The Centers for Disease Control and Prevention (CDC) has published on their website guidelines for people who identify themselves as trans and nonbinary about how to “chestfeed”.

The CDC website has updated information about how to feed biological women whose breasts were removed during gender-reassignment surgery, and biological men who take hormones to grow breasts.

In the section of the CDC’s website entitled “Infant & Young Child Feeding Tools” under the heading “Health Equity Considerations,” the statement read: “Transgender, nonbinary and non-binary individuals can give birth to a child and breastfeed them or feed at their chest.”

The agency noted that the gender identity and expression of transgender people is different than their birth sex, noting that nonbinary gendered individuals do not neatly fit into either a man or a woman.

The agency’s website uses the term “chestfeeding” in the section “Breast Feeding,” which discusses breastfeeding for people who have had surgery.

The health agency also wrote: “Can transgender mothers who have undergone breast surgery breastfeed their babies or chestfeed them?”

Answer: “Yes,” with the explanation that some transgender parents may want to breastfeed or chestfeed their infants (a term used in transgender and nonbinary parenting).

The healthcare providers who work with these families need to be aware of the medical, emotional and social aspects of gender changes in order to provide optimal care for the family and meet the nutritional requirements of the infant.

The CDC stated that transgender mothers “may also need help” with “maximizing milk production, supplanting with donor pasteurized human milk or formula or avoiding medication that inhibits lactation, suppressing milk (for those who choose not to breastfeed, chestfeed),” and “Finding the appropriate lactation management, peer support and/or emotional supports.”

The Daily Mail reported the recommendations are for men who can produce breastmilk after taking hormone drugs. FDA warned that domperidone “can pass through breast milk and cause babies to have an irregular heartbeat.”

Dr. Jane Orient is the executive director of the Association of American Physicians and Surgeons. She told the outlet that “the CDC had a responsibility to discuss the health risks but they were negligent in doing so.”

She said, “We don’t know what long-term effects will have on the child” if the trans parents use “all sorts of hormones off-label.”

Off-label means that the drug is used for another purpose than it was intended for. The report stated that some medications required to induce lactation among trans women have not been approved in the US for increasing milk production.

In 2004, the FDA issued an advisory warning women who are breastfeeding not to use domperidone because of safety concerns.

The Daily Mail reported that experts had warned trans women against using the Newman-Goldfarb Protocol, which involves consuming a drug cocktail to enable one to milk. It is unknown what the long-term effects of this treatment will be for both adults and babies.

The Daily Mail reported that New York-based Dr. Stuart Fischer said it was “very difficult to believe” the breastmilk that naturally occurs in biological women is the same as that created by hormone medications in biological men. He added that “if it’s only been tested a few times, how could we know the long range effect?”