Lactation After Stillbirth and Infant Loss

Losing a baby any time after 16-18 weeks gestation may lead to breastmilk “coming in” as the arrival of milk is driven by the drop in hormones irrespective of whether a mother planned to breastfeed or not. A mother may not have anticipated this and may find it very upsetting. While some mothers will want to stop lactation after stillbirth, miscarriage or loss of a baby as quickly as possible, others may take comfort in pumping and donating breastmilk.

Stopping milk production after stillbirth

The Australian Breastfeeding Association’s website has very comprehensive information on reducing milk supply after loss. The full article explains how breastmilk is made, how to suppress lactation, what to do about engorgement and thoughts about coping with the funeral:

Another short guide in a printable leaflet form is available from Empty Arms Bereavement Support:

Express just enough milk to stay comfortable

The key to stopping breastmilk production is to express just enough milk to stay comfortable. This will avoid severe enorgement (breasts painfully full of milk and tender) and reduce the risk of mastitis. Cold compresses (e.g. frozen peas in a damp cloth or chilled cabbage leaves) against painful areas of the breast for 20 minutes at a time can reduce inflammation and help reduce milk production. Advice to ‘bind’ the breasts with tight cloths or wear a very tight bra, or to ignore sore tender breasts without expressing to comfort can lead to breasts becoming engorged. If engorgement is ignored it can lead to painful blocked ducts or mastitis (‘milk fever’) which could lead to an abscess.

Herbs to dry up breastmilk?

Kelly Bonyata has written a useful article discussing how sage, peppermint, parsley and other herbs are thought to help reduce milk supply, it also discusses the use of green cabbage leaves around the breast, wearing jasmine flowers, hormonal birth control pills and certain decongestant medication.

Drugs to dry up breastmilk?

Years ago it was common place to use drugs to dry up breastmilk. These drugs interfered with prolactin secretion (one of the hormones needed for producing milk). This type of drug had some undesirable side effects namely gastrointestinal, cardiovascular and neurological side effects. One of them; bromocriptine fell out of favour as a lactation suppressant due to several maternal deaths, seizures and strokes, however some countries still prescribe it. Another drug cabergoline also has side effects of nausea, vomiting, headache and dizziness. For further information about using drugs to dry up breastmilk consult with your doctor. By expressing to comfort and using the ideas in this article drugs are less likely to be needed.

Bromocriptine inhibits prolactin secretion, and can be effective if given early in lactation, while prolactin levels are high. However, it may be less effective after some weeks when prolactin levels are low. It has been withdrawn from use for this indication in several countries because of the risk of myocardial infarction, hypertension, seizures and strokes. Other side effects reported include nausea, dizziness, hypotension, and severe headache.

Cabergoline is similar to bromocriptine, and also inhibits prolactin secretion. It is longer acting. It may have some of the same minor side effects including headache, dizziness, hypotension, and nose bleeds, but is considered safer.

Donating breastmilk after loss

If a mother is interested in pumping and donating breastmilk she can find her nearest milk bank in North America at Human Milk Banking Association of North America (HMBANA) or in the United Kingdom at United Kingdom Association for Milk Banking (UKAMB). Monique’s story may be helpful; Freya’s Gold: Milk Donation After Loss (Lactation Matters, ILCA).

Still Birthday (a support site for bereaved parents) has a helpful article on Post Loss Lactation. (Editor’s Note: the article states that pumping endlessly can “fatigue the breast and actually dry the milk”. I have never heard of that! Pumping endlessly is much more likely to bring in a big supply of milk, unless the pump is not working properly. Also, please note that you only need drink enough water to quench your thirst when pumping.)

Expressed breast milk and pump
Photo courtesy Emily Walker

As long as a mother keeps pumping she will keep making milk. When she decides to stop donating milk, she can gradually pump less often and for shorter pumping times over a period of a couple of weeks. In this way her breasts will adjust naturally so that the production of breastmilk can come to a gradual end without engorgement.

Support organisations

There are many other support websites that a mother or her supporters may find helpful including Glow in the WoodsCarly Marie ProjectMasons’s Cause, and Still Standing Magazine. For a very comprehensive list of international support charities and websites see LLLI’s When a Mother Experiences Infant Loss.