PDF(Pubmed)
Abstract：
BACKGROUND: We present a case of non-puerperal induced lactation in transgender woman. Medical literature on lactation induction for transgender women is scarce, and the majority of literature and protocols on lactation induction is based on research in cisgender women. Healthcare professionals may lack the precise knowledge about lactation induction and may therefore feel insecure when advice is requested. Subsequently, there is a rising demand for guidelines and support.
METHODS: Patient medical record was consulted and a semi-structured interview was conducted to explore the motive for lactation induction, the experience of lactation induction, and to gather additional information about the timeline and course of events.
METHODS: In this case a 37-year-old transgender woman, who was under the care of the centre of expertise on gender dysphoria in Amsterdam, and in 2020 started lactation induction because she had the wish to breastfeed her future infant. She was in a relationship with a cisgender woman and had been using gender affirming hormone therapy for 13 years. Prior to initiating gender affirming hormone therapy she had cryopreserved her semen. Her partner conceived through Intracytoplasmic Sperm Injection, using our patient\'s cryopreserved sperm. To induce lactation, we implemented a hormone-regimen to mimic pregnancy, using estradiol and progesterone, and a galactogogue; domperidone. Our patient started pumping during treatment. Dosage of progesterone and estradiol were significantly decreased approximately one month before childbirth to mimic delivery and pumping was increased. Our patient started lactating and although the production of milk was low, it was sufficient for supplementary feeding and a positive experience for our patient. Two weeks after birth, lactation induction was discontinued due to suckling problems of the infant and low milk production.
CONCLUSIONS: This case report underlined that lactation induction protocols commonly used for cisgender women are also effective in transgender women. However, the amount of milk produced may not be sufficient for exclusive nursing. Nevertheless, success of induced lactation may be attributed to its importance for parent-infant bonding, rather than the possibility of exclusive chestfeeding.
METHODS: Patient medical record was consulted and a semi-structured interview was conducted to explore the motive for lactation induction, the experience of lactation induction, and to gather additional information about the timeline and course of events.
METHODS: In this case a 37-year-old transgender woman, who was under the care of the centre of expertise on gender dysphoria in Amsterdam, and in 2020 started lactation induction because she had the wish to breastfeed her future infant. She was in a relationship with a cisgender woman and had been using gender affirming hormone therapy for 13 years. Prior to initiating gender affirming hormone therapy she had cryopreserved her semen. Her partner conceived through Intracytoplasmic Sperm Injection, using our patient\'s cryopreserved sperm. To induce lactation, we implemented a hormone-regimen to mimic pregnancy, using estradiol and progesterone, and a galactogogue; domperidone. Our patient started pumping during treatment. Dosage of progesterone and estradiol were significantly decreased approximately one month before childbirth to mimic delivery and pumping was increased. Our patient started lactating and although the production of milk was low, it was sufficient for supplementary feeding and a positive experience for our patient. Two weeks after birth, lactation induction was discontinued due to suckling problems of the infant and low milk production.
CONCLUSIONS: This case report underlined that lactation induction protocols commonly used for cisgender women are also effective in transgender women. However, the amount of milk produced may not be sufficient for exclusive nursing. Nevertheless, success of induced lactation may be attributed to its importance for parent-infant bonding, rather than the possibility of exclusive chestfeeding.
摘要：
背景：我们介绍了一例变性女性非产褥期泌乳的病例。关于变性女性泌乳诱导的医学文献很少，大多数关于泌乳诱导的文献和方案都是基于对顺性女性的研究。医疗保健专业人员可能缺乏有关泌乳诱导的精确知识，因此在要求建议时可能会感到不安全。随后，对指导方针和支持的需求不断增加。
方法：查阅患者病历，进行半结构化访谈，探讨催乳动机，泌乳诱导的经验，并收集有关事件时间表和过程的其他信息。
方法：在这个案例中，一个37岁的变性女性，在阿姆斯特丹的性别焦虑专家中心的照顾下，并在2020年开始哺乳诱导，因为她希望母乳喂养她未来的婴儿。她与一位顺性女性有关系，并且已经使用性别确认激素治疗13年。在开始性别确认激素治疗之前，她已经冷冻保存了精液。她的伴侣通过胞浆内单精子注射怀孕，用我们病人冷冻保存的精子.诱导泌乳，我们实施了一种激素方案来模仿怀孕，使用雌二醇和孕酮，和半乳糖；多潘立酮。我们的病人在治疗期间开始抽水。孕酮和雌二醇的剂量在分娩前约一个月显着减少，以模拟分娩并增加泵送。我们的病人开始泌乳，尽管牛奶产量很低，这足以为我们的患者提供补充喂养和积极的体验。出生两周后，由于婴儿的哺乳问题和低产奶量，停止了泌乳诱导。
结论：该病例报告强调，顺性女性常用的泌乳诱导方案对变性女性也有效。然而,生产的牛奶量可能不足以进行独家护理。然而，诱导泌乳的成功可能归因于其对父母与婴儿之间的联系的重要性，而不是独家chested的可能性。
方法：查阅患者病历，进行半结构化访谈，探讨催乳动机，泌乳诱导的经验，并收集有关事件时间表和过程的其他信息。
方法：在这个案例中，一个37岁的变性女性，在阿姆斯特丹的性别焦虑专家中心的照顾下，并在2020年开始哺乳诱导，因为她希望母乳喂养她未来的婴儿。她与一位顺性女性有关系，并且已经使用性别确认激素治疗13年。在开始性别确认激素治疗之前，她已经冷冻保存了精液。她的伴侣通过胞浆内单精子注射怀孕，用我们病人冷冻保存的精子.诱导泌乳，我们实施了一种激素方案来模仿怀孕，使用雌二醇和孕酮，和半乳糖；多潘立酮。我们的病人在治疗期间开始抽水。孕酮和雌二醇的剂量在分娩前约一个月显着减少，以模拟分娩并增加泵送。我们的病人开始泌乳，尽管牛奶产量很低，这足以为我们的患者提供补充喂养和积极的体验。出生两周后，由于婴儿的哺乳问题和低产奶量，停止了泌乳诱导。
结论：该病例报告强调，顺性女性常用的泌乳诱导方案对变性女性也有效。然而,生产的牛奶量可能不足以进行独家护理。然而，诱导泌乳的成功可能归因于其对父母与婴儿之间的联系的重要性，而不是独家chested的可能性。
