As Certified Breastfeeding Counselors (CBC), we support families in all stages of lactation. With one in four women experiencing a pregnancy or infant loss in their lifetime, we will inevitably support loss parents at some point in our career. Being familiar with lactation after loss is an important part of our role in supporting families.

After experiencing a loss, many parents are caught off guard having to navigate lactation after loss. Unfortunately, a placenta detaching from the uterine wall triggers milk regardless of whether there is a baby ready to feed or not.

Supporting families through lactation after loss can be difficult. However, we have the opportunity to provide empathetic care during an awful experience.

Lactation After Loss – What Happens After Pregnancy and Perinatal Loss?

Pregnancy is a complex hormonal process. The physiology of pregnancy means when the placenta detaches from the uterine wall, it plays a role in triggering lactation. While some leak throughout the second half of pregnancy, it is when the placenta detaches that lactation really begins.

For those who experience the end of a pregnancy after as early as sixteen weeks, they are likely to experience some lactating.

While we know breastfeeding is a supply and demand process, it is also a physiological norm following pregnancy. This means that even if there is no nipple stimulation, colostrum and then some mature milk, is likely to be produced.

This can lead to leaking, engorgement, and even infection. On top of the immense physical and emotional pain of losing a baby, parents must navigate the physical and emotional pain of lactation without their baby feeding.

Typically, about day three post birth, a parent may experience engorgement and milk leaking if they haven’t already experienced it. Regardless of nipple stimulation, mature milk can come in due to the normal hormonal fluctuations after birth.

One can continue to leak and be encouraged for days, weeks, or even months after a loss depending on their body, management, and level of stimulation.

Managing Lactation After Loss

For many parents, lactating is a cruel reminder of not having their baby to feed. While they certainly never forget their baby, the physical reminder is extra salt on their unimaginable wounds.

It is not surprising then, that most wish to end their body’s lactation as soon as possible. For some bodies, this easily happens with just minor leaking and discomfort for a bit with no interventions.

For other bodies, the engorgement can be extremely uncomfortable and require support.

To provide relief, parents can:

• Express just enough milk for comfort to relieve some engorgement. Ideally, just a bit of hand expressing, though some find it necessary to use an electric pump. Try to avoid completely emptying the breast unless necessary due to infection, clogged ducts, etc.
• Use cool compresses, especially after expressing milk. Cold cabbage leaves can also be used and might help relieve engorgement more than standard cool compresses.
• Typically, over-the-counter pain relief, such as ibuprofen, can be used. Parents should check with their midwife or doctor.
• While binding used to be suggested, it no longer is standard to suggest. Wearing a supportive bra, however, can provide some support and relief of discomfort.
• Herbs such as peppermint, sage, and parsley in large quantities or as supplements can help some people. They can ask their doctor, midwife, herbalist, etc. about these options if more than dietary quantity.
• Some find hormonal birth control pills will reduce supply. This is no longer standard, however, if a person is otherwise interested in birth control, they can discuss the benefit and risk of these options with their medical provider. It is no longer advised to take prescription medication purely to dry milk supply.
• Decongestants will reduce supply in some, another option to discuss with their medical provider.

Some medical providers will suggest some pumping for a couple weeks to aid in perinatal hormonal adjustment. However, that is often balanced with understanding the immense stress of losing a baby.

Pumping To Donate – Lactation After Loss

Every parent has a unique way to navigate the loss of their baby. There is absolutely no right or wrong way to manage. For some parents, lactation is a cruel reminder of loss. For others, it is a reminder they carried their baby, and they are not comfortable simply stopping.

For some, they find healing and a way to navigate grief by giving back in honor of their child. They do this through pumping milk for however long they are comfortable and donating the milk to others. It is helpful for parents to be aware this option exists. However, it is important to navigate this topic very carefully.

Unless a parent asks about what to do with pumped milk or the option of donating, it can be difficult to broach this topic.

Supporting parents through loss can be quite challenging. As a certified breastfeeding counselor, you can lean on your training and education to help navigate supporting these families.