Subject: Inducing Lactation
Author: Walt and Sarah
Origin: SNCLIST (Lactation Group)
Publish Date: 12 November 1998
Revision: First Edition
This is the first edition of a three part tutorial posted on the message board of the adult nursing group SNCLIST. The contents of these tutorials are the personal experiences of Walt and Sarah, an adult nursing couple who induced lactation on their own. Each successive tutorial is an update of the previous.
Nursing for Couples - A Tutorial
By W. and S.
12 November 1998
All nursing involves a couple but we will be talking about a woman breast-feeding a man, rather than a baby. This might be because the couple thinks nursing might be enjoyable or for another reason, such as preparation for adopting a baby. We'll cover how to make the "machinery" work, what nursing demands from and gives to a relationship, why this might or might not be for you and some of the special issues of couples nursing. This short article can't include everything you need to know about breast feeding so we also recommend a book.
We're a nursing couple without special medical or other related training. The information that follows is a mixture of our own experience and book learning; while we've been as careful as possible in preparing it, it is still "use at your own risk."
The short story.
Nearly any woman of child-bearing years can produce breast milk with enough time and effort. If she is already nursing a baby then couples nursing can be started with the man taking "leftovers" and then replacing the baby as it is weaned. A woman who isn't nursing now but has before probably can bring in milk again ("relactate") in a couple of months. A woman who has not nursed can often still bring in milk but it will take longer. Since shifting from a nursing baby to an adult partner usually is simple, we'll talk mostly about how to start if the woman doesn't already have milk.
Couples nursing requires you to spend perhaps half an hour together perhaps ten times a day for about two months to bring in her milk, and almost that much time thereafter if you want to keep a full supply. While the schedule doesn't have to be rigid, it must be regular both to bring in milk and to maintain the supply and her comfort afterward.
Not only is there a very demanding schedule, there will be problems to be solved. The woman gives the milk; the man drinks it, so the feelings can't be exactly the same on both sides of the nipple. Like anything complicated you do together, couples nursing can put a strain on a relationship and not all couples will feel that it's worth it. On the other hand, many couples that like nursing can't imagine giving it up. If you want to try, the best approach may be to think of it as a shared adventure, to be taken and enjoyed together, wherever it may lead.
Milk is produced in hundreds of tiny sacs called "alveoli" inside the breast. These sacs are connected by tiny tubes (ductules) which join to make 10-25 larger tubes (ducts) each ending in a tiny hole in the nipple. There are bulges in the ducts just below and behind the nipple area; these are called "sinuses" and are about ¼" in diameter.
Both boys and girls are born with the beginnings of this system. As a girl becomes a woman, becomes pregnant, and carries her baby, the breast machinery develops from these beginnings until she is able to nurse right away after delivery. When the baby is weaned, the machinery turns off, but even years later it will still be there. With the right stimulation a full milk supply may come back.
Through the weeks or months a baby is being nursed the amount of milk adjusts to its needs. A baby who needs more milk will nurse longer and more often than one who is getting plenty. The stimulation of the nipples caused by sucking signals a part of the woman's brain to make a chemical (prolactin) which causes the alveoli to make more milk. It is this "adjust to the baby's needs" feed-back that allows starting milk production without a baby. You apply lots of nipple stimulation to signal a need for much more milk and over a few weeks or months production will increase from nothing to tiny drops to, within limits, as much as you want. A woman who has not been pregnant may not be able to bring in a full supply but probably can make enough to satisfy most couples.
A feeding begins with most of the milk in the alveoli, which have been making it since the last feeding. When the woman gets a cue she connects with nursing (such as thinking of her partner nursing), an automatic response called "let-down" pushes her milk out of the alveoli and through the duct system to the sinuses. Letdown is often felt as a tingling or prickling sensation behind the nipple as the sinuses fill. After letdown, the pressure of the partner's mouth and tongue on the sinuses pushes the milk out of the openings in the nipple into his mouth. If the feeding is over-due, let-down may not only fill the sinuses but make milk dribble or even squirt from the nipple.
Because letdown is also partly triggered by pressure, it won't happen when milk production is just starting. You'll probably have to massage the breast to bring down those very first drops.
How to Bring in Her Milk.
The best nipple stimulation is the sucking of a partner. Second best is the woman's hand (manual stimulation), rolling and squeezing the nipples themselves and massaging the area near the nipple as if she were squeezing out ("expressing") milk. Breast pumps are good for drawing milk from a working breast but they don't give ideal stimulation to the nipples so they're less effective when you are starting out.
Sucking by a nursing partner should be as a baby does it: get a 2" to 3" circle of breast with the nipple just above the center (the end of the nipple will be well back on the tongue) and squeeze while pressing upward with the tongue. Release immediately but hold the lips against the breast while sucking gently. Squeeze — release — wait/suck… squeeze — release — wait/suck… Try to keep the teeth mostly off the breast, don't slide the lips but stay "latched" in place, as a baby should.
To get the most milk, sucking should squeeze the sinuses. When things are working right, this will feel like chewing soft clay. If the end of the breast is firm, let go and latch again or switch to the other breast for a while. If that doesn't work (it often won't when you're starting) then just press softly on the firm area. Because the man, the woman, and the woman's breasts are all learning and changing at once, it takes a while to get the hang of this but in a couple of months it will be completely natural.
When her milk first starts to come in, there'll be a few drops of milk with each suck at the start of a feeding, then quickly less until there seems to be none. You can get more by massaging the breast with a cupped hand.
Stimulating one breast helps the other let down so nurse each side at least twice at each feeding. Be sure to empty both breasts completely every time.
Be gentle. Hard sucking and massaging will not bring milk much sooner and may hurt the breast. If you want faster results use more frequent feedings (up to every hour if you have time and nothing hurts), not more force.
For manual stimulation use a rolling motion rather than sliding skin on skin to minimize trouble with sore nipples. Breastfeeding books like the one mentioned below have more details under "manual expression."
Until you get milk, plan feedings every two hours including, if practical, through the night, and don't go over four hours between feedings if you can avoid it. The woman should use manual stimulation when her partner isn't available.
Start with five minutes on a side and increase gradually to ten minutes if nipple soreness isn't a problem. Allow the nipples to dry before covering the breasts and if chapping occurs use a breast cream such as Lansinoh (great but expensive), Udderly Smooth or any hand lotion that works for you. "Works" means it prevents chapping, tastes okay, doesn't sting when you put it on, and doesn't make the nipple so slippery that the partner can't latch.
If soreness is a problem even though you're using cream, it's probably due to stretching of the skin of and near the nipple. The nursing partner should be careful to latch properly and to not suck too hard. This is also the answer if he has soreness of the lips or elsewhere in his mouth. The only rubbing that's normal is between the end of the nipple and the back of his tongue and roof of his mouth.
You may see no results for several weeks, but definite milk production ought to begin in a month to two months. When it does, you're past the hard part. When you have about as much milk as you want you can cut the number of feedings by one a week until you find how many it takes to keep her supply. You may have to keep at least one middle-of-the-night feeding.
What about drugs?
It is possible that some of the often mentioned herbs (fenugreek and milk thistle are two of them) have some effect but if so they may have little benefit until milk production is at least partially established. Such products are often not as well standardized and tested as regulated, prescription drugs — for strength, purity, and effectiveness for the job, and some manufacturers of these products commit outright fraud, so we advise caution. If you do purchase these products, we recommend that you buy a brand that is independently tested or guaranteed for purity and strength by a reputable distributor such as one of the large drug chains. There are prescription drugs that may help both milk production and letdown but you'd have to get them from a doctor and they're not completely risk-free.
For most women any drug will at best shorten the job of bringing in milk. It won't keep that milk coming and it definitely won't help you build the kind of relationship you'll get by working through the start-up problems together. We recommend the natural method: build her supply with nipple stimulation from a loving partner while working out a tender and trusting friendship in which letdown will happen automatically once her milk comes in.
It's not easy, part one.
Starting milk production requires a huge commitment of time — up to four or more hours a day. The partners must be together, in a private place, for about a half an hour every two to four hours for at least several weeks and maybe months. Both will need to be able to ask for adjustments to the schedule and sometimes the whole thing will be impossible for hours. At first this will just delay results but as she nears full milk production that milk will have to come out somehow not more than a few hours past the usual time. There may be other problems such as sore nipples and tender breasts, perhaps the loss of sleep caused by night time feedings. Can you solve such problems together, with love?
What if you don't have that much time?
The plan above fits both our own experience and the other information we have. However, there's lots of variation in women's bodys and other things (such as drugs they take) that could make things easier in some cases. Some couples are happy with just a little milk. If the plan above is more than you can do, you might want to try doing the most you can for as long as you can, and seeing what happens. You might be pleasantly surprised!
You already have everything essential to get started. We strongly recommend a breastfeeding book to help you solve problems and to fill in details not included here; we like "The Complete Book Of Breastfeeding," by Eiger and Olds, ISBN 0-553-26232-7, in paper for under $10.
If the woman isn't nursing now, then her breasts probably will get one or two cup sizes larger. She'll need new bras; it's handy to have some of the nursing kind with cups that drop down. Pressure in the breast signals the body to cut down milk production and can cause other problems so the "painted on but comfortable" fit that was perfect when she wasn't nursing would be one size too tight now. Bras should however give good support to prevent sagging and minimize breast soreness and the chance of back problems. Look at the fit just before the biggest feeding of the day (usually noon or afternoon); it's okay if the cups are filled, but if they are tight they're too small.
Keeping a good fit as her milk is coming in may mean buying an in-between size or two. Since her final size depends somewhat on how much milk the couple wants, don't rush buying the last set of bras and when you do get them, get a single style and brand so the cup hooks will all be alike. We like the Playtex ones because the cups can be released with the flick of a finger and hooked back up with one hand even if you can't see what you're doing.
Blouses that used to fit closely will now be too tight; a minimizer bra (flatter cups than normal) may allow wearing them for short periods but will interfere with milk supply if worn all day. Loose fitting button-front maternity shirts are handy for knockabout wear and can be undone or pulled up to nurse.
A breast pump may be useful for removing extra milk (say from missed feedings) after it comes in; if this will be a daily thing you might want the type that pumps both sides at one time. Other small things may be needed but you'll figure them out as you go.
Larger drug stores have most of what you'll need to nurse. There are also catalog companies that specialize in maternity and nursing wear.
Don't get far beyond a few drops without reading up on nutrition for the nursing mother and adjusting her diet accordingly. The basics are that the woman MUST get plenty of calcium to prevent pulling it out of her bones (osteoporosis is a very serious disease: you do NOT want to go there); she needs a balanced diet with enough vitamins and minerals and she probably will need a little more to eat and drink. A useful rule for liquids is to drink a cup or so with each feeding. A woman who is satisfied with her weight before nursing can at first be guided by her hunger. Since full milk production takes up to 500 calories out of her body, the woman who wants to lose weight should find it fairly simple if low calorie foods are used for the "extra" — fat free yogurt, diet drinks, fruits, vegetables and so on. Do not lose more than a pound a week and do not allow yourself to become underweight. The woman's body will change as she nurses. She should check her weight at the start and then weekly thereafter, remembering that the increase of breast size will add two or more pounds as her milk comes in.
The nursing partner's diet can go either way. He will be getting up to 500 calories a day extra so he may need to cut back elsewhere. Or, feedings of high nutritional value milk may naturally substitute for high-calorie, low-value "junk food," and his over-all nutrition, health and weight may improve.
Living with the world.
If you live together and have no close friends or jobs, nursing can be pretty simple. Otherwise you are going to have "issues." It's hard to keep a weekend visitor from noticing that you go off together for half an hour out of every four. Close friends and relatives will notice the change in her figure. Breast-feeding a baby in public during an all-day shopping trip is okay if you're discrete but feeding a man … If either partner works out of the home, she'll probably have to pump or express milk at about the midweek feeding time.
All of these situations will need to be thought through. Some may have to be handled by stopping nursing for a while (perhaps you can get more than a single bird with a stone such as by scheduling annual medical work next to a Christmas visit to the family), comments on her figure can be ignored or deflected. Public places may have secluded corners where it's possible to nurse once you're skilled.
If you can't handle this sort of thing you may find that "nursing lite" will work: bring in her milk, then very gradually cut back the number of feedings. Many women will still be able to give an ounce or more of milk almost at any time while feeding as little as three times a day, and on this schedule going 24 hours without a feeding shouldn't be a problem. The "lite" approach will take a while to work out because it gives mixed signals to the breasts about how much milk is needed (you may have to start over a time or two) but it can get you some of the joy with much less complication than the whole quart-per-day routine.
Doctor's appointments can be an issue. We recommend confiding in and working with a Doctor (preferably one with particular experience and knowledge of lactation issues) who has a professional, nonjudgmental, sympathetic attitude. Visits to other specialists, etc., can be taken care of by nursing (or expressing) beforehand. There will probably be no comment if a Dr. gets a few drops of milk during an exam since about ¼ of women who have nursed a baby will have a bit of milk in their breasts long afterward. But if asked, we feel the best approach is to be direct and honest about your chosen lifestyle.
If you have to stop quickly switch to bras that put pressure on the breasts (one or two cup sizes smaller than her nursing size) and keep a bra on day and night. Stretch the time between feedings by one or two more hours each day and take only enough milk to relieve the pressure.
When nursing, stimulate the nipples as little as possible. The partner should latch in the normal way, but suck gently without squeezing, as from a soda straw. The breast may be massaged if milk won't flow.
It will take about a week to go from full production to being comfortable for 24 hours without nursing, and about another week to get back to roughly normal breasts.
Stopping isn't a total waste. When we had to do it for a few days we discovered we really were a nursing couple: stopping was almost as hard as stopping kissing would be. It's easier to start back up than relactating was the first time; we got small sips on both sides after just a couple of days.
It's not easy, part two.
Not only must both partners keep a schedule and solve "how to" problems together, they'll have social problems to work out, they'll need new clothing and equipment, and her body is going to change. Breastfeeding is going to take over a chunk of your life for months while you get started, and possibly for a lot longer.
There's yet another level of "not easy." Full nursing brings more dependence than many people can get comfortable with. Most men like to think of themselves as independent, going and doing as they please. The male half of a nursing couple isn't actually dependent, but if he can't live a dependent role, emptying those breasts on schedule day after day just like a baby would, then the female half won't be able to live her role, which actually is more dependent, since her milk needs to be taken. You must talk this through before starting but the reality is very simple: marriage can be just a piece of paper, sex can be a one night stand, but if you nurse, you are partners.
And another level yet: couples nursing brings up very sensitive issues. Power and control in the relationship, fairness, masculine and feminine roles, going along with what other people expect or doing things your own way, are some examples. Some couples may relish the chance to get closer together as they talk about these issues, while others may not.
So why do it?
Many couples wouldn't want to. However, there are things about couples nursing that make some people really like it:
- Feeding another person from your body or being fed from the body of another is so intimate it's hard to talk about. Of course nursing a baby is intimate, but this is your chosen and wonderful adult partner. Imagine the "high" when you wake up in the morning, and, looking into each other's eyes, he takes an offered breast and starts her milk flowing.
- What a comfort when one partner wakes from a nightmare or can't quit worrying about the bills or has a hard day at work, to offer or ask for a breast. Each of you is saying "you are really all that matters to me" in the clearest way possible.
- Because it is so private, breast feeding forces you to sink or swim together. Each step from first drops to happy, confident letdown and sucking is your own doing.
- In breast feeding each partner gives the other something he or she could get from no one else.
- Breast feeding is intimacy you can have several or even many times a day — sex with your clothes on and without the sweat, you might say.
- The nursing couple puts everything and everyone else aside and concentrates on each other every few hours. When things get rough you do not have the choice of staying mad all day.
- It's sharing on a very different basis from sex — a real team activity because if the woman can't relax, her milk won't let down and so will be almost impossible to get. In effect the partners must work together following the rules of her breasts in order to succeed.
- Just as for a baby, a healthy snack is always available. For us, breast feeding is first when we wake up in the morning then the man starts breakfast and chores while she goes back to sleep until he brings coffee and toast. He asks for a breast rather than reaching for the cookie jar.
- Because of all the new issues, nursing takes your partnership down new pathways. The "you" that will be after her milk is in and you're settled as a nursing couple will be different from what exists today. The nursing bond is unbelievably tough and elastic and once it forms, all sorts of small problems between you will fade to unimportance.
- From the man's point of view, breast milk usually tastes wonderful — often between sweet cream and melted vanilla ice cream. Men also like the absolutely knockout figure that a nursing woman can have. Women generally are delighted to have a way to get rid of 500 calories a day (depending on how much she feeds and how often) without having to eat less.
- Most couples find that breast feeding itself is powerfully erotic and that the nursing relationship improves sex.
Of course making all this happen depends on the partners. The real truth is that breast feeding will most likely only reinforce what you and your partner have in a relationship. So it is a way to build (and enjoy!) a relationship that is already good, though probably not a way to fix one that has big problems. Finally, it's a wonderfully private thing to share and it's just plain fun. If you both really like the idea, starting isn't a big decision. You can always stop if it doesn't work out and perhaps a year or five years from now things will have changed.