Did a Man Really Breastfeed a Baby?

There are reasons to doubt it

By William M Briggs Published on February 17, 2018

A paper in the journal Transgender Health reports that a man injected with a myriad of chemicals was able to temporarily breastfeed a baby.

The press is reporting the event .. enthusiastically. For instance, The Guardian calls the event a “breakthrough.”

There are reasons to doubt the study, however, as we shall see.

Reported Details

Here are the salient details. A thirty-year-old man desirous of breastfeeding presented at the Mount Sinai Center for Transgender Medicine and Surgery.

The man at that time was in a “feminizing hormone regimen,” taking spironolactone, estradiol, and micronized progesterone. He was also taking occasional clonazepam for a “panic disorder” and zolpidem for insomnia.

Presumably because of the long use of hormones, and without augmentation surgery, the man’s breasts appeared well developed.

To induce lactation, the researchers:

(1) increased estradiol and progesterone dosing to mimic high levels seen during pregnancy, (2) use of a galactogogue [a lactation-inducing drug] to increase prolactin levels, (3) use of a breast pump with the speculation that it would increase prolactin and oxytocin levels, and (4) subsequent reduction in estradiol and progesterone levels, with the intention of mimicking delivery.

Potentially Dangerous Drugs

The galactogogue was domperidone, which is banned in the United States. The FDA said:

The serious risks associated with domperidone include cardiac arrhythmias, cardiac arrest, and sudden death. These risks are related to the blood level of domperidone, and higher levels in the blood are associated with higher risks of these events. Concurrent use of certain commonly used drugs, such as erythromycin, could raise blood levels of domperidone and further increase the risk of serious adverse cardiac outcomes.

Domperidone is used ordinarily as a digestive aid. A listed side effect is “swelling of the breasts or discharge from the nipple in men or women.”

The man was able to secure domperidone from Canada.

How Much Milk?

After one month of treatment, the man “was able to express droplets of milk”. His drug dosages were increased. After three months of treatment “the patient was making 8 oz [one cup] of breast milk per day.”

The baby in question finally arrived weighing 6 pounds, 13 ounces.

Here are the reported results:

The patient breastfed exclusively for 6 weeks. During that time the child’s pediatrician reported that the child’s growth, feeding, and bowel habits were developmentally appropriate. At 6 weeks, the patient began supplementing breastfeedings with 4-8 oz of Similac brand formula daily due to concerns about insufficient milk volume. At the time of this article submission, the baby is approaching 6 months old.

Suspicions

This is where we should suspect we haven’t learned the whole story.

This is where we should suspect we haven’t learned the whole story.

Newborn babies weighing 6-7 pounds require about 14-17 ounces of breast milk per day. This is double what the paper reports the man could produce.

Normally developing babies at six weeks need somewhere north of 24-30 ounces of milk daily. The paper reports the baby’s diet was only then supplemented by 4-8 ounces of formula. This means the man must have consistently been producing at least 20 ounces of milk per day!

No paper offers no details of the content of the man’s lactation. Was it mostly water? How much fat? How much lactose? Did it differ in any way from a new mother’s normally produced milk? This is a most curious, even glaring, omission from a medical study of a breakthrough in male lactation.

We also hear nothing about the baby except a second- or third-hand account from a pediatrician. The paper does not claim to have growth information directly from the pediatrician. Was it a self-report from the man?

No chart of the baby’s weight-gain is given. No blood work is reported. This would be considered a stunning oversight in a normal medical paper. It is not as if blood work couldn’t be done. Blood work of the man’s feminine hormones was reported through time.

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Possibilities

Non-puerperal (not-due-to-childbirth) induced lactation has been reported in women. Success rates to full milk production vary, but range between 31-90%. This must be less in men. Recall too that women typically produce more milk than babies need.

Males do have the rudiments of tissue in their breasts that might allow some lactation with hormone treatment. But no research to this date suggests a man can produce enough milk to feed a baby. It’s an open question whether the milk from lactating men matches on average the content (lactose and so on) of women.

Not the Last Word

There are potential dangers in male lactation. The man took “spironolactone while breastfeeding for androgen blockade.” A metabolite of spironolactone is cancrenone, which is excreted in breast milk. It “has been reported to have tumorigenic potential in rats.” The amount passed is “thought to be clinically insignificant.”

The New York Times reports on the study authors. Tamar Reisman is a physician at Mount Sinai. Zil Goldstein is a nurse practitioner and “transgender activist.”

We have not heard the last word on this research.

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