Co-feeding
Accompanying client resource
Co-feeding (also known as co-lactation) occurs when more than one person bodyfeeds the same infant or child. Co-feeding may occur after pregnancy, surrogacy, or adoption and may involve one or more people being pregnant or inducing lactation [1,2]. Co-feeding provides multiple immunity benefits to infants and allows parents to experience sharing the responsibility and bonding of bodyfeeding [3].
While co-feeding in this document is referring to people who are sharing bodyfeeding, there are many ways to share infant feeding responsibilities and co-feeding may describe many different feeding relationships.
Some families may not be aware that co-feeding is an option, and others may be unaware of the time required for lactation induction. Discussing co-feeding early in the pregnancy or family creation journey will ensure that clients have enough time to make an informed feeding decision [4].
For more information about how to have informed feeding discussions, see Gender-Affirming Approach to Infant Feeding and the client resource Deciding How to Feed Your Baby.
Due to the supply and demand nature of human milk production, frequency of milk removal is a primary factor in producing and maintaining a milk supply [2,3]. Co-feeding requires clients to navigate how to share feeding responsibilities, meeting the infant’s needs while also maintaining the milk supply of two or more people [4].
If the gestational parent is planning to bodyfeed, some families choose to delay co-feeding until two to four weeks postpartum. This allows the gestational parent to establish their milk supply before navigating the complexities of co-feeding.
For some families, co-feeding will cause exhaustion and overwhelm [1]. People who are co-feeding should be encouraged to be honest about their experiences and supported to stop co-feeding if it does not work for their family or worsens their mental health.
Planning for co-feeding
Lactation induction should ideally begin about six months before the baby is due to arrive. If there is less time, clients can still induce lactation but will have less time to prepare their bodies before attempting to establish their milk supply [3].
When parents are planning to co-feed, there should be a clear discussion of practical considerations, expectations, priorities, and values [3]. Having these conversations before the infant is born may decrease the stress of navigating the early days and weeks of infant feeding.
Areas to consider:
- When to begin co-feeding
- Feeding goals for each parent
- How nighttime feeding and pumping will be navigated.
- How supplementation will be given, if required.
- Expectations for time away from the infant for each person.
- Each person’s plan to continue or return to work.
- How they will check in with each other and navigate ongoing infant feeding conversations after their baby arrives.
- Ways to cope with stress and emotions such as jealousy, guilt, relief and/or grief, especially if one person has difficulty with bodyfeeding or a lower milk supply.
Birth planning and the immediate postpartum
When planning for birth, adoption, or parenting by surrogacy, ensure everyone who is planning to feed in the planning process (e.g., in the birth plan). This is of particular importance when one person has gestated the infant to ensure non-gestational parents are not excluded [3].
Discuss the benefits of colostrum with clients to support them in making an informed decision about their infant’s first feed(s). Colostrum is the first milk that provides known immune and gut benefits to infants [5]. Production of colostrum begins in pregnancy and begins to transition to mature milk around day 2-4, completing the transition around 4-6 weeks [6]. People who induce lactation do not produce colostrum; however, their milk provides many immune benefits, and it is safe for them to provide an infant’s first feed.
Support is essential for successful lactation induction. This support network includes healthcare professionals, peers, partners, and family members [4]. Work with clients to create a support plan for the postpartum period, considering their emotional, physical, and environmental support needs [3].
Establishing milk supply
Establishing and maintaining milk supply in two or more people requires extra effort and attention in the first weeks of parenting [3].
- Gestational parents can expect their milk volume to increase at 2-5 days postpartum. Feeding on demand can help manage milk supply and address engorgement.For more information on managing engorgement, see What to Expect During & After Pregnancy .
- Infants should be fed as soon as they display feeding cues. If not alternating feeds, parents should decide who will be providing the next feed before the infant displays hunger cues. This will prevent the infant from becoming overly hungry and refusing to latch.
- If parents are sharing co-feeding equally, each parent should aim for 8 milk removals a day (approximately every 3 hours, not accounting for cluster feeding). This may be through a direct feed or a pumping session.
- Prolactin levels are at their highest in the very early morning (around 3 am), making an overnight pumping or feeding session important to establishing and maintaining milk supply.
- Frequent feeding and pumping can be exhausting and overwhelming for parents [1]. Each parent, whether or not they are bodyfeeding, should aim for a minimum total of 6 hours of sleep every 24 hours to support their physical and mental health. This sleep is not usually continuous and may consist of nighttime sleep and daytime naps.
Maintaining milk supply
Milk supply is dependent on removing milk, which may occur by bodyfeeding or expressing [3]. When co-feeding, one person may need to be pumping while another is bodyfeeding.
For more information about pumping, see Pumping & Maintaining Your Milk Production.
Once milk supply is established, parents should aim for approximately 8 milk removals per day.
- Most parents do not need to pump with every feed the other parent does [3].
- Every person is different, and some people will be able to maintain their milk supply with less milk removals.
- McGuire E. Induced lactation and mothers sharing breastfeeding: A case report. Breastfeed Rev. 2019;27: 37–41.
- Wilson E, Perrin MT, Fogleman A, Chetwynd E. The intricacies of induced lactation for same-sex mothers of an adopted child. J Hum Lact. 2015;31: 64–67. doi:10.1177/0890334414553934
- Schnell A. Successful co-lactation by a queer A reclaimed term for non-heterosexual or non-cisgender people. "Queer" provides convenient shorthand for "LGBT2Q+", and is also used by some people to describe their personal identities. couple: A case study. J HUM LACT. 2022;38: 644–650. doi:10.1177/08903344221108733
- Juntereal NA, Spatz DL. Breastfeeding experiences of same-sex mothers. Birth. 2020;47: 21–28. doi:10.1111/birt.12470
- Fogleman A, Singletary N, Costello R, Allen JC. Biochemistry of human milk. Second edition. In: Lactation Education Accreditation and Approval Review Committee, Spencer B, Campbell SH, Chamberlain K, Lauwers J, Mannel R, editors. Core curriculum for interdisciplinary lactation care. Second edition. Burlington, MA: Jones & Bartlett Learning; 2022.
- Krebs C. Breast anatomy and milk production. Second edition. In: Lactation Education Accreditation and Approval Review Committee, Campbell SH, Spencer B, Chamberlain K, Lauwers J, Mannel R, editors. Core curriculum for interdisciplinary lactation care. Second edition. Burlington, MA: Jones & Bartlett Learning; 2022.
| Current version | January 14, 2025 | |
| Authors | Caitlin Botkin | Nurse Educator, Trans Care BC; Registered Midwife (non-practicing) |
| Rowan McNiven Gladman | Registered Midwife, IBCLC | |