30/06/2022
A heartfelt share by Lucy Ruddle IBCLC about lactation after infant loss
**Trigger Warning –This post is about lactation after infant loss.**
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Once or twice a year I find myself supporting a mother* through the difficult experience of lactating after her baby has died. The following story is fictional but based firmly on the families I have worked with at such a difficult time. I've decided to write about this very heavy topic because it's often a hidden part of grief, and as such, ,many parents aren't aware that their milk will "come in" and that they do have options. I also want to highlight to other support workers and volunteers that our own feelings here are normal.
I knew the call was likely to come. I’d been alerted by a local doula as to what had happened and I was keeping my phone close by, anticipating it would ring around the third day. Still though, when I saw the mobile number flash up on my screen, fairly late in the afternoon on day 3, my heart stopped for a beat before I took a deep breath and answered.
“Hi there, this is Lucy speaking”
“I’ve been told you can help me with my milk supply. My baby was stillborn 3 days ago.”
I was almost surprised at how “together” she sounded. Her voice was matter of fact and calm, only a tinge of something that could be tiredness or grief creeping in somewhere around the edges when she said “My baby.”
“I can help you, yes.” My voice was soft. “Would you like to tell me your baby’s name?”
One part of my grief and loss training that stands out to me above everything else is the importance of knowing and using the baby’s name (if the parent is ok with this.) I heard an intake of breath, and then “Toby.” Was whispered across the phone line. “Toby.” I repeated gently. “That’s a lovely name.”
There was silence for a moment, then I realised she was crying. “I’m here.” I said “Take your time. I’m right here.”
Once she was ready, we talked about her milk. Her breasts were full and sore. She had been given some helpful information at the hospital about what to expect, and how to hand express. However, she wanted to talk over her options with someone else, and I was very happy to help her with that.
Essentially, there are 3 options for lactation after you lose a baby.
1. You can take medication to stop your milk supply.
2. You can gently reduce milk supply over several days / into a week or two.
3. You can maintain a supply and pump to donate your milk.
There is no right or wrong way to approach this, and it’s really important to say that while a lot of the parents I’ve worked with have chosen to pump for a little while and donate their milk, others just want the whole situation done as soon as possible. It’s a situation that is so unique and incredibly emotional for the mother, and the way they navigate these sorts of decisions always fills me with awe.
Back to our fictional Mother, now:
“I feel mixed.” She was telling me. “This milk – it’s for toby, and I don’t want to waste it. It’s reminding me I’m his mummy – it’s the only thing I have left of him... But that reminder hurts so much. It’s not fair – he’s gone, why does my body not understand that?!”
I was almost completely taken over with a desire to scream as I felt just a touch of the grief she was experiencing. Grateful we were on the phone; I closed my eyes and brought my focus back to where it was needed.
“I really hear your conflict in this.” I reflected to her - grateful my voice wasn’t shaking. “It seems like whatever you do it’s going to be difficult.”
People often assume that the “best” thing to do is simply to give the mother a pill to supress lactation as soon as possible, but mothers often describe feeling a connection with their milk supply to their baby – a reminder that they are in fact mothers. While this can be painful, for many, it can also be part of the grieving and subsequent healing process. It’s not the place of ANYONE to tell a parent what to do in this situation, and it’s important we put aside any desire we may have to “resolve” things.
“I think I want to express, but only for a little bit. Is that an option?”
“Of course! That sounds like it could be a great middle ground. How might that look for you?”
She didn’t know anything about expressing – Toby was her first baby. I started to talk about exclusive expressing as being 8 times a day. Then I stumbled. I wanted to tell her “But you don’t need to do that, because you’re not pumping to feed Toby.” But that felt incredibly insensitive, and I wasn’t sure how to word it. Fortunately, she did the work for me. “I’m guessing I don’t need to do 8 times a day though, right?”
I exhaled slowly, and carried on, wondering if she taken my pause as anything other than a therapeutic technique. We talked a bit more, and then, happy with the plan of pumping to empty her breasts as often as she felt able to, she said goodbye and I was surrounded by the silence of my home. Suddenly, I was painfully aware of my own children sleeping in their beds. I let out a deep sigh and sat quietly for quite some time.
About 3 months later, I received a photo message from the mother’s phone number. It was of a necklace made of breastmilk.
*I am using the term “Mother” here because so far, I have only supported parents through this who identify at mothers, and my work is influenced by the clients I work with.
