Binding during pregnancy & lactation
Accompanying client resource
Binding During Pregnancy & Bodyfeeding
Some transgender, Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) , and non-binary Umbrella term referring to people whose gender does not fall within the binary gender system of woman/girl or man/boy. Some individuals identify as non-binary while others may use terms such as gender non-conforming, genderqueer, or agender. Non-binary people may or may not conform to societal expectations for their gender expression and gender role, and they may or may not seek gender-affirming medical or surgical care. (TTNB) people may practice chest binding Wearing compression garments or using other methods to flatten the chest. , a gender-affirming practice where commercial binders, compressive clothing, trans-tape or sports bras are used to flatten the appearance of the chest [1,2]. Binding during pregnancy and lactation may become less effective and more uncomfortable. The decision to bind is personal and TTNB people may continue to bind their chests despite discomfort [2,3].
Long term binding may, theoretically, impact milk ducts and ability to bodyfeed [3,4], but there has been no research done to study this.
Most TTNB people who practice binding Wearing compression garments or using other methods to flatten the chest. outside of pregnancy experience at least one complication, including skin breakdown An umbrella term for rashes, blisters, cuts, scrapes and chafing. Can refer to anything that breaks down the barrier the skin provides. or infections, musculoskeletal pain, respiratory concerns, and pain [2]. Despite these complications, almost all participants in one study reported improved mental health outcomes when practicing binding [2]. Trans masculine people are more likely to discuss complications of binding if they are comfortable with their providers [5].
Chest growth during pregnancy is expected for almost everyone, although the amount of growth is dependent on many different factors, including history of chest or breast surgery. This growth causes increased discomfort when binding and, for some clients, may make binding less effective [3].
For people planning to bodyfeed, binding in the immediate postpartum period is not recommended as it will increase the risk of inflammation, ductal narrowing (previously called ‘plugged ducts’), and mastitis. It may also decrease milk supply [1].
Once milk supply is established, intermittent binding may be a gender-affirming practice that prolongs the bodyfeeding relationship. This requires careful monitoring for complications, including skin breakdown, mastitis, and decreased milk supply [1,3].
Harm reduction practices
Avoid judgement when discussing chest binding Wearing compression garments or using other methods to flatten the chest. with clients, offering harm reduction practices to clients who choose to bind through their pregnancy and postpartum periods. Check in regularly throughout the pregnancy about the ongoing comfort of binding and any concerns the client may have.
Harm reduction practices include ensuring commercial binders are the appropriate size, using sports bras to decrease skin related complications, limiting the number of hours wearing a binder, monitoring skin for breakdown, taking days off from binding, and knowing when to seek medical care [2].
Discuss side effects of binding during pregnancy and lactation and ensure clients know when to take off their binder and how to contact their provider if they have concerns related to binding, including shortness of breath, chest pain, or signs of infection.
The accompanying client resource, Binding During Pregnancy & Bodyfeeding, provides more information on managing concerns and when to seek medical care.
Binding in the postpartum period
Clients planning on bodyfeeding should know the significant risks of ductal narrowing, mastitis, and decreased milk supply with binding in the early postpartum period [1,3].
If clients are planning on suppressing lactation through non-pharmacological means, light binding may be used to decrease milk supply. Clients should closely monitor for engorgement and mastitis while suppressing lactation.
For more information, see Lactation Suppression.
Once milk supply and bodyfeeding are both established and comfortable, short periods of binding may be attempted. Clients should be encourage to monitor their milk supply, discomfort, and chest health (including condition of skin) to guide their binding practices [1,3]. Ensure that clients who are binding in the postpartum are aware of signs of a declining milk supply, including pumping less milk (if exclusively pumping), more frequent feeding, slower infant weight gain, and/or chest or breasts feeling less full.
- Gender Confirmation Center. “Chestfeeding”; Before we start. In: Gender Confirmation [Internet]. 5 Jun 2018 [cited 7 Nov 2023]. Available: https://www.genderconfirmation.com/blog/chestfeeding
- Peitzmeier S, Gardner I, Weinand J, Corbet A, Acevedo K. Health impact of chest binding Wearing compression garments or using other methods to flatten the chest. among transgender adults: A community-engaged, cross-sectional study. Culture, Health & Sexuality. 2017;19: 64–75. doi:10.1080/13691058.2016.1191675
- MacDonald T, Noel-Weiss J, West D, Walks M, Biener M, Kibbe A, et al. Transmasculine Refers to trans people who were assigned female at birth and whose gender expression leans towards the masculine. individuals’ experiences with lactation, chestfeeding, and gender identity A person's deeply held, internal sense of themself as male, female, a blend of both or neither. (Source: GenderSpectrum.org) : A qualitative study. BMC Pregnancy & Childbirth. 2016;16: 1–17. doi:10.1186/s12884-016-0907-y
- Charter R, Ussher JM, Perz J, Robinson K. The transgender parent: Experiences and constructions of pregnancy and parenthood for transgender men in Australia. International Journal of Transgenderism. 2018;19: 64–77. doi:10.1080/15532739.2017.1399496
- Jarrett BA, Corbet AL, Gardner IH, Weinand JD, Peitzmeier SM. Chest binding and care seeking among transmasculine adults: A cross-sectional study. Transgender Health. 2018;3: 170–178. doi:10.1089/trgh.2018.0017
| Current version | January 14, 2025 | |
| Authors | Caitlin Botkin | Nurse Educator, Trans Care BC; Registered Midwife (non-practicing) |
| Rowan McNiven Gladman | Registered Midwife, IBCLC | |