The composition of the family has shifted with increased diversification in Western societies. Social recognition and acceptance of individuals identifying as lesbian, gay, bisexual, transgender, and queer (LGBTQ) have led to a new population of parents. There is limited research on the lactation experiences of these parents. However, in a case series report, same-sex mothers report a lack of information being provided by healthcare providers about the role of the nonbirth mother and challenges with the heteronormative paradigm of many healthcare providers (Juntereal & Spatz, 2019). Transgender men also report concerns about the information and assumptions that healthcare providers make about their experiences (Wolfe-Roubatis & Spatz, 2015). Females who undergo changes to become male are able to lactate provided the breasts are present. Their preferred terminology is chestfeeding (Wolfe-Roubatis & Spatz).

Recently, the International Lactation Consultants Association released a statement about using inclusive language for lactation (MacDonald, 2019). There have been several publications in the Journal of Human Lactation (Duckett & Ruud, 2019) and Breastfeeding Medicine (Dinour, 2019). In the position statement and articles, recommendations include using the term "human milk" as opposed to "breast milk" or "mother's own milk" as well as using the term "parent(s)" instead of gendered language. The term "human milk" should be used to describe the milk from the infant's birth parent versus informally shared milk or pasteurized milk. If two parents were lactating, one would have to consider documenting human milk from the birth parent versus nonbirth parent.

At Children's Hospital of Philadelphia, our hospital-wide breastfeeding committee recently reviewed and approved our updated milk expression log for our families. For example, the log book used to be called "Mom's Pumping Log" and now it is called "Family's Pumping Log: A Resource for Pumping Human Milk." We had already been using the term human milk in all of our educational materials but in the new log we changed language to use the term "parent(s)" and we now use the term chest/breastfeeding. We also continue to emphasize the importance of partner and family support (however the individual defines their family) in the lactation journey.

At first, some healthcare providers found it difficult to embrace this change in language. We consulted the literature as well as experts at our institution to address and assist our clinical team members with their concerns and provide education to facilitate changes in how we converse with our families. We encouraged all clinicians to inquire with families on admission or first consultation, what the preferred pronouns are for each family member and then document this in the electronic patient record. This information can be shared in report at each shift so that everyone is familiar with the preferred pronouns as well as words the family would prefer to use when describing their lactation journey.

As healthcare professionals, I would urge you to work with your local resources in your hospital, university, or local community to gain knowledge in this area. By using inclusive and nongendered lactation terminology, we can enable all families to be empowered to reach their personal goals for the provision of human milk to their child.

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