LETTER - NHS chestfeeding advice is harmful for the baby and for trans identifying parents
A letter one of our members sent, edited to preserve anonymity
Dear Mr Streeting
Re web page: Chestfeeding if you're trans or non-binary
https://www.nhs.uk/pregnancy/having-a-baby-if-you-are-lgbt-plus/chestfeeding-if-youre-trans-or-non-binary/ (downloaded 20.3.2025) https://archive.ph/Gk8Wi (archive 30.1.2025)
I am an NHS GP who has cared for many women as they go through pregnancy, childbirth, breastfeeding, also caring for their babies as they grow up. In recent years I have become alarmed by dangerous messages of trans healthcare. This NHS webpage is just one problem that I have seen on the NHS website regarding the care of women.
Given that you are now taking over the management of the NHS from NHSE, you and the DHSC is now responsible for the information available online in the name of the NHS. I am bringing this page to your attention, as it is spreading thoroughly misleading and inaccurate advice about chestfeeding. It should be taken down with immediate effect.
It is very clear that feeding a baby from a chest is not possible as no milk can be produced unless there are functioning breasts with intact nipple, ducts, lobules and alveoli from which the milk is produced and delivered. A woman who has had breast surgery to remove any part of the breast is likely to experience difficulty when breastfeeding her baby, particularly if ducts have been disrupted. A woman who has had “top” surgery, meaning bilateral removal of breast tissue with nipple graft or reconstruction to flatten the appearance of the chest, has none of the necessary organs to breastfeed. Indeed, a woman who has had such surgery should NOT attempt to latch a baby onto a grafted nipple as there is the potential for that graft to fail: a grafted or reconstructed nipple has no function other than cosmesis, having lost the supporting breast structure and having had the nerves cut leaving the skin and nipple with no sensation, so she might not even realise that damage is being done to her reconstruction.
Sometimes, a woman who has had her breasts removed may find that she has a few lobules remaining. This remaining breast tissue will respond in pregnancy to hormonal changes thus she could develop painful cystic collections in her breasts that put her at risk of mastitis, infection and even sepsis. For a woman who has detransitioned, who now accepts her sex and has become pregnant, this pain adds to the psychological burden of having lost her breasts from the iatrogenic harm done to her as a younger woman or even as a child. There is no warning on this web page about this.
For a woman with intact breasts there is a technique that can be used in some circumstances to attempt to induce lactation or mimic breast feeding. This involves the use of a tube filled with artificial milk attached to her nipple so that a baby can suckle, a technique that is sometimes effective in allowing an adoptive mother to be able to breastfeed. But if there are no breasts then there can be no maternal milk for the baby. In this case, there is no benefit to the baby in using this technique.
Similarly, a man who says he is a woman, who has developed gynaecomastia in response to his cross-sex hormone treatment or other conditions, can simulate breastfeeding in this way, a practice that some trans identifying men may attempt as it adds to their delusion of having female body parts. To produce some nipple secretions he will need a cocktail of drugs which we know could harm the child. Once again, there is no good reason for the health and wellbeing of the baby for a man to attempt to breastfeed and we should be aware of the motives for this practice.
On this same chestfeeding page a mother is advised to speak to her doctor or midwife if she wants to take testosterone while breastfeeding, and that testosterone can reduce milk supply. I find it shocking that the information here does not raise the risk that the testosterone could have on a baby, male or female. While women are reminded not to drink alcohol, nor take most medication nor oestrogen containing contraception when breastfeeding, somewhat contradictorily a woman who says she is a man is not informed here that testosterone could harm her baby, and that she should not take this hormone while breastfeeding. See for example this page:
The chestfeeding page also has information on binding the breasts while breastfeeding, but this conflicts with the NHS’s own breastfeeding site which makes clear that compressing the breasts during lactation increases the risk of mastitis. Binding is clearly incompatible with breastfeeding.
Finally, the page also links to the organisation La Leche League which used to be such a powerhouse of support for breastfeeding mothers but now has information for men who wish to feed a baby for themselves, encouraging men to take control and support away from mothers which will inevitably see a drop in breastfeeding success.
Pregnancy, birth and breastfeeding are uniquely female experiences, when a mother needs support to care for her child as best she can. The majority of the NHS information rightly focuses on the vulnerability of the baby to the mother’s health and wellbeing, the effect of maternal medication on the child and the responsibility that the mother has for doing all she can to give her child a healthy start in life. When it comes to trans identifying mothers, the NHS appears to have lost this perspective.
Can I ask for your assurance that this web page will be taken down as a matter of urgency, with a revised page posted in due course?
Kind regards
Shame that the obvious has to be pointed out!! Glad this GP is being so brave in this climate
Well said. It’s hugely damaging to BABIES and the reputation of the NHS to publish dangerous and contradictory advice like this. Whoever thinks you can carry on binding your breasts at this time has clearly never breastfed a baby!!.