How to deal with Lactation post Loss – a review

This post struck as a such a huge part of losing a child close to the birth is dealing with your milk supply. It is an emotional topic and there is not a right or good answer. The following is from This post is from Tanya at This is a review of a publication By Jessica Welborn.

Review: Lactation Support for the Bereaved Mother

hmA few years ago I collaborated with Carol McMurrich, the leader of our local bereavement support network, to produce a pamphlet called Lactation after Loss. It’s intended to help mothers deal with lactation after they’ve lost a baby in pregnancy or infancy.

When I heard that the Human Milk Banking Association of North America had just released a book on this topic I knew just whom I’d ask to review it! Carol’s review of it is below.

The book is written by Jessica Welborn. I interviewed on this topic for a podcast on the Motherlove Blog.

When my first baby, Charlotte, died during her birth in 2003, I remember that it was me who asked my midwife what I should do when my milk came in. I remember her long, grave face, and her recommendations to wear a tight bra, use ice and ibuprofen for pain, and avoid any stimulation to my breasts at all– even a hot shower.
The excruciating agony I experienced, mostly emotionally but also physically, during the weeks that it took for my milk to come in and subside left me yearning for a better way for women to go through this stage of their bereavement. At the time I was too bereft to look into whether any resources existed, either for mothers or professionals. But as time went on and I did try to drum up some information, I was dismayed to find that it seemed a blind eye had been turned to the whole topic of lactation after loss.
I was pleased to discover recently that Jessica Welborn, who wrote a dissertation on mothers who had chosen to donate their milk following the deaths of their babies, has produced a document entitled, Lactation Support for the Bereaved Mother: A Toolkit – Information for Healthcare Providers. Here there is finally a resource that spells out for professionals the very real and possibly healing options (or at least not detrimental, as the breast-binding was for me) that mothers have when their baby dies and their milk still flows.
First and foremost, Welborn’s style clearly demonstrates the time and care she has spent with bereaved mothers. The document is extremely compassionately written, yet also fully factual and accurate. It spells out, in careful detail, exactly how a mother who is still producing milk after the death of a baby can and should be supported around the issue of lactation. Welborn does not dance around the fact that lactation is often not addressed with mothers and that this can be very harmful. She is clear in stating the obvious fact that no mother can escape the production of milk; therefore how to manage this milk in a way that is least harmful and most healing is an essential role that a healthcare provider plays.
Welborn beautifully lays out the ways in which milk can be meaningful for a bereaved mother. In sections titled, Pumping as Ritual, Pumping to Identify as Mother, and Pumping as a Tool for Grieving Loss, she is able to make clear the different ways in which continued lactation can assist in the grieving and healing process. As a bereaved mother, I appreciate the sensitive way that these sections were written and could personally relate with much of what Welborn communicated.
This section is particularly important because it precedes the section on milk donation. From work that I have done personally with health care providers who work with bereaved mothers, I know that many of them are very hesitant to bring up the idea of milk donation with mothers, fearing that it is presumptuous to imagine that a mother might want to deliberately maintain some milk supply when she has no baby to feed. Coming to understand some of the ways in which milk production can be a tool for healing may help some of these providers to see that pumping and donation are a very real option for some mothers and should always be offered at the time of a baby’s death.
That said, Welborn also addresses how to assist those mothers who do not choose to continue lactation and prefer to let their milk supply dwindle and subside. This section is written with clear suggestions on how to do this safely and comfortably, and how to support the mother emotionally while this is happening.
While Welborn’s piece clearly leans in the direction of encouraging mothers to donate their milk whenever possible, I also respect that the lens through which she may understand the healing power of this ability to sustain life through milk donation is the result of the many mothers she has known who have benefited from donating. The sections which talk about mothers who choose to dispose of unused milk or dry up their supply are respectfully and thoughtfully written; I will state again that there was nothing in this entire piece that I, as a bereaved mother, found in the least offensive.
The one thing this piece left me yearning for was slightly more division between suggestions for mothers who have had stillbirths versus those whose babies have lived for some time. The experience of lactation is very different for a mother whose milk comes in at a time in which she hopes that her baby will survive and someday need that milk. likewise, the decision to donate or pump when one has already established a supply and has a relationship with a good, hospital grade breastpump is different from a mother whose baby has already died deciding to build a supply exclusively for donation. It is far more common to find the mother whose baby has died in utero, who has been sent home and surprised to awaken alone at home on the second or third day with engorged breasts and little idea of what to do. Specifically addressing the importance of working with this population could use slightly more attention.
This said, I can’t imagine that a better resource could exist for those mothers whose young babies have died. I am impressed with Welborn’s research and presentation and hope that this document will find its ways into NICUs and birthing centers across the country and the world.

Leave a Reply