed if one of us had an appointment outside the home”, says Tiboni.

After researching the subject on the internet, they found the international lactation consultant Kely Carvalho, who knew a protocol that could be used to help those who did not manage to produce milk. “She knew the protocol, but hadn’t used it yet. That’s why she wanted to know if we accepted being the first experience and we agreed”, recalls the mother of Bernardo and Iolanda, who are currently 4 years old.

She says she started the medication and milk extraction protocol in June and, in September, she started having the first drops of milk. When the babies were born, in October, she was producing a large amount, which allowed the little ones to be nourished by both of them from the delivery room. They continued to breastfeed their children until they were two years old, as recommended by the World Health Organization (WHO).

Induced lactation is an option for all cases in which the person wants to breastfeed but is unable to do so naturally because they have not gone through pregnancy or have given birth for some time. “This includes cases of adoption, of homoaffective couples in which the mother who has not gone through the pregnancy also wants to participate in breastfeeding, and of trans and transvestite women, in addition to mothers who want to reintroduce breastfeeding. It is only not indicated for cis men, because it would be necessary to block testosterone, which is unethical”, says gynecologist and obstetrician Ana Thais Vargas, who specializes in the subject and is part of the Lumos Cultural team, made up of health professionals prepared to welcome families from pregnancy to infancy.

Digital influencer Erika Fernandes, 29, also managed to breastfeed her son Noah, who is now one year old. She is a trans woman who always wanted to have a child, but knew about her difficulties due to the fact that she went through the transition. She married a trans man and, after much discussion, he decided to face the pregnancy. “During this period I began to wonder how my baby could be breastfed, since the father had had a mastectomy [retirada das mamas]a process that affects the lactation ducts”, says the influencer. She started researching trans women who breastfeed and found little information.

Some time later, she met the Lumos Cultural team, who showed that this was a possible dream. They started treatment with the use of hormones and stimulation, simulating a pregnancy in her body about 3 to 4 months before giving birth and, to her surprise, after 20 days, she already started to show signs of lactation.

“The specialists said that my desire to breastfeed was so great that it helped to get my brain to stimulate this induction process and, therefore, I released a lot of oxytocin, one of the hormones that help with milk production. By the time I was due, I was already gushing the liquid and I was able to feed Noah for three months”, he remembers.

How is the protocol for milk production?

Kelly Carvalho, lactation consultant, also works at Lumos Cultural and explains that there are several protocols for this process in the literature, but the most used one is of Canadian origin. “It involves the use of hormones, such as estrogen and progesterone, herbal medicines galactagogue, a medicine that is not manufactured for that purpose, but which has the side effect of milk production. Plus, of course, a suction pump which mechanically stimulates the breasts and, thus, the production of prolactin, a hormone that stimulates the production of liquid”, explains the specialist.

Carvalho advises that this process begin in advance, that is, at least six months before the baby is born. “Up to eight weeks of life, the child has a better chance of latching on to the breast, as it has a reflex sucking function”, explains the breastfeeding consultant.

When it is not possible to specify when this baby will arrive, in the case of mothers via adoption, it is possible to stimulate this breast, but it is more difficult for this mother to be able to exclusively breastfeed, as this baby may already be a few months old and be using artificial teats, such as a bottle and pacifier, which can make it difficult to accept the breast.

In some cases, says the specialist, there is a need to carry out translactation, when a probe with infant formula is placed in the baby’s mouth next to the woman’s breast so that he stimulates this breast and she produces milk.

This whole process does not offer any burden to the health of the mother or the baby, but in order for her to undergo it, she must undergo a careful health assessment and medical follow-up. “Today we have more than 150 patients and we see that the risks they may face are the same as any breastfeeding mother, such as mastitis, fissures, low milk production and engorgement, when production is exaggerated”, says the doctor.

“And, as with everyone else, in addition to working on the production of the liquid, they will also have to go through the adaptation so that the baby learns to latch on and suck the nipples properly”, adds Carvalho.