Like her own mum, Alice couldn’t birth her baby – but she can breastfeed her
Inducing lactation is not often talked about. But here, Australia’s first IVF surrogate child – and her mother – discuss their experiences, 36 years apart.
By Alice Clarke
Left: Maggie Kirkman in 1988, feeding Australia’s first IVF surrogate baby, Alice, via a tube from a packet of breast milk hanging around her neck. The aim was to stimulate lactation. Right: decades later, Alice went through induced lactation herself to feed her and her wife Karma’s baby, Artemis.
I’m a lot like my mother in all the expected ways: we’re both tall, have similar dark senses of humour and our hair has the same general vibe. But it turns out I’m also like my mother in less common ways: we both had issues with fertility in our 20s, followed by a hysterectomy due to massive uterine fibroids in our early 30s. Then we both managed to have children anyway with the help of a sperm donor (both our spouses had sperm counts of zero) and another woman to birth our daughters. Where the similarities end, though, is that my aunt Linda gave birth to me, marking the first IVF surrogate birth in Australia, whereas I had the coincidental good sense to be a lesbian, and my wife, Karma, gave birth to our daughter, Artemis.
Another similarity, more relevant to this story, is that despite neither of us giving birth to our children, both my mother and I induced lactation to breastfeed our babies, 36 years apart. Inducing lactation – breastfeeding a baby despite not having carried it – isn’t new; people have been doing it for thousands of years. But many don’t know it’s possible, why someone would do it or what’s involved. That’s leading some to miss out on an incredible bonding experience – and an opportunity to regain control over a fertility process that might have been challenging.
Samantha Bryant, a 47-year-old midwife and maternal and child health nurse from Melbourne, induced lactation in 2016 after she and her husband Ben had their daughter through a surrogacy arrangement. Her sister Rachel gave birth to her daughter, Starla, after Bryant’s years-long unsuccessful quest to get pregnant herself through IVF necessitated by her history of ovarian cancer. Bryant’s decision to breastfeed her daughter came from a desire to take charge of some part of the ordeal and have as much of the experience she’d wanted as she could physically achieve.
“I’m a midwife, so I understand the benefits [of breastfeeding]. But also, it was the one thing in that whole process that I could actually have some control over because I’d had no control,” she says. “I had lost my ovaries, and I had been fighting for my life. I followed the directions to make me well after my cancer, and then I went through all the IVF and followed those instructions. Once we moved on to surrogacy, that was an even bigger [deal] because it’s not your baby at the moment, it’s not your pregnancy. It’s your sister’s pregnancy. So, I realised how important it was for me to have decided to feed Starla – [to] have that choice and control.”
Bryant is sitting in her living room, in the Melbourne beachside suburb of Frankston, on a comfortable-looking grey couch, a framed motivational poster behind her. She’s a woman with kind eyes and an easy laugh, and you get the impression she gives excellent hugs. You can also see the weight of trauma from her experiences leading up to breastfeeding.
My reasons for wanting to breastfeed were complicated. I had the smug sense that two mothers were better than one, and that by being able to split the feeding night shift, allowing both of us to get eight hours of sleep, we would “revolutionise” parenting. On a deeper level, I wanted the connection that comes with literally giving of myself to my child. I’d tried to be a gestational mother, and have the emotional scars of several failed rounds of IVF to prove it, so I perhaps also had something to prove to myself. Plus, I didn’t want all the physical burden of child creation to be on my wife when I have the parts and we humans have the technology. It’s something helpful my body could do, so why wouldn’t I give it a shot?
Writer Alice Clarke (centre) with wife Karma, baby Artemis and Alice’s mum Maggie.Credit: Courtesy of Alice Clarke
My mother, Maggie Kirkman, is now 77. She is a senior research fellow at Monash University, religiously walks at least 10 kilometres a day, does weights at the gym and fairly recently took up riding a tricycle after an injury ended her regular running routine, which she started at 64. There’s an edge to her that some find intimidating. I interview her for this story in her Melbourne CBD apartment. Like everywhere she’s ever lived, it’s filled with books and the largest TV she felt she could get away with, signs of her two main inactive hobbies: reading deeply and watching reality TV.
Mum had her hysterectomy at 30. We sometimes argue over who had the largest fibroids, but I’m at an unfair advantage, given I was able to take a bucket of my uterus home after surgery (it seemed like a good idea at the time, I thought it would make a nice decorative object) and she couldn’t. Using surrogacy was my dad Sev Clarke’s idea, and it was Mum’s idea to ask her little sister, Linda, to act as a surrogate.
‘I wanted you to have all the benefits of my breast milk [and not] rely on other people’s donations.’
Maggie Kirkman, Alice’s mother
My birth in 1988 was a fairly big deal: I was the first IVF surrogate baby in Australia, which caused both excitement that it was possible and controversy over what it might mean. The media interest was so great, Mum and Linda had to switch hospitals for safety. After my birth was leaked to the press, my parents were summoned to a press conference at a large city hotel, where I was presented, Lion King-style, to local and international media. It was only when I was in mid-primary school that I realised that not everyone was interviewed for the papers or TV on their birthday.
My mother induced lactation for me using a combination of manual stimulation and taping a supply-line straw (connected to packets of breast milk donated by my aunt’s friends) to her nipple so that I would take both. It was a huge effort.
Her motivation was my welfare. “People just assumed it was so that I could bond with you, but I never had any doubt about bonding with you,” she tells me. “It was more because I didn’t want you to have any disadvantages from the manner of your birth. After Linda gave birth, you were going to be my responsibility. I wanted you to have all the benefits of my breast milk. I didn’t think it was appropriate to rely purely on other people’s milk donations. I thought it was my responsibility and my pleasure to do what I could to induce lactation so that you had my antibodies, which were suitable for the environment in which we lived.”
According to the Melbourne-based editor-in-chief of International Breastfeeding Journal (and the doctor I worked with to induce my own lactation), Lisa Amir, the main things needed to induce lactation are sufficient breast for a baby to latch onto, and plenty of hormones. It’s easy to think that because our bodies evolved to breastfeed, it should be simple, but there’s a lot involved. “Part of my job is helping manage that expectation when people first come in,” says Dr Anita Bearzatto, a GP and certified lactation consultant.
Because information is thin on the ground for inducing lactation, it’s hard to know what to ask and when appointments are necessary. You also need the help of experts to get your timing right.
The best time to begin is around the start of the second trimester, but getting the referrals you need could be the first challenge because many well-meaning obstetricians and midwives don’t know how long the process takes. One midwife said we didn’t need to think about it until my daughter was born. One obstetrician claimed heroin makes people lactate (while heroin can increase prolactin, one of the main hormones responsible for lactation, experts are divided over whether or not it actually makes you lactate). Eventually, he gave me a referral to a lactation consultant (presumably not for heroin). Getting that referral took a couple of months of repeatedly asking around.
The process of inducing lactation is relatively straightforward but quite labour-intensive. The current best-practice method was developed in Canada by Drs Jack Newman and Lenore Goldfarb. A lactation educator, Goldfarb was able to produce almost a litre of breast milk a day for her adopted son in 1999. It begins by simulating the hormones of pregnancy by taking the combined contraceptive pill once a day plus two domperidone tablets three times daily. Domperidone is a prescription-only medication used off-label as a galactagogue, which is an excellent word for foods and medicines that promote breast milk production. Closer to the birth of the baby, the parent stops the contraceptive pill (to trick the body into thinking it’s given birth) and starts trying to express milk, and continuing to take the domperidone.
Alice’s weekly pill planner includes domperidone and assorted vitamins and minerals.Credit: Courtesy of Alice Clarke
The main people who induce lactation are non-gestational mothers – usually as part of adoption or surrogacy arrangements, but also queer parents. There’s been recent success with transgender women receiving hormone therapy being able to feed their babies, and cases of particularly involved, babysitting relatives. There have even been documented instances of men breastfeeding babies in dire circumstances, such as after the death of the mother.
Domperidone is a dopamine antagonist, often prescribed for gastrointestinal issues, to combat nausea, or as an antipsychotic. I experienced side effects, which mostly manifested as an upset stomach, difficulty focusing, crying more easily and being a bit more irritable. Think mild PMS, but without being able to concentrate long enough on your usual comfort activities to relax. In a 2019 Australian online survey of women using domperidone, roughly half reported side effects such as headaches and weight gain, some so bad that they stopped taking it. My headaches calmed down a bit after the first six weeks, although the weight gain has been deeply inconvenient.
It’s also possible to induce lactation without taking hormones, as my mother did, but the chances for success are lower and it’s much more labour-intensive. The process is to stimulate the nipple every few hours and to build up to expressing. Then, after the birth, getting the baby to further stimulate milk production by getting the baby to suck at both the nipple and the attached supply line of donated milk. “I was offered drugs, and I now can’t remember why I chose not to have them,” Mum says, “but [probably] because I thought it was a possibility without drugs, I decided to try it. I’d had so many drugs to produce eggs [during IVF attempts], my whole body seemed to have been attacked for a long time with assorted medications. Drug-free just seemed like a good option.”
I’ll never forget the weird excitement I felt the first time some milk came out.
Alice Clarke
When I was a small child, I visited a farm and milked a cow. I remember no details other than how the udder felt and the way I had to move my fingers. It was a forgotten memory – until it was suddenly unearthed by my need to express every three hours for a couple of weeks before my daughter was born.
Milking oneself (for want of a better term) is very boring, until it becomes both boring and uncomfortable. While Dr Amir insisted that an electric pump wasn’t necessary, I ended up getting one so I could pump and at least play video games to break up the monotony. Still, I’ll never forget the weird excitement I felt the first time some milk came out. It felt like victory. I was not brave enough to see whether it also tasted like victory. But those drops of white gold meant the months of medication were going to be worth it. I could produce milk and feed my daughter. The relief was immense. It was difficult to tell who was more thrilled, me or my wife.
Mum also remembers the joy she felt the first time she produced milk. “It is really hard to describe the feeling. [My sister] Linda was just massaging my breasts to try and draw milk out, and there was a drop. It was clearly milk. ‘Triumphant’ is the wrong word, but I was satisfied and fulfilled, having achieved what I had wanted to achieve, and that even if you weren’t getting a lot from me, you’d be getting important antibodies and whatever else to help you.”
Samantha Bryant went more impressively hardcore than Mum or me, pumping every three hours and freezing the milk to later mix with donated breast milk from her sister. “I wasn’t getting huge quantities, but I was freezing all of it,” she says. “I was OK with that because I knew I had done absolutely everything possible. I was taking max domperidone, I was on fenugreek, I was on brewer’s yeast [both natural galactagogues], and I was going to acupuncture. I had a community of women helping me.”
I went into inducing lactation with the same cockiness that I’d had going into IVF, thinking my personal history would somehow make it easy. Even though the medications for inducing lactation did a real number on me, and having to wake up every three hours to pump was inconvenient, it didn’t seem that bad. The process of getting to this pregnancy had been so complicated, and I’d taken so many hormones for egg collections, and the hysterectomy in 2022 had required so many blood draws and tests, that I was grateful it was six pills a day rather than any more injections.
Alice with baby Artemis.
The day your child is born is a profound one. If you’re very lucky, the memories are entirely good: of a beautiful birth, of getting to hold them for the first time and of feeling them feed. But this depends on the care you get and whether everyone’s bodies cooperate to give you a good birth and a good latch. Parents can spend nine months preparing, but there are factors well beyond our control.
We were even more lucky that Artemis was a natural when it came to breastfeeding. Karma enjoyed the “golden hour”, where the baby is allowed time to crawl up the mother’s chest to find the breast and latch on naturally, and little Artie latched with gusto. A couple of hours later, she was ready to feed again and it was my turn. My supply was lower than Karma’s, so Artie had to latch differently onto me, but she worked it out in under a minute. She fed hungrily, and I remember feeling this surge of relief that it had all been worth it. I was finally getting to hold my daughter after eight years of trying, and I was able to feed her.
Surrogacy still seems to raise more eyebrows in Australia than queer parenting. In fact, both Mum and Samantha Bryant had bad experiences with their initial hospitals. The private hospital where Bryant’s sister gave birth treated Bryant with suspicion, refusing to let her lactation consultant in to help her establish feeding. She faced so much hostility, lawyers became involved. Somehow, her experience was worse than my mum’s, despite Bryant having 28 years of IVF surrogacy precedent to point to.
It is surprisingly difficult to gain access to donated breast milk in Victoria. It’s also difficult to donate it formally, causing many people to turn to formula or, sometimes, unregulated Facebook groups. When I was born, friends of my aunt would bring breast milk to the hospital, and later to her house, to feed me.
‘I couldn’t birth her, I couldn’t make her … But after I [fed her], the connection was instantaneous.’
Samantha Bryant
Setting up the supply lines took a bit of doing, and Mum would have to defrost the milk in a hurry. “I never, ever managed to get the milk properly unfrozen,” she says. “I had to get it too quickly, so I’d have [the breast milk packet] attached to my chest and pressing my hand on it to try to warm it up. The joke was always, for years, that that’s why you always preferred your peas still semi-frozen.”
There was a moment that made it worthwhile for Bryant, despite an overall unpleasant experience in the hospital. “The minute she was born, she just latched on and bang,” Bryant recalls. “We bonded instantly. I never realised how important being able to make that connection is. I couldn’t birth her, I couldn’t make her, I paid for her to be made, and I had to rely on the lab. But after I did that, the connection was instantaneous, and she knew I was her mum.”
The first couple of nights after we took Artie home, my wife and I slept in shifts. I was able to feed Artie completely during my turn and then get eight hours’ sleep while Karma took over. Unfortunately, after a few days, I could no longer keep up with Artemis’s demands as her stomach grew while my supply stayed steady. I was relegated to one or two full meals (from five or six) and a couple of snacks throughout the day, which ended up fitting in better with what our family needed, anyway.
While some people can generate a full milk supply to feed their baby, most who induce lactation can’t. Lactation consultant Anita Bearzatto puts it well: “When someone says they were successful with inducing lactation, there’s just so many layers to that because success doesn’t just equal volume of milk achieved. The way I look at it is: breastfeeding is the milk, but it’s also … the importance of the relationship and what goes on – closeness, neurotransmitters, bonding – separate to just the properties of the milk …”
Karma and I have noticed a measurable difference from having us both able to feed,
Alice Clarke
Most parents who induce lactation stop after a few months, particularly in queer couples when one partner has a full natural supply. At the time of writing, I’m only 18 weeks into this journey, and I don’t plan on stopping any time soon, though the thought has crossed my mind a few times when it’s been more challenging. Some days, Artie will just scream at one of my breasts as though it’s haunted, and while I know she’s not doing it deliberately, it can still hurt my sleep-deprived feelings. It can also be difficult to justify all the extra effort when my wife is right there, offering more than enough milk to instantly satisfy our baby. But both Karma and I have noticed a measurable difference from having us both able to feed, in terms of how much sleep we can get and how it allows us to maintain active hobbies, like cycling and running a tea club, even while parenting a newborn.
Both my mum and Samantha Bryant continued breastfeeding for four months. That struck the right balance between achieving their aims and knowing when to quit. “I have no regrets,” says Bryant. “I stopped at four months because it wasn’t fun any more. I felt the psychological aspect was starting to pull away, because of the pumping and the tedious supply line … I’m just so grateful for what I did for her.”
While I wouldn’t recommend inducing lactation recreationally and would caution that it’s not for the faint of heart, despite all the complications and difficulty, it’s an experience I wouldn’t trade for the world. I’d do it again in a heartbeat.
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