Inducing Lactation and Relactation
As an IBCLC, I hold an internationally recognized clinical credential in lactation care. My scope of practice is defined and specific: I support the parent-child feeding relationship. Everything I do — from building a pumping protocol to coordinating with your endocrinologist or prescriber — is in service of getting milk to your baby. Lactation work involves the body in intimate ways, as does a lot of healthcare. My role is clinical, evidence-based, and always centered on infant nutrition.
Lactation is a precipitous event that is driven by hormones, which means that anyone with the right hormone makeup can lactate! Isn't that amazing?
The two big players are prolactin (the milk-making hormone) and oxytocin (the milk-releasing hormone). When prolactin goes up, your body gets the signal to produce. When oxytocin fires, the milk lets down. That's the whole engine.
So when you picture the pregnant woman giving birth and bringing baby to breast, what is happening is a pretty narrow — if extremely common — scenario of all the available options for making breastmilk.
Sometimes even in that scenario, milk is hard to come by because the proper hormonal channels are blocked or inaccessible.
But what if you have the anatomy of female but never were pregnant?
What if you are trans, and want to feed your child?
What if you were making milk, but stopped and want to start again?
These are all scenarios where you might elect to bring on lactation through exogenous means, and you can, because science is COOL and the body is AMAZING.
A few things worth knowing about each of these paths:
Inducing lactation for adoption or surrogacy: If you're adopting or using a surrogate, the ideal scenario involves advance preparation — hormonal priming and breast stimulation through pumping before baby arrives. Full exclusive supply is often not the outcome, and that's okay. Many people use a supplemental nursing system (SNS) at the breast so baby gets the feeding experience while supplementing with donor milk or formula. Research shows that breast stimulation is the one non-negotiable — it shows up in every successful case of induced lactation, whether or not medications are involved.
Trans women inducing lactation: Published case reports have documented trans women successfully inducing lactation using estrogen, progesterone, and breast pumping, with some achieving several ounces per day. When the milk was analyzed, its macronutrient content was comparable to typical human milk. This is real, it is documented, and it is powerful.
Trans men and chestfeeding: If you've been on testosterone, it may suppress milk production, and current guidance recommends completing chestfeeding before resuming testosterone. Even after top surgery, lactation may still be possible with the right support and devices. These are conversations worth having with your provider early.
Co-nursing: In same-sex couples, the non-gestational parent can induce lactation too. Same principles apply — hormonal support and breast stimulation.
Relactation: If you were making milk and stopped, research shows milk secretion returned in roughly 65% of people who had completely weaned, with first drops appearing around days 6–9 on average. A shorter gap since weaning increases the chance of success. And here's something I love from the research: people who focused on the relationship rather than the volume had better outcomes. That tracks.
A note on medications: There are pharmaceutical galactagogues — medications that can boost prolactin and help bring in milk. In the US, the main option is metoclopramide, which is sometimes used off-label. Domperidone, which is widely used internationally, is NOT available in the United States — the FDA issued a safety warning and import alert due to cardiac risks including dangerous heart rhythm changes. It is not legally obtainable here except under very narrow research exceptions. Herbal galactagogues like fenugreek, fennel, and milk thistle are also commonly used, though the evidence on their effectiveness is mixed. Current guidelines say galactagogues should never be the first step — optimizing latch, frequency, and breast stimulation comes first. Always work with your medical provider on any medication decisions.
Setting realistic expectations: Full exclusive milk supply through induced lactation is the exception, not the rule. Partial breastfeeding with supplementation is the more common — and completely valid — outcome. The marathon metaphor is real: this takes time, patience, and support. But the destination is worth it for those who choose this path.
All IBCLCs are trained about inducing lactation and relactation, but many never see it in their whole careers.
I have guided many people through inducing lactation and relactating. While I cannot dispense hormones or other medications, I can help you ask your provider the right questions and I can prepare a training plan for your body to prime it to make milk.
I still remember being a young lactation consultant and being absolutely blown away when our client came into clinic for her pumping appointment. She was inducing lactation for an adopted baby, and after 9 months of effort (and some help from an endocrinologist) she was dripping milk. The elation that she felt was bigger than I had experienced. This person ran a marathon and then did a long hike and got to this nebulous place that few understand is even an option — lactation without birth.
Lactation is a precipitous event that is driven by hormones, which means that anyone with the right hormone makeup can lactate! Isn't that amazing?
The two big players are prolactin (the milk-making hormone) and oxytocin (the milk-releasing hormone). When prolactin goes up, your body gets the signal to produce. When oxytocin fires, the milk lets down. That's the whole engine.
So when you picture the pregnant woman giving birth and bringing baby to breast, what is happening is a pretty narrow — if extremely common — scenario of all the available options for making breastmilk.
Sometimes even in that scenario, milk is hard to come by because the proper hormonal channels are blocked or inaccessible.
But what if you have the anatomy of female but never were pregnant?
What if you are trans, and want to feed your child?
What if you were making milk, but stopped and want to start again?
These are all scenarios where you might elect to bring on lactation through exogenous means, and you can, because science is COOL and the body is AMAZING.
A few things worth knowing about each of these paths:
Inducing lactation for adoption or surrogacy: If you're adopting or using a surrogate, the ideal scenario involves advance preparation — hormonal priming and breast stimulation through pumping before baby arrives. Full exclusive supply is often not the outcome, and that's okay. Many people use a supplemental nursing system (SNS) at the breast so baby gets the feeding experience while supplementing with donor milk or formula. Research shows that breast stimulation is the one non-negotiable — it shows up in every successful case of induced lactation, whether or not medications are involved.
Trans women inducing lactation: Published case reports have documented trans women successfully inducing lactation using estrogen, progesterone, and breast pumping, with some achieving several ounces per day. When the milk was analyzed, its macronutrient content was comparable to typical human milk. This is real, it is documented, and it is powerful.
Trans men and chestfeeding: If you've been on testosterone, it may suppress milk production, and current guidance recommends completing chestfeeding before resuming testosterone. Even after top surgery, lactation may still be possible with the right support and devices. These are conversations worth having with your provider early.
Co-nursing: In same-sex couples, the non-gestational parent can induce lactation too. Same principles apply — hormonal support and breast stimulation.
Relactation: If you were making milk and stopped, research shows milk secretion returned in roughly 65% of people who had completely weaned, with first drops appearing around days 6–9 on average. A shorter gap since weaning increases the chance of success. And here's something I love from the research: people who focused on the relationship rather than the volume had better outcomes. That tracks.
A note on medications: There are pharmaceutical galactagogues — medications that can boost prolactin and help bring in milk. In the US, the main option is metoclopramide, which is sometimes used off-label. Domperidone, which is widely used internationally, is NOT available in the United States — the FDA issued a safety warning and import alert due to cardiac risks including dangerous heart rhythm changes. It is not legally obtainable here except under very narrow research exceptions. Herbal galactagogues like fenugreek, fennel, and milk thistle are also commonly used, though the evidence on their effectiveness is mixed. Current guidelines say galactagogues should never be the first step — optimizing latch, frequency, and breast stimulation comes first. Always work with your medical provider on any medication decisions.
Setting realistic expectations: Full exclusive milk supply through induced lactation is the exception, not the rule. Partial breastfeeding with supplementation is the more common — and completely valid — outcome. The marathon metaphor is real: this takes time, patience, and support. But the destination is worth it for those who choose this path.
All IBCLCs are trained about inducing lactation and relactation, but many never see it in their whole careers.
I have guided many people through inducing lactation and relactating. While I cannot dispense hormones or other medications, I can help you ask your provider the right questions and I can prepare a training plan for your body to prime it to make milk.
I still remember being a young lactation consultant and being absolutely blown away when our client came into clinic for her pumping appointment. She was inducing lactation for an adopted baby, and after 9 months of effort (and some help from an endocrinologist) she was dripping milk. The elation that she felt was bigger than I had experienced. This person ran a marathon and then did a long hike and got to this nebulous place that few understand is even an option — lactation without birth.
