To help medical professionals, parents, and the parents' network of support navigate lactation after loss, Carrying To Term has partnered with Mothers' Milk Bank at Austin to provide insight into expressing and donating milk as well as suppressing lactation.
When a woman loses a baby, her body still responds in the way it was designed: to produce sustenance for the life she spent months growing and nurturing. The physical and emotional weight of producing milk for a child who has passed away is a loss in its own right because it is a form of secondary loss- a loss that emerges as a result of the primary loss. It is the loss of the mother-baby bond, the motherhood experience, and the gift of creating memories.
It is normal for a mother to feel as though her body has betrayed her by not realizing that her baby or babies died and no longer have need for her milk. It is also normal if a mother feels empowered by her ability to produce milk, how it validates her motherhood, and the sense of connection with her baby or babies the lactation brings. Only a grieving mother can determine the most emotionally and physically healthy option for her in the days, weeks, and months after saying goodbye to her precious baby.
Medical professionals should discuss lactation and provide resources for expressing and donating milk as well as lactation suppression to ensure women are informed and their wishes and needs are met. All women should be provided with this information in a straightforward manner along with the acknowledgement and validation of her grief and the weight of her decision. In the case of pregnancy continuation following a prenatal diagnosis of a life-limiting condition, information should be presented during the pregnancy to allow time to process, plan, and find support. Specific recommendations about lactation after loss should be avoided. Rather, the purpose should be to provide insight into those options and to encourage mothers to seek a support system along the way.
expressing and donating Milk
Donor human milk is life-saving for babies who are born very early or are very sick. Research shows that human milk decreases risk of necrotizing enterocolitis by 75%. Necrotizing enterocolitis is a serious and often fatal intestinal condition seen in premature infants who are not fed exclusively human milk. Expressing and donating milk has far-reaching effects that truly change lives, and the idea of helping other families and babies in the midst of heartache can bring a sense of comfort, peace, and purpose to a mother as she creates the legacy she desires for her baby.
How It Works:
The first step in expressing and donating milk is for the bereaved mother to reach out to a milk bank near her. To start this process, mothers can simply send an email, and any questions she may have, to Mothers' Milk Bank at Austin (MMBA) at email@example.com, or she can fill out the milk donation form online to request a screening.
MMBA is not the only nonprofit milk bank that mothers can donate to. The Human Milk Banking Association of North America (HMBANA) is a member association that advances the field of nonprofit milk banking through the development of guidelines, member accreditation, and advocacy designed to ensure that all infants have access to human milk. As a member of HMBANA, MMBA encourages women to visit www.hmbana.org/locations to explore their comprehensive list of milk banks throughout North America and determine the location closest to them for donation.
For women donating to MMBA, the milk bank offers drop-off sites in 40 different locations in Texas and beyond, and they also provide all collection materials including: a shipping box, styrofoam cooler, reimbursement for dry ice, and overnight shipping labels to mothers outside of the drop-off areas who need to ship their milk. Mothers receive no payment or compensation for their selfless and generous act of donation, except the knowledge that they have helped improve the health of a fragile baby.
After contacting her local milk bank, the mother will be asked to complete a 10-15 minute screening over the phone with a trained member of the milk bank staff. At MMBA, all employees who walk bereaved mothers through screenings are trained to care for, and communicate sensitively with, grieving parents.
The screening questions are aimed at gathering information to help the milk bank discern whether a donation is safe for premature, sick, and fragile babies, or whether it is best used for research. The person conducting the screening will ask simple questions about a mother's overall current health, any medication or supplements, recent travel history, alcohol intake, and any health history that might help the milk bank determine the best use for the donation.
For some grieving mothers, beginning this process can be overwhelming and difficult. The milk bank works diligently to ensure that every mother feels comfortable and supported at every step of the phone screening process.
Following the screening process, the mother will be asked to complete and return an information packet and have a blood test done, paid for by the milk bank. Once the packet and test results have been received and approved, the mother is then ready to drop off or ship her milk.
MMBA and other nonprofit milk banks do not require a minimum donation amount for bereaved mothers. They believe that whether a mother can provide 10 ounces or 1,000 ounces, her milk is precious and life-changing. By not requiring a minimum donation amount, the milk bank gives grieving mothers the freedom to start with a one-time donation and assess along the way whether or not she wishes to continue expressing and donating.
Expressing and donating milk may not be the right or best option for every grieving mother. For some women, lactation after loss can be a traumatic experience. It can cause an intense emotional reaction and exacerbation of grief. In situations where a mother determines that continuing lactation through expressing and donating milk is not emotionally or physically healthy for her, her decision to suppress lactation should be fully supported. Suppressing milk production is always an option at any point in the lactation process.
Suppressing lactation is the act of stopping milk production. It is a gradual process and can take several weeks for the milk to stop entirely. A grieving mother should suppress lactation under the care and guidance of her doctor, midwife, or a lactation consultant to help her process her decision and care well for herself during suppression. There is no perfect timeline, and each individual woman has the right to choose when suppressing lactation is right for her.
To suppress lactation naturally, a woman should stimulate her breasts as little as she can, avoiding touching, massaging, or pumping milk when possible. Discomfort alleviating processes include:
- placing clean, cold cabbage leaves against her breast, changing them as they wilt
- wearing a supportive--not too tight and not too loose--bra day and night
- using breast pads to soak up any milk that may leak
- hand expressing small amounts of milk to relieve pressure and discomfort
- taking a hot shower and allow her breasts to leak to relieve some pressure and discomfort
- placing cold compresses in her bra to relieve pain and swelling
Bereaved mothers seeking to suppress their milk production should continue to eat regularly and stay hydrated. Dehydration and calorie restriction are not effective ways to suppress milk, and they will negatively impact her health. Binding breasts is not recommended as it can lead to clogged milk ducts and infection. If a woman experiences engorgement- painful and overfull breasts- or painful changes in her breasts like lumps, soreness, red patches, or hot spots, she should contact her doctor to check for infection. Quick on-set flu-like symptoms can indicate mastitis, an infection of the breast tissue, and the lactating mother should contact her doctor right away.
A woman should contact her doctor, midwife, or a lactation consultant if she is experiencing discomfort or finds the process of naturally suppressing lactation to be too long in duration.
The decision to express and donate milk or suppress lactation is a deeply personal decision for a bereaved mother. It is important to ensure she knows her options prior to the start of lactation, when possible, since there is no way to predict how she will feel when her milk does come in. Every bereaved mother has the ability to change her intended plans for expression, donation, and suppression at any point in her postnatal care. A special thank you to Mothers' Milk Bank at Austin for providing the resources and information necessary to write this piece.
Written by Sarah Garvey- in memory of her triplets Bridget, Vivian, and Liam Garvey- for Carrying To Term (www.carryingtoterm.org) and Mothers' Milk Bank at Austin.
Who We Are
Mothers' Milk Bank at Austin (MMBA) is a nonprofit milk bank that saves babies' lives through the provision of pasteurized donor human milk. In 2017, MMBA celebrated dispensing 5 million ounces of milk since opening their doors in 1999. In 2017 alone, MMBA dispensed 600,635 ounces--or 4,693 gallons--of milk to 129 hospitals and 82 outpatients across the United States. Their work has been instrumental in changing the standard of care for sick and fragile babies through the use of donor human milk for consumption, and for their research aimed at improving outcomes for babies born prematurely.
Carrying To Term is a national nonprofit organization dedicated to broadening public support of pregnancy continuation through educational, logistical, and emotional support of life-limiting prenatal diagnoses. We work closely with medical professionals to ensure every physician and member of a woman's care team feels equipped to support pregnancy continuation, and we believe every woman has the right to the same standard of care and deserves to be fully informed in her decision to carry to term.
Mothers Milk Bank, www.milkbank.org.
Mothers' Milk Bank. Express Your Inner Lifesaver: Become a Milk Donor. n.p., Print.
Mothers' Milk Bank. Teardrops and Milkdrops: Lactation Options After the Loss of Your Baby. n.p., Print.