Yoga for Breastfeeding

I practiced yoga throughout my pregnancy, including headstand.

Half-moon pose helped alleviate back pain as well as nausea.

Did you know that yoga can have a beneficial impact on breastfeeding? While tight or ill-fitting bras (not that as a post-surgery transgender man I have anything to do with those, ha!) can damage breast tissue and inhibit the flow of milk, yoga can improve circulation in the chest and help the body to produce more milk. At least Diana West says so anecdotally in her book Making More Milk, and so does Geeta Iyengar in her impressive, enormous, virtually biblical, Iyengar Yoga for Motherhood - from personal experience, I agree with them both. I finally went again to a yoga class this week after an absence of almost a year (time well spent constantly breastfeeding Jacob - I just never felt like leaving him for long enough to go to a class).

I am far from an expert, but I did practice Iyengar Yoga for a few years before having Jacob. The Iyengar method is careful, thoughtful, and thorough. Geeta's book includes meticulous descriptions of poses to be done, and not to be done, in each trimester. Some sequences are said to alleviate pregnancy-related headaches, others are for treating nausea, others for dizziness, still others counteract high blood pressure. And, again in my personal experience, they work.

I began my yoga studies before I transitioned. I wanted to try a different physical activity in my new hometown of Winnipeg that I could do completely away from my new work colleagues. At the end of my second class I left the Yoga North studio only to see a man from my job, whose face was only vaguely familiar to me, rushing in just in time for the next session. Ugh! I came here to get away from you, I thought. Then I married him three years later. But that's a story for another time.

I kept going to the yoga studio despite Ian's presence there. At the end of my first year, I was ready to transition to male. I thought about quitting yoga - I wasn't sure I'd be at home in either the men's or the women's change room. A large and varying population of clients attend the studio, some of whom I know reasonably well and some I don't. I talked to the instructor, Drew, about my plan to transition, and he didn't see any problem at all. He didn't want me to stop attending class and said I should simply use the men's change room. He told the other instructors about my situation so that no one would be confused. When a number of my fellow students learned of my decision, they gave me a congratulatory card and a fancy razor, an incredibly kind though useless gesture since I maintained a terrible scruffiness and pretty much never shaved (and still don't). I felt completely welcome.

A few years later, in my second trimester of pregnancy, my back and hips started to ache. I didn't go to yoga because this time I really didn't believe there was any way I could stomach being seen in my unusual (for a man, anyway) state by the other students who ranged from friends and acquaintances to complete strangers. Ian mentioned my shyness to Drew, who immediately came up with a plan to teach me one on one. In the months that followed we worked together once a week right up until Jacob was born.

I am certain that these classes saved me from much discomfort during the pregnancy and helped me get through the hard work of a long labour. They also put more food in Jacob's belly. I worked with another instructor, Lisa, on creating space and lift in my chest. In addition to being an experienced teacher who has studied frequently in India with the Iyengar family, Lisa has practiced yoga through two of her own pregnancies. On days that I worked with her, I was able to express twice as much colostrum as usual. I diligently saved the precious liquid in syringes and stored it in the freezer in anticipation of Jacob's birth, fully aware that milk production would be an issue for me due to my chest surgery. Thank you Geeta, Lisa, and Drew for helping me to feed my baby in his early days some of the best food in the world.

Newborn Bliss All Over Again

A few days ago I enjoyed a most powerful deja vu with a teeny tiny baby. I can still see her little mouth gaping wide open searching for my nipple as she tries again and again to latch. Her hands make tight fists that press into my chest, pushing herself away from my nipple, and away from what she wants so desperately - the food source. Not having much, if any, breast tissue to accommodate her limbs, I gently move her arms out of the way to bring her lips in contact with my nipple. In hunger, she puts her finger in her mouth at the same time as my nipple. Again, I move her hand out of the way. Absolutely everything in her life is about wanting to suckle and swallow.

Lila doesn't care that I'm transgender - she just wants to breastfeed.

And then I feel her finally grab hold and not let go. The pull of her lips is strong and determined, yet precarious. I don't dare move my arms for fear of unlatching her. I hear her rhythmic, satisfied gulping and know that I am the centre of her universe. Nothing can distract her from her desire to breastfeed. She doesn't know or care that I'm a transgender guy using a supplemental nursing system and donated breast milk. I share in her bliss.

Then my back starts to ache from the stiffness of my pose. I look at the clock and see that forty-five minutes have gone by and she's only taken an ounce or two. Those newborns take forever to eat! She sleeps for a brief few minutes and then is ready to nurse yet again. Now I remember the sheer exhaustion of the early weeks. Still, my day spent with this seven-week-old was a gift.

My friend had called us around 10am that morning to say that she was feeling very ill. Ian picked her up and brought her to the hospital. He took her infant, Lila, and toddler, Samuel, to our home where I was entertaining a number of friends and their babies. It turned out that the poor sick mom had appendicitis and would spend that night and the following day in the hospital.

First we tried to bottlefeed our tiny charge, but she choked and gagged on the fast-flowing milk. Then my friend Emily attempted to finger-feed her with an SNS tube - sometimes it worked, other times the milk wouldn't flow at all.

In the afternoon, Ian walked Lila over to the hospital to be nursed by her mother in the emergency waiting room. He suggested that I could breastfed Lila the next time around, and my friend agreed. So, a few hours later, after a failed attempt at finger-feeding, I did what was easiest for everyone and nursed the babe.

Breastfeeding Lila was beautiful and joyful, and also brought up some anxiety for me. I have so little breast tissue that latching on a baby takes tremendous focus and determination from both parties involved. Today I am suddenly in awe of myself for having done it, day in, day out, and never, ever giving in to a single bottle feeding when Jacob was little. And I got a good reminder this week of WHY I did it: even with all my specific challenges, nursing was obviously a happier and more comforting experience to Lila, who surely must have been missing her mother.

My own Jacob is almost a year old, and I breastfeed him with ease. He crawls into my lap, pulls my usually open, button-down shirt out of the way, and latches on by himself whenever he wants. If he seems tired, or upset, or out of sorts, or even if I'm just sick of running after him and badly want to sit down for a few minutes, I get out the SNS and nurse him. I wish that more people knew about the pleasures of nursing an older baby or toddler. Gone is all that intensity and effort of feeding a newborn, and what is left, for us anyway, is a comforting, easy relationship.

After my friend received her diagnosis and a surgery was planned for later in the evening, her husband came over to pick up their kids. Lila was full and fast asleep, and Samuel, the toddler, grinned from ear to ear at the sight of his Dad. We were thanked profusely, but in all honesty I just about feel guilty: I got to nurse a precious, heart-melting seven-week-old baby and hang around with her sweet, surprisingly helpful toddling brother while their Mom was dealing with a ton of pain. I'm pretty sure I got the long end of the stick on that one.

Time to Breastfeed Outdoors Again

Baby's first winter presented special challenges..

All winter long in our frigid city I've been timing my walks with Jacob and my dog ever so carefully. I make sure the baby is well fed just before I start out, and I never walk for more than an hour. Usually Jacob falls asleep, snuggled comfortably against my chest in a cloth carrier and wrapped in a massive winter coat that fits around both of us. Bringing along donated breast milk and feeding using the supplemental nursing system just isn't practical in minus twenty. Thankfully I've only rarely misjudged our outings and had to rush home with a hungry, crying baby a very few times.

These last few days it's been warm enough to sit down and nurse leisurely outside again. Yesterday Jacob and I spent the afternoon in our yard looking at butterflies, cuddling, and breastfeeding as desired. We live in the middle of the city, in between one neighbour who refuses to speak to us, and a family on our other side who is just thrilled with Jacob. At first I was a little self-conscious to open my shirt outside once again after a whole winter spent bundled up, but then I felt the warm sun on my back and smelled the grass beginning to dry out, and knew that my son, too, should enjoy all this - and why not while he ate?

Of course there are reasonable limits to where I'll nurse this summer, the same as last. I won't breastfeed Jacob on an isolated park bench with, say, just a few strangers nearby. I won't nurse him down by the river where the drunks reside. But I will breastfeed my baby anywhere that I think it is physically safe to do so - at the beach with other families around, at the Winnipeg Folk Festival, in my own back yard, at the playground... If others don't like it, they can shut their eyes and listen to the birds, smell the leaves in the trees, and feel the wind in their hair. That ought to be enough for anyone.

Last September I nursed Jacob at Calgary's Spruce Meadows while watching Team Canada take its victory lap. The crowd was far too busy enjoying the horses to care that we might have been doing anything out of the ordinary.

Privacy

Some have wondered why the names on this blog have been changed, and, well, the answer is MY SON! I have made the choice to be a queer, breastfeeding activist - I am not only comfortable with this, I love it. It is my passion. My child, however, must be allowed to make his own decisions regarding how open he wants to be about his life. I don't want my writing to follow him around wherever he goes. For now and for many years to come, he will simply be a boy with two loving parents. I believe this is his right.

All of our friends and family know that I am transgender and that I birthed our baby. They are all fine with it. We will try to raise our boy with honesty and integrity. He will grow up understanding where he came from, but we will also have to teach him to guard his own privacy in some situations for his own safety.

This blog is important to me because I hope it will help make the world a better place for our child, and others like him, to live in. Awareness of transgender lives increases every time someone puts him or herself out there in some way. Because Thomas Beatie discussed his transgender pregnancy on Oprah, some of my friends were already familiar with what we were up to when we announced our own pregnancy. And little by little it gets better, right?

Dear Paramedic: I'm Transgender!

Last night I sat on the cold bumper of a fire truck parked in front of my house and told a young, dashing male paramedic surrounded by burly firefighters, "well, I'm transgender and I, uh, breastfeed my baby."

He didn't blink an eye. I guess he sees all sorts of strange people in strange situations all night long and he was just doing his job. I, however, was a little bewildered to find myself coming out in this fashion.

This weekend I had the flu, or maybe food poisoning, and I was still feeling nauseous last night. I was nursing Jacob in bed when our carbon monoxide detector went off. Ian opened the windows and doors and called police non-emergency but was told that he ought to dial 911. Could be deadly serious. We waited outside on our front steps and the fire truck pulled up within minutes.

Since carbon monoxide poisoning can resemble flu symptoms, the paramedic wanted to check me out while the firefighters went inside to measure the CO levels. He took my vitals and soon asked, "are you on any medications?"

"Yes, I take domperidone." This is a drug normally prescribed, ironically enough, for controlling nausea.

"And what do you take it for?"

"Um, well, I'm transgender, and I, uh, breastfeed my baby. Domperidone increases milk production..."

So my lovely paramedic got a mini-lesson in lactation - queer lactation, at that.

As it turned out, it was all a false alarm. The firefighters determined the house to be fine, and I must have just had the flu. Unfortunately Jacob is not yet at an age where he can appreciate a fire truck but all the commotion left him wide awake until 1:15am. We'll be replacing our CO detector today.

And while I'm on the subject of domperidone, Health Canada recently came out with a new warning against its use: http://www.cbc.ca/news/health/story/2012/03/08/domperidone-maleate-drug-.html

Breastfeeding expert Dr. Jack Newman had this to say about it on Facebook:

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"Based on a study that was published in Belgium which looked at over 1000 cases of sudden death and found that some of the people who died suddenly were taking domperidone, Health Canada has put out a warning about possible concerns about treating with domperidone. This is a bit of an overreaction on the part of Health Canada. Well, a big overreaction given the data.

"Note that in the study, the youngest person who died was 55 and the average age of those who died was 75 years. What has this to do with breastfeeding mothers who are rarely older than 45 years and are usually in reasonably good health? Furthermore, this information came from a data base with no clinical information. It simply has information that so and so died suddenly and was taking such and such a drug. The thing is that domperidone in these patients was used for reflux and we know that heart disease is frequently misdiagnosed as reflux; severe pain at the top of the abdomen or lower part of the chest is typical of both reflux and cardiac pain. Misdiagnosis is particularly possible in Europe where domperidone is available in countries like the United Kingdom, Belgium and the Netherlands without a prescription and it is likely that many people are self-diagnosing and self-medicating.

"So that's it and it does not mean that domperidone kills. I will continue to prescribe domperidone at our doses which are based on many years of clinical experience. I have treated many thousands of women with it with only minor side effects. I believe this article from Belgium proves nothing and does not require us to stop prescribing it.

"It would be a pity that mothers and babies not benefit from domperidone when used in conjunction with our Protocol to manage breastmilk intake."

Thanks for the insight, Jack! Although you might want to add "fathers" to the list of those who derive benefit from this drug.

Hormones!

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Many of us have heard before about the importance of hormones during childbirth and breastfeeding. Natural oxytocin, together with other hormones in a "love cocktail", can help you transcend the pain often associated with labour and then assist you in falling head over heels for, and breastfeeding, your baby. I am lucky enough to have had the pleasure of listening, live, to the renowned obstetrician Michel Odent speak in his lovely French accent about “ze luuuuuve coq-tail-uh”. It’s enough to make even the most prudish gay man swoon. You, too, can enjoy Mr. Odent by watching him on YouTube here.

Dr. Michel Odent

But my own hormones cause people a little confusion sometimes, so with this post I’ll attempt to clear things up. “How do you know that this is safe for your baby, what with all those hormones you’re taking?” Number one most common misconception about a transgender pregnancy: people tend to assume that I continued to take testosterone while carrying the baby.

I can see how someone might think this. After all, my voice remained low, and I continued to grow facial hair, and these are (wonderfully for me) masculine traits. However, once testosterone thickened my vocal chords, ceasing injecting it into myself could never thin them. This is why male to female transsexuals often spend much time and energy learning how to speak in a higher-pitched, female voice – it is not easy to sound feminine once they have gone through a biologically male puberty (and, for the record, it's actually all way more complicated than I'm making it seem, so if you like you can read up on it here). Again, after testosterone use had developed new hair follicles on my face, nothing but electrolysis could permanently remove my beard, as female to male transsexuals unfortunately know all too well. As an aside, this is a large part of the argument in favour of providing transgender teens with hormone blockers to delay the onset of puberty – as a trans kid, once puberty hits, it’s like you’ve boarded a fast-moving express train with zero stops to a country you have no desire to visit. Oh, right, and there is NO train that can take you back unless you practically build the tracks (and train) yourself.

On the other hand, testosterone leaves the bloodstream and tissues within ten days, said my endocrinologist. We consulted with him about the idea of trying to conceive, and he paused for a few minutes, looking thoughtful. Then he said, “well, just stop taking the testosterone, and wait for your cycles to return to normal. When they do, you’ll know that you are ready to try. The eggs should still be there…. I can’t see any problem. If I think of anything else, I’ll get back to you.” He never did.

Within two weeks of my last testosterone injection, I got a period. My cycles were immediately regular, even to the time of day, but we waited through four or five of them before trying. We got pregnant on the first attempt, and the entire pregnancy was utterly normal and healthy, as is our child.

I haven’t started taking testosterone again yet because it would seriously inhibit the hormones that affect breastfeeding, plus we haven’t decided for the time being if we’d like to have more kids. Gotta learn how to take care of this 11 month old little ball of energy first!

Tips for Transgender Breastfeeders and Their Lactation Educators

I've been in touch recently with several lactation consultants and they have all asked me similar questions: What is it like to breastfeed as a transgender man? Are there special challenges that you face? What do we need to learn in order to help people like you to breastfeed?

So here's a post for anyone out there who may one day be in a position to help a trans guy and his nursling in their journey towards achieving a kick-ass breastfeeding relationship, because it CAN happen.

Tip One: Simply know that it is possible for a trans guy to breastfeed even after a dramatic chest surgery like mine. A lot of people thought I was ridiculous and delusional for trying to breastfeed, but I did it. My son gets a little bit of my very own milk plus the milk of lots of wonderful women via a supplemental nursing system (SNS - see FAQ). All feedings take place at the breast.

Tip Two: Know that latching will likely be particularly tough. Lactation advisers should know that trans men may face special challenges in latching their babies - accomplishing a deep latch can be very difficult with next to zero breast tissue. Teaching a trans man to make an effective "breast tissue sandwich" is essential to successful and reasonably comfortable breastfeeding. Using an SNS on top of this makes breastfeeding even harder. A first time trans breastfeeder will need lots of extra hands to help with latching and using the SNS.

 Tip Three: Lactation consultants should be aware that in the case of a trans guy who has not had any chest surgery, he may have practiced years of breast binding to flatten his chest, and this, of course, may affect milk production.

Many FtM individuals practice breast binding, using very tight fitting garments to flatten the chest. As we know, even an ill-fitting bra can affect milk production.

Tip Four: Watch out for postpartum depression (PPD), even more than usual. Emotional factors surrounding breastfeeding should be given serious consideration by any lactation adviser. A trans man may be very averse to breastfeeding if he perceives the practice to be a feminine activity (I for some reason never felt this way myself), or depending on his own feelings about his chest and nipples. Alternately, even though he is happy he had his surgery, he may still feel very guilty if he is unable to make enough milk for his baby. Watching out for PPD could be very important since trans people as a group are already at higher risk of suicide and depression than the general population.

Tip Five: Act as a liaison between your client and others, such as La Leche League. Remember all those women you urged to contact La Leche League but they never did? Think they were anxious about going to a meeting full of strangers? Well, now imagine being a trans guy walking into a room of breastfeeding women who know nothing about you. How daunting would this be? To help a trans client find peer-to-peer breastfeeding support, locate a queer-friendly LLL chapter or similar group and let them know ahead of time that a trans breastfeeder may be joining them. Then tell your client that the group leader is familiar with the notion of a breastfeeding trans man and will be welcoming.

Finally, be prepared to learn, innovate, and improvise. Have fun!

An All-Boy House

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The only female member of our household.

Sometimes people have trouble understanding even the basics of our family, never mind the breastfeeding and milk sharing and everything else. A friend of mine overheard her four-year-old talking to her grandmother on the phone:

“This afternoon we’re going overto Trevor’s house… Trevor and his baby Jacob… No, it’s a boy house. Trevor, Jacob, and Ian… No, it’s all boys! [sounding more emphatic] Well except forQuinoa [our dog]…. Trevor, Jacob, and Ian!... Jacob is their baby!!"

Hopefully grandma figured it out in the end. Yep, guys can raise babies too. In our more audacious moments we even like to think we're pretty good at it.