What Can a Mother Do with Breast Milk after the Loss of a Baby?

During the tender time after the loss of a baby, families go through many challenges. It is normal for mothers to be unsure of where to begin with coping with their loss. One of the hardships a mother immediately faces is what to do with her breast milk. We have gathered some information to help a mother and her supporter(s) make the decision that is right for all involved. These options are to help guide a mother with her emotions and what her body is going through, including what she chooses to do with her milk.

An Unexpected Decision

Your body has either been preparing to make milk or has been making milk for your baby and will not know your milk is no longer needed right away.

• If you do not have milk yet, you may find that your milk “comes in” even after the loss of your baby. This can be surprising and painful, both emotionally and physically. Some mothers may feel more sorrow when the milk arrives, while others find some comfort knowing their body would have nourished their child.
• You may already have an established milk supply if your child was older at the time of loss. Some mothers experience additional emotional and physical pain as their body continues to prepare milk for feedings.

You have options for your milk. There is no right or wrong decision, just the path that feels right to you. Your milk can be safely stored until you decide. The possibilities include:

• Donate milk you have stored or continue to express to a milk bank.
• Continue to express milk regularly.
• Wean (dry up) your milk supply.
• Discard your expressed or stored milk as you would any liquid or frozen food.

Your supporters may be equally surprised at this part of your journey through loss. Many people will not be sure how to help you during this time. Feel free to share this information with anyone who needs to understand the process of lactation after loss.

Donate Your Milk to a Milk Bank

As part of their healing process, some mothers donate the milk they already have stored or continue to express to honor their baby and help other sick babies in need. It can be difficult to throw away milk for some. There are breast milk banks all over the world and they are like blood banks. The breast milk donated to a milk bank is pasteurized and sent to hospitals to help feed sick infants. Milk banks accept any amount of milk, no matter how much or how little, in honor of a child’s legacy.

Milk donors are screened by phone and given further information on the process. Testing, supplies and shipping of the milk are provided by the milk bank. To learn more about milk donation, contact the Human Milk Bank Association of North America.

We do not recommend any mother give her milk directly to another mother. Breast milk should always be pasteurized before it is fed to another baby.

Continue Expressing Your Breast Milk

Some mothers choose to continue to express their milk to help themselves through the healing process, for donation, or for other reasons. Some continue for just a brief time, while others will go for longer. The weaning process can be started at any time. The amount of milk your body makes depends on the number of times your breasts are emptied. Regular and thorough milk removal helps maintain a supply of breast milk.

• Pumping should occur in regular intervals throughout a 24-hour period.
• You can use hand expression, a manual breast pump, a personal breast pump, and/or a medical-grade breast pump to maintain a milk supply.
• If you receive WIC benefits, your local WIC office may be able to provide a loaner pump.
• Many insurance providers will cover the cost of a personal breast pump. Check with your insurer if you have questions about your coverage. Let your healthcare provider know if you need a letter of medical necessity for your insurer that states the reason you need to pump breast milk.
• Pump in a clean location. Sanitize surfaces with an antibacterial wipe or spray, and wash your hands.
• Assemble your kit for pumping. Pump both breasts at the same time if you can.
• Center your nipples in the breast shields (flanges) and turn on the pump with the suction adjusted to the lowest setting. You can increase the suction to a comfortable level.
• Keep the pump on if you see milk sprays or drips coming into the bottle. When there are no more sprays or drips, then stop the pump.
• If you do not see any milk coming after a few minutes, stop the pump and try again in a few hours (see “Breast Engorgement” under “Challenges” below).
• Pumping should not hurt. If you have pain, discuss your technique with a lactation professional.
• Follow the manufacturer’s directions on pump cleaning and sterilizing.
• Pumped milk may be stored in bottles or bags specifically for breast milk.
• Freshly pumped milk can be stored at room temperature (77°F or colder) for up to four hours, in the refrigerator for up to four days, and in the freezer for about six months; up to 12 months is acceptable.
• Some mothers find it helpful to keep a log of when and how much milk they pump.
• Watch for signs of plugged milk ducts or mastitis (see “Challenges” below).

Wean (Dry Up) Your Milk Supply

Weaning a full milk supply can take weeks, but often the process will go faster. The key to weaning is going as slowly as is comfortable to you. Remember that this too is a part of the healing process and it is OK to go through a variety of emotions. Here are some tips:

• If your milk is just coming in and you do not want to continue expressing milk, remove enough milk from the breast to feel comfortable and leave the rest. Try to do this before you are extremely full. Use either your hands to do hand expression or a breast pump.
• To begin the weaning process of an established milk supply, continue to remove milk from your breasts as often as you were latching or pumping.
• When you are ready, start removing your milk less often. For example, if you previously were taking out milk from the breasts every three hours, start stretching out that time to every four hours for a few days, then five hours for a few days, and so on.
• When you start expressing your milk less often, you can also decrease the amount of time you spend expressing your milk. For example, if you were taking out milk from the breasts for about 10 minutes each session, then reduce your time to nine minutes each time for a few days, then to eight minutes for a few days, and so on.
• If your breasts feel extremely full when you make a change in your routine, take a step back and keep expressing as you were. When your breasts feel more comfortable you can continue the weaning process.
• If your breasts are uncomfortably full between milk expression sessions, you can hand express or pump small amounts of milk. Remove just enough to ease fullness and feel comfortable. Talk with your healthcare provider about medications to lessen breast soreness.
• Watch for signs of plugged milk ducts or mastitis (below).

Challenges

Some mothers experience breast engorgement, plugged milk ducts, and/or mastitis during their time making milk or during the weaning process.

Breast Engorgement

Breast engorgement is swelling of the breasts. This swelling can cause warmth, and tenderness or discomfort in the breasts, and can make it hard for the milk to flow.

Ease engorgement by expressing milk before your breasts feel overly full. If you feel engorgement, express your milk by using a pump or your hands to do hand expression. Call your healthcare provider immediately if your symptoms worsen to include a hot, red, swollen, tender area in the breast with fever, chills, and flu-like symptoms. This could be mastitis.

Plugged Milk Duct

A narrowed milk duct (known as a plugged duct) is caused by inflammation of the breast. It usually feels like a tender lump. It may be warm and have some redness over the lump. This can happen when milk is being expressed less often or not completely.

Treatment for a narrowed duct includes:

• Cold compresses to the breast as long and as often as is comfortable until it is gone.
• Ask your healthcare provider if you can take an anti-inflammatory medicine (such as ibuprofen), how much, and how often you can take it.
• If you are pumping:
• Express milk as regularly as you have been. If you have recently taken a step toward weaning, go back to what you were doing before the narrowing occurred.
• Do not express more often or massage the area. This can lead to more irritation and inflammation, causing the duct to narrow more.

Narrowed ducts sometimes lead to an infection called mastitis. If your symptoms do not get better within 24 hours, worsen at any time, or you develop fever, chills, or a fast heart rate, you could develop mastitis. Contact your healthcare provider right away if this happens.

Mastitis

Mastitis is an inflammation of the breast. Mastitis occurs from not emptying milk from the breast. Symptoms include a hard, red, swollen, tender area in the breast with fever, chills, and flu-like aching. Contact your healthcare provider if symptoms do not improve within 12 to 24 hours.

Help for You

Your own healthcare provider will be able to help you with many of the challenges you face after a loss.

We at Cincinnati Children’s are also here to help you and your supporters:

• Center for Breastfeeding Medicine | Call 513-636-2326
• Bereavement (grief) Support | Call 513-636-8484