The human body possesses the remarkable capacity to produce milk even without the hormonal triggers of a recent pregnancy. This process, known as induced lactation, offers a pathway for individuals who have never been pregnant or given birth to establish a milk supply. This option is pursued for a variety of personal and family-building reasons.
What Induced Lactation Means
Induced lactation is the process of initiating milk production in a person who has not been pregnant or lactated before. This is distinct from relactation, which is the re-establishment of a milk supply after a person has previously lactated and then ceased milk production. Induced lactation starts from a non-lactating state, often requiring more intensive preparation.
Motivations for pursuing induced lactation include adoptive parents who wish to nurse their new baby, parents utilizing a surrogate, or the non-birthing partner in a same-sex couple. Induced lactation allows these parents to share the intimate experience of nursing and provide human milk to their child.
The Physiological Requirements for Milk Production
The body’s ability to produce milk is dependent on a specific sequence of hormonal events, which must be simulated during induced lactation. The initial phase is the development of the mammary gland. High levels of estrogen promote the growth of the milk ducts, while progesterone stimulates the formation of the alveoli, the small sacs where milk is produced.
The second phase, milk synthesis, is triggered by the hormone prolactin. During pregnancy, high levels of progesterone suppress the action of prolactin, preventing the body from making milk prematurely. Once the placenta is delivered, this hormonal block is removed, allowing prolactin to stimulate the milk-producing cells.
Finally, the release of milk requires oxytocin, which causes the myoepithelial cells surrounding the alveoli to contract. This contraction pushes the milk into the ducts, a process known as the milk ejection reflex. Induced lactation protocols must artificially replicate the high levels of estrogen and progesterone to prepare the breast tissue, followed by a sudden reduction to remove the suppressive effect and allow prolactin to initiate milk production.
Standard Protocols for Inducing Milk Supply
The typical approach to induced lactation involves a two-stage process: hormonal priming and mechanical stimulation. The initial phase, hormonal priming, is designed to mimic the effect of pregnancy on the mammary glands. This often involves taking a combination oral contraceptive containing estrogen and progesterone for several months to encourage ductal and alveolar growth.
Some protocols, such as the Newman-Goldfarb protocol, also incorporate a galactagogue, such as domperidone, alongside the oral contraceptive. This medication works by increasing the levels of prolactin, the milk-making hormone. This phase can last from a few weeks to six months, depending on the timeline available before the baby’s arrival.
The second stage begins approximately six weeks before the expected arrival of the baby, when the hormonal priming is stopped. Cessation of the estrogen and progesterone components simulates the drop in these hormones. At this point, the parent begins an intensive schedule of mechanical stimulation using a breast pump.
The pumping schedule is critical and typically requires 8 to 12 sessions per 24 hours, including at least one session during the night when prolactin levels naturally peak. This frequent stimulation drives the production process forward. Skin-to-skin contact, even before milk appears, helps to further encourage the release of oxytocin, which aids in milk flow and strengthens the parent-child bond.
Realistic Outcomes and Timelines
Establishing a milk supply through induced lactation is a process that requires time and consistency. It may take several weeks of stimulation before the first drops of fluid appear. A measurable milk supply is typically not established until several months into the pumping regimen.
The volume of milk produced varies widely among individuals and is not guaranteed to meet a baby’s full nutritional needs. Some parents achieve a full milk supply, while others produce a partial supply that requires supplementation with formula or donor milk. Even a partial supply is beneficial, as any amount of human milk provides health benefits to the infant.
It is important to manage expectations, focusing on the bonding and comfort aspects of nursing in addition to the volume of milk. Many parents use a supplemental nursing system, which allows the baby to receive formula or donor milk through a thin tube while simultaneously stimulating the breast. This technique ensures adequate nutrition while reinforcing the nursing relationship.