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Infant Loss and Breast Milk Production
It is easy to forget that women who experience the crushing tragedy of infant demise, stillbirth or even late-term miscarriage will still have to face the reality of dealing with the onset of breast milk production. If you, a loved one or a friend are facing this terrible reality, here is some helpful information on reducing and stopping milk production.
It's important to know if the mother was nursing or pumping at all before the loss of the baby. The process of weaning if the mother was pumping for or nursing a premature or sick baby will be more gradual and complex than for a mother who delivered a stillborn baby but never stimulated the breasts to establish/increase production.
There is no longer a pill or shot that is given to mothers to "dry up" breast milk. While there were drugs of this nature given in the past, they are no longer sanctioned for use due to serious adverse affects including strokes, seizures and death (per Breastfeeding Answer Book, 3rd Edition, pg. 198).
It is important to understand that a pregnant mother begins to produce milk in the breasts (a concentrated, high protein milk called colostrum) starting at around 10 weeks gestation, generally when the breasts increase in size. This is why a mother must deal with the issue of breast milk production regardless of a baby's health status.
Tightly binding breasts is also not recommended, as this can lead to plugged ducts or a more serious condition called mastitis (an infection of the milk ducts). However, a snug sports bra which flattens the breasts and exerts steady pressure, without stimulating the nipples, will send the body signals to slow and stop production.
As milk increases somewhere around the 3rd - 5th day post-delivery, the mother should not pump the breasts, but may use gentle hand expression to express just enough milk to be comfortable and avoid plugged ducts (see my article on Hand Expression in related links, below).
Sage tea or sage tincture is known to reduce breast milk production and can be given to the mother following the directions on the product. The mother can drink to thirst taking care to avoid dehydration, but should not drink excess fluids. Avoid oatmeal, which is known to increase breast milk production and decrease salt intake. Flattened cabbage leaves worn on the breasts and changed every few hours also decreases milk supply. Sudafed (pseudoephedrine) is also known to reduce milk supply – however, a doctor should be consulted before using this method as pain medications or treatment protocols may make this undesirable.
Dads, who may be searching for ways to support the wife in this horrible time, can be important in this process in many ways. Mothers may be sedated in the post-partum period to manage grief as well as compassionately dull post-partum pain. Dads can be aware of the need to watch for plugged ducts and mastitis, understanding that the awareness of breast tenderness which is the most clear signal of these conditions can be dulled by pain medication (see my article on plugged ducts, in related links below). Dads can also manage the cabbage leaf protocol timing for the mother.
If mothers have been pumping milk, the above methods will be of assistance in reducing production, but reduced episodes of pumping may need to continue if hand expression is not sufficient in reducing pressure, but should be used to lower pressure without the goal of completely emptying the breasts. Pumping episodes should be able to be eliminated at the rate of approximately one session each 3-7 days, or possibly faster in combination with other milk reduction protocols.
If mothers express a desire to donate milk, whether previously pumped or pumped while weaning, hospitals may be able to provide resources, or details are available at http://www.hmbana.org/index/donatemilk. They can also provide resources to a mother who might be interested in bringing up her milk supply for the sole purpose of donating. While this is a wonderful service, it is certainly not right for every mother, and mothers experiencing child loss should not be routinely asked about milk donation (as family members are asked about organ donation after a loss) unless they raise the issue on their own.
Child loss is a devastating experience. Understanding how breast milk production works in these situations is important in compassionately handing the practical aspects of the mother's recovery and avoiding physical complications that could make the experience even more difficult.
Disclaimer: All material on the BellaOnline.com Breastfeeding website is provided for educational purposes only and does not constitute medical advice. Although every effort is made to provide accurate and up-to-date information as of the date of publication, the author is neither a medical doctor, health practitioner, nor a Board Certified Lactation Consultant (IBCLC). If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation. Information obtained from the Internet can never take the place of a personal consultation with a licensed health care provider, and neither the author nor BellaOnline.com assume any legal responsibility to update the information contained on this site or for any inaccurate or incorrect information contained on this site, and do not accept any responsibility for any decisions you may make as a result of the information contained on this site or in any referenced or linked materials written by others.
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