Lactation Suppression After Infant Death

This is never a topic that anyone wants to encounter or discuss in their lifetime. However, the fact remains that, as rare and devastating as it is, babies do die. And, if you're a breastfeeding mother, you will have the painful reminder that your body is still working for the baby: leaking breasts, let-down discomfort, breast engorgement (potentially leading to mastitis, or infection, if not managed properly). So, what happens next? How do you suppress your breast milk in a comfortable, natural way when you're in the process of mourning the loss of your child?

In that respect, breast engorgement is the biggest concern at this stage. It is important to keep in mind that the frequency and duration of this process vary from woman to woman. It depends on the amount of breast milk you're producing; how often you pumped or breastfed before the loss of your child; and the length of time it has been since the birth of your baby. So, what do we do about it?

When a Baby Dies at Birth or a Few Days After 

If you have a stillbirth or a child that you know will only live for a few days after birth, your body will not get enough stimulation to create a full breast milk supply. In some cases, lactation will follow its normal course even without a nursing baby and you may still go through a stage of breast engorgement within the first two weeks after you give birth, but severe engorgement will likely not be an issue.

When a Baby Dies Suddenly After a Period of Breastfeeding

If you have been breastfeeding for a while and your baby dies suddenly, your body is still in the throes of milk production. You need to reduce the pressure in your breasts, so removing some of the breast milk (not emptying completely!) will slowly drop your milk production without horrible discomfort. The easiest and most efficient way to remove your breast milk is with a breast pump. Although, despite the fact that it's more time consuming and more work, some women choose to hand-express their breast milk. Also, make sure you're wearing a supportive, comfortable bra. Generally speaking, you will pump to comfort and then gradually go longer stretches between pumping, and pump for shorter periods of time. For example, if you have been feeding your baby every three hours, your schedule may be:

• Day 1: Pump for 5 minutes every 4 to 5 hours
• Day 2: Pump for 3-5 minutes every 6 hours
• Day 3-7: Pump only long enough to relieve discomfort

Other Options If You're Not Quite Ready to Give up the Process

Donate your breast milk! The Human Milk Banking Association of North America will guide you as far as how to do so. For many grieving moms, the act of donating their milk is very cathartic, and they feel like they're still connected to their baby as their body is still producing breast milk.

Some Other Helpful Hints:

• Warm showers, after icing engorged breasts, will help to reduce pressure and will aid in letting your breasts leak
• Ice packs, or cabbage leave compresses, can lessen the pain and swelling
• Take ibuprofen or acetaminophen for pain relief
• Specially-designed creams, like Cabocreme, may help to suppress lactation

What About Medications Intended to "Dry up" Breast Milk?

Before the 1990s, medications such as Parlodel were used to suppress lactation. Side effects were intense (nausea, headache, dizziness, and constriction of the blood vessels). Also noted in some women, although rare, was significant low blood pressure, shock, and heart attack. Some reported transient low blood pressure and hair loss. However, the main reason that it is no longer used to suppress lactation is that a number of deaths occurred. A newer medication, cabergoline (Dostinex) is considered much safer for lactation suppression. but as always, the natural route is the better way to go if you can do it.

Edited By: Donna Murray