MadSci Network: Anatomy

Re: can a normal human male produce breast milk?

Date: Sun Jul 10 18:47:20 2005
Posted By: Jens Peter Bork, M.D., Internal Medicine, Erlangen University Hospital
Area of science: Anatomy
ID: 1119872136.An

Dear Corey, 

thank you for your question regarding the production of breast milk in males. 

The answer here is short: It's a yes. The circumstances however are, if not
abnormal then at least, well, special. 

Let's start at birth. There is the phenomenon of galactorrhea (Greek for
"milk flow") in new-borns. This phenomenon  stems from the fact that of
course the expecting mother is laden with oestrogen. Oestrogen passes the
placenta and does the same work in the breasts of the foetuses/new-borns as
it does in the mother: It leads them to mature and produce milk. The
phenomenon is not that common and, as the maternal oestrogen is degraded
and not replenished after birth, usually wears off after a few days. My
mother tongue, German, has a very ugly word for the milk which is produced
in the new-born’s breast: "Hexenmilch" - witches' milk. It comes from the
time where any apparently unusual or abnormal phenomenon would be
attributed to the actions of "witchcraft". 

The next time galactorrhea can occur is during puberty. There are isolated
reports that with the surge of sex hormones during puberty (during which
boys as well as girls experience a rise in oestrogen levels, though of
course not as pronounced), some boys can experience swelling and soreness
of the breast with an associated discharge upon physical stimulation or
self manipulation. 

The next part is a bit more speculative: From ancient times, there have
been "reports" or rather, legends, of fathers who started to produce milk
after the mother of a new-born had died. I was unable to nail it, but there
appears to be a similar story in the Bible. However, it is not just ancient
books and legends: The famous German naturalist, Wilhelm von Humboldt,
cites credible reports of a lactating man in the South American Andes who
nourished his child for a year; infrequent reports cam from Russia as well.
In the 19th Century, an American physician named Knott collected such
cases, publishing them in 1906. Maybe you can get hold of the reference:
Knott J. Abnormal lactation: in the virgin; in the old women; in the male;
in the new-born of either sex («Witches’ Milk»).Amer Med 1907;XIII:373-8. 

All reports of lactating males have in common that milk production was
inadvertent and surprising. The story is usually that the mother died, and
the father, overwhelmed with grief and love for the child put it to his
breast which upon stimulation by the suckling child started to produce milk
unexpectedly. While I want to stress that Russian anatomists or American
physicists from the 19th century - or Wilhelm von Humboldt, for that matter
- are not an inch less credible in their reporting than we are today, there
are no confirmed, documented first-hand reports of consistent lactation in
grown men available to the literature canon of modern medicine. The subject
thus remains a bit speculative. It is easier in veterinary medicine - it is
a confirmed fact that rams do, on occasion, produce copious milk. 

The question of male lactation seems to be entirely one of the "right"
circumstances: The milk-producing organ is there, complete with fat,
glands, nipple and the requisite hormones: Oestrogen, oxytocine, and
prolactine. They are just not usually there in the right amounts at the
right time. If and when, by a particular whim of nature or unusual
circumstances, these hormones do appear in halfway the right quantities,
lactation in males is - or at least appears - possible. 

Quite apart from this galactorrhea can be a symptom of underlying disease,
usually concerning the hormones oestrogen and prolactin. Some of the
better known conditions leading to galactorrhea in men are
prolactin-producing tumours and liver cirrhoses, a condition in which the
normal degradation of male estrogens is impaired. 

So again, normal males can produce milk under unusual circumstances, not
all of which are associated with disease.

I hope that helps.

Yours truly 
Jens Peter Bork


- contains an overview
about galactorrhea due to prolactine producing tumours 
- Galactorrhea in a patient with liver cirrhosis: Journal of Clinical
Gastroenterology. 25(4):716-717, December 1997 
is a general article about
  has a case of galactorrhea after self manipulation
- - Here you find the article
referring to v. Humboldts report (in German, but nice pictures; loads
directly as a .pdf file)

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