Sen. Roger Marshall demands answers from CDC on ‘chestfeeding’ guidance

Sen. Roger Marshall (R-Kan.) on Tuesday accused the Centers for Disease Control and Prevention of failing to explain the health and safety risks posed to infants and transgender individuals in “chestfeeding” guidance issued by the federal agency.  

Marshall – a physician who has delivered more than 5,000 babies as an OB/GYN – argued in a letter sent to CDC Director Mandy Cohen that the agency’s advice for transgender and nonbinary individuals seeking to “breastfeed or chestfeed” their infants “seems driven by political considerations rather than science.” 

The Kansas Republican and Sen. Bill Cassidy (R-La.), a co-signer on the letter, expressed concern that the CDC doesn’t adequately explain the problems that may arise from transgender individuals using “medication to induce lactation” – which could be passed along to an infant with dangerous consequences.

The lawmakers note that the “only reference to any of the serious risks involved” with “chestfeeding” appear at the very bottom of two pages of guidance issued by the CDC. 

“The [Academy of Breastfeeding Medicine] protocol, which was published in 2020, noted that there was only one official case report of a transgender individual successfully inducing lactation, but cautions that ‘Significant research gaps exist in this field,’ and that ‘there is no published research on the frequency of success’ with inducing lactation,” Marshall and Cassidy write. 

“It further emphasizes that ‘investigation is needed into milk production in parents who have undergone gender-affirming surgeries and those who have induced lactation,’” they add. 

The senators say that while the CDC’s apparent burying of the very limited research available on “chestfeeding” is “troubling,” it is not the most concerning part of the agency’s advice. 

“Perhaps the most concerning aspect of the CDC guidance is where the Agency states that health care providers should help transgender individuals obtain ‘Medication to induce lactation,’” Marshall and Cassidy write.

“As you know, there are currently no medications approved by the U.S. Food and Drug Administration (FDA) to increase the supply of breast milk,” they note. 

Metoclopramide and domperidone, the most common drugs used off-label for the purpose of inducing lactation, “come with significant risks and side effects,” according to the two doctors-turned-lawmakers. 

“The drug’s label states that metoclopramide ‘can pass into your breast milk and may harm your baby,’” Marshall and Cassidy write. 

They add that the FDA has “explicitly warned against using domperidone to increase milk production since 2004 because of safety concerns.”

“The CDC should only issue guidance that is informed by sound data and that informs people of potential health risks. To issue breastfeeding guidance that does not highlight the clear risks posed to transgender women breastfeeding unnecessarily puts the parent and infant in jeopardy of potentially serious health complications,” the senators write. 

In the letter, Marshall and Cassidy demand that Cohen provide them with answers to several questions by Aug. 1, including what peer-reviewed studies and data the CDC used to inform its guidance and why the agency recommends that healthcare providers help transgender individuals obtain a drug that is not approved for use in the US for inducing lactation. 

A CDC spokesperson told The Post that the agency “did not endorse using drugs to induce lactation.”

“Our website references clinical protocol from Academy of Breastfeeding Medicine and information on discussing medications with healthcare providers,” the spokesperson added. “CDC has received the letter and will respond to the senators.”