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Lactation Induction in a Transgender Woman With Electrocardiogram Abnormalities.

Marisa Horak1, Lauren DeLeon1

  • 1Grand Rapids, MI, USA.

Journal of Human Lactation : Official Journal of International Lactation Consultant Association
|July 15, 2026
PubMed
Summary

Lactation induction in transgender women using domperidone is possible even with pre-existing EKG abnormalities. Careful cardiac monitoring is essential for safe breastfeeding support in transgender individuals.

Keywords:
LGBTQIA+access to carebreastfeedinggalactogogueshormonesinduced lactationself-efficacy

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Area of Science:

  • Endocrinology
  • Reproductive Health
  • Transgender Healthcare

Background:

  • Transgender women desiring to breastfeed may pursue lactation induction protocols.
  • Domperidone-based protocols are commonly reported for lactation induction.
  • Domperidone use carries risks, including ventricular arrhythmias, prompting provider caution with electrocardiogram (EKG) abnormalities.

Purpose of the Study:

  • To report the successful use of a domperidone protocol for lactation induction in a transgender woman with EKG abnormalities.
  • To describe institutional barriers encountered in providing lactation induction care to transgender patients.

Main Methods:

  • A domperidone-based protocol was utilized to induce lactation.
  • The patient had multiple EKG abnormalities, including first-degree atrioventricular block and right bundle branch block.
  • Non-pathogenic QT elongation was observed during therapeutic domperidone dosing.

Main Results:

  • Successful lactation induction was achieved using the domperidone protocol.
  • The patient tolerated therapeutic domperidone doses despite pre-existing cardiac conduction abnormalities.
  • Institutional barriers to accessing lactation induction care were identified.

Conclusions:

  • Domperidone can be safely used for lactation induction in transgender women with appropriate cardiac monitoring.
  • Clinicians should collaborate with transgender patients seeking lactation induction rather than withholding care.
  • Further research into safe domperidone use in this population is warranted.