For the past few months I’ve been successfully lactating, based loosely on the Newman Goldfarb Protocol:
https://www.asklenore.info/breastfeeding/induced_lactation/protocols4print.shtml
Where to get Domperidone?
I couldn’t find a lactation protocol adapted specifically for Trans women, so I kept my base HRT regiment the same while adding Domperidone, acquired from a source on https://hrt.cafe Note that Domperidone is basically illegal in the USA and you cannot get it with a prescription at a pharmacy in the USA; although with a prescription from a doctor in the USA you can acquire Domperidone from a Canadian pharmacy; it was easier and cheaper to source Domperidone “illegally”.
My Lactation Protocol
I started by taking 10mg Domperidone 3x daily, about every 6 hours (8 hours un-medicated sleep), for the first week. The second week I went up to 5x daily, about every 3 hours (8 hours un-medicated sleep). I had a hard time increasing the number of dosages after the second week, so I began taking 2x 10mg Domperidone at a time. I took 20mg Domperidone about every 6 hours (8 hours un-medicated sleep). After a couple of weeks I began to lactate, though it was somewhat underwhelming.
I kept up the medication schedule of 20mg Domperidone every 6 hours (3x daily) for several months. Over time my breast milk yield increased to the point that I could breast feed partners and also spray milk from my breasts using my hands. I expect I could continue to increase my yield over many months; however, one of the side effects of Domperidone is dry mouth; medications that cause dry mouth I tend to develop mouth sores on, which is what I continuously fought against using oral peroxide rinse, dry mouth rinse, lozenges, etc. Eventually I developed mouth sores that were resistant to healing and decided to stop taking Domperidone before my supply was used up.
Additionally Domperidone acts as an anti psychotic, so my mood tended to be more stable throughout the duration of the lactation protocol. During the first week I had mood struggles and heart palpitations/arrhythmia when trying to sleep. Prolactin also has an effect of increasing insomnia. Overall I just felt increasingly run down with minor muscle aches, poor sleep, mouth sores, etc. I don’t believe I would be able to continue the protocol for any substantially long duration.
In an attempt to increase my milk yield, I took Fenugreek for a short time. This caused all body odor to have a sickly sweet maple syrup smell. Honestly the smell was so potent that I had to discontinue Fenugreek due to how sick I felt from the constant smell of maple syrup.
Discontinuing Domperidone
To discontinue Domperidone I basically just stopped for 1 day, then the next day took a single 20mg dose, then stopped completely. I did this primarily because of heart arrhythmia/palpitations I had on other anti psychotic medications when stopping historically. The medical guidance on tapering Domperidone is mixed; some saying a gentle taper should be used and others stating you can simply stop.
The cost of Domperidone?
The cost of domperidone was roughly $75 USD and it took a couple of weeks to be delivered via USPS. During the time of lactation I was taking 200mg oral Progesterone and Estradiol Valerate injections; roughly equivalent to an average of 300 pg/mL serum estradiol (as I’m on monotherapy). https://transfemscience.org/articles/e2-equivalent-doses/
Modulating HRT Protocol
A few weeks into taking domperidone I stopped taking Progesterone because Prolactin is a gonadotropin; helping to suppress the generation of testosterone from my testicles. I also skipped a couple of doses of Estradiol Valerate on and off for the same reason. Neither adjustment seemed to affect milk production in any noticeable way.
Speculations about Lactation and Breast Development
I’ve read many speculations that some cis women do not achieve a Tanner 5 breast stage before breast feeding/pregnancy. Personally being almost 40 years old at the time of this writing, but only on HRT about 2.5 years; I wished my breasts had more “fall” or were more “saggy” rather than so “perky”. I’ve also been stuck at tanner stage 4 for maybe the past year; based upon raised nipple mounds; a sign of Tanner 4 for about half of cis women.
Certainly the conical shape and volume of my breasts were increased during lactation; honestly to the extent that in pictures I was more satisfied with how my breasts looked. Post lactation, as my breasts “dry up”, they are certainly more “deflated” or “saggy” looking. I am marginally more satisfied with the look of my breasts post lactating for about 3 months.
Frustrations and Observations About Lactation
- It kind of sucks that Domperidone is the most safe and effective way to evoke lactation… the side effects of other medications are even more intolerable. You cannot purchase/acquire a human prolactin to directly induce lactation.
- Part of my lactation journey was a desire to share the experience with someone wanting to play “baby” while I played “mommy”. Although I breast fed partners, it was largely in a sexual context and was fairly short lived in duration. I suspect the only way to truly scratch this maternal itch would be to actually breast feed a baby. Because I take Dutasteride, I was not comfortable with the idea of finding a baby to breast feed.
- Something people probably don’t think/know about is that HIV/AIDS virus can be transmit via breast milk. I was screened before and during lactation and was negative, but sharing breast milk is a fairly high risk activity for the receiver.
- Some part of me wishes I could have produced more of an abundance of breast milk, though my overall yield was acceptable to have a sense of accomplishment and satisfaction.
- I had an immense sense of relaxation as people breast fed. The oxytocin going to my brain was the most relaxing experience I’ve ever had.
- Although the shape of my breasts changed somewhat from lactation, it would have been nice if the development changes were higher.
- I suspect if I had a baby latching several times a day and feeding for long periods of time, I would have produced a lot more milk supply.
- I was quite annoyed at the number of people who were surprised that being “male” (assigned male at birth) I could successfully lactate. I had to constantly explain that all mammals can lactate. Trans women may be women, but almost everyone is fixated on bio essentialism.
Should all Transfeminine People Induce Lactation for Breast Development?
Did lactation get me to a Tanner 5 in breast development? I’m honestly not sure. Should lactation be a standard protocol for Transfeminine people? I’m honestly not sure…
I have no regrets about undergoing a lactation protocol and may do it again at some point in the future. It seems to simply require taking Domperidone without any adjustments to HRT regimen. Certainly the side effects were challenging for me personally, but I tend to be intolerant of many medications.
Cheers