It is possible to breastfeed without having given birth through a process called induced lactation, also known as non-puerperal lactation. This process relies on artificially stimulating the body’s natural physiological pathways to encourage the mammary glands to produce milk. Induced lactation is often pursued by non-gestational parents, adoptive parents, or those using a surrogate, and it requires a dedicated, multi-step approach.
This method mimics the hormonal changes of pregnancy and childbirth to prepare the breasts for milk production. The goal is to trigger the full hormonal cascade that occurs over nine months, followed by the hormonal shift that initiates milk production. This allows a parent who has not given birth to establish a nursing relationship with an infant.
The Hormonal Foundation for Lactation
Lactation is a complex biological process orchestrated by several hormones that work in sequence to develop the milk-producing structures within the breast. During pregnancy, estrogen and progesterone prepare the mammary glands. Estrogen promotes the growth of the milk ducts, which are the pathways for milk delivery, while progesterone stimulates the formation of the alveolar-lobular system, where milk is produced.
Prolactin levels also increase significantly during pregnancy, stimulating the milk-producing cells (lactocytes) to begin the initial production of colostrum. However, the high levels of estrogen and progesterone circulating during pregnancy act as an inhibitory block, preventing prolactin from initiating large-volume milk secretion.
The shift from preparation to production occurs after birth. The delivery of the placenta causes a sudden drop in estrogen and progesterone levels. With this inhibitory block removed, high levels of prolactin trigger the onset of copious milk production.
The physical act of nursing or pumping introduces the final hormonal mechanism. Nipple stimulation sends signals to the brain, which releases more prolactin to ensure milk synthesis for the next feed. The brain also releases oxytocin, which causes the “let-down” reflex. Oxytocin causes the small muscles around the milk-producing cells to contract, pushing the milk out through the ducts and making it accessible to the infant.
Protocols for Inducing Milk Production
The process of induced lactation typically attempts to replicate the hormonal environment of pregnancy and the subsequent shift to postpartum milk production. This involves a multi-month protocol using both pharmacological and mechanical stimulation. The Newman-Goldfarb protocols are a widely recognized framework designed to maximize milk production for non-gestational parents.
The first phase is hormonal priming, which uses medications to mimic the effects of pregnancy. A monophasic oral contraceptive pill, containing estrogen and progesterone, is commonly taken for several months. This promotes the structural development of the milk ducts and glandular tissue, simulating the breast changes that occur during gestation.
A person may also be prescribed a galactagogue, a medication that helps to increase prolactin levels. Domperidone, a drug primarily used for gastrointestinal issues, is often used off-label for this purpose because it raises prolactin levels as a side effect. This combination simulates the necessary pre-birth hormonal state.
The second phase begins when the individual stops taking the estrogen and progesterone, typically six to eight weeks before the baby’s expected arrival. The abrupt cessation of these hormones mimics the rapid drop that occurs after placental delivery, signaling the body to begin milk secretion.
Mechanical Stimulation
At this point, the mechanical stimulation phase begins, which is essential for establishing and building a supply. This involves frequent, scheduled use of a hospital-grade double electric breast pump. Pumping is recommended every two to three hours during the day and at least once during the night to take advantage of the natural peak in prolactin levels that occurs in the early morning. The frequent emptying of the breasts is the primary signal for the body to produce more milk, operating on a supply-and-demand basis.
Milk Supply and Nutritional Expectations
The outcome of induced lactation is variable regarding the volume of milk produced. While some parents achieve a full milk supply, many produce a partial supply, meaning they will need to supplement with donor milk or formula. The amount of milk produced depends on factors like the length of time spent on the induction protocol and the consistency of the pumping schedule.
Despite the potential for lower volume, the nutritional quality of the milk produced through induced lactation is generally comparable to milk produced after a biological birth. The macronutrient composition—the levels of protein, fat, and carbohydrates (lactose)—is conserved. These components, which provide the bulk of the infant’s energy and growth material, are present in similar concentrations.
The main difference lies in the immune factors, specifically colostrum. Colostrum is rich in immune-protective components like secretory Immunoglobulin A (IgA). While induced lactation can produce a fluid that resembles colostrum, the exact profile of immune cells and antibodies may be different or absent.
Supplementation is a common part of the feeding plan for a baby receiving an induced milk supply. Parents can use a supplemental nursing system, which delivers formula or donor milk through a thin tube attached to the breast while the baby is nursing. This method allows the baby to receive a full feeding while simultaneously stimulating the breast, which helps to build the milk supply and maintains the nursing relationship.