Supporting the Lactation Needs of Mothers Facing Perinatal and Neonatal Loss

Background Breast milk, long recognized as the optimal food for newborns, has immeasurable benefits to both mom and infant. However, in cases of anticipated perinatal or neonatal loss, breast milk is not usually considered in the plan of care. As hospital‐based lactation consultants, who are also practiced labor and delivery nurses, the authors have been challenged by colleagues who are not supportive of the use of breast milk for infants who are likely to die. These well‐intended professionals feel they are acting in the best interest of the family. However, in many of these cases, the use of breast milk can be a wonderful experience for the mother and her infant. By creating a sense of normalcy in tumultuous times, the use of breast milk can contribute to creating positive memories. Overwhelming grief often accompanies the loss of an infant. In addition, some grieving mothers experience unexpected breast changes that accompany lactogenesis II. Addressing lactation issues immediately postpartum should be routine care aimed to decrease discomfort and distress. These mothers also have options regarding lactation other than suppression, such as donating their breast milk, and should be allowed to make informed choices. Case Some mothers who have experienced a neonatal loss call to inquire about donating their breast milk. These mothers seek to give meaning to their loss experience and to honor their children. Information regarding this option should be provided with knowledgeable guidance. Not all mothers will qualify, and disappointment can be abated if they are counseled properly. Mothers who have not started to pump must be educated on the commitment and possibility of stress interfering with milk production. Ultimately, praise for offering a selfless act enhances their emotional healing, regardless of the outcome. An example case involving an infant in the neonatal intensive care unit (NICU) involves the physical and emotional comfort of a mother who gave her son drops of breast milk, prior to his death. Conclusion In difficult loss situations, mothers should still have information about the use of breast milk. Maternity and NICU nurses should be familiar with all options and refrain from making judgments for these families. Lactation consultants can be supportive team members who can assist with the care of these special patients. Educating the mother who elects not to use her breast milk should include engorgement management and the normal process of breast involution so she does not encounter unexpected changes alone. Breast milk, long recognized as the optimal food for newborns, has immeasurable benefits to both mom and infant. However, in cases of anticipated perinatal or neonatal loss, breast milk is not usually considered in the plan of care. As hospital‐based lactation consultants, who are also practiced labor and delivery nurses, the authors have been challenged by colleagues who are not supportive of the use of breast milk for infants who are likely to die. These well‐intended professionals feel they are acting in the best interest of the family. However, in many of these cases, the use of breast milk can be a wonderful experience for the mother and her infant. By creating a sense of normalcy in tumultuous times, the use of breast milk can contribute to creating positive memories. Overwhelming grief often accompanies the loss of an infant. In addition, some grieving mothers experience unexpected breast changes that accompany lactogenesis II. Addressing lactation issues immediately postpartum should be routine care aimed to decrease discomfort and distress. These mothers also have options regarding lactation other than suppression, such as donating their breast milk, and should be allowed to make informed choices. Some mothers who have experienced a neonatal loss call to inquire about donating their breast milk. These mothers seek to give meaning to their loss experience and to honor their children. Information regarding this option should be provided with knowledgeable guidance. Not all mothers will qualify, and disappointment can be abated if they are counseled properly. Mothers who have not started to pump must be educated on the commitment and possibility of stress interfering with milk production. Ultimately, praise for offering a selfless act enhances their emotional healing, regardless of the outcome. An example case involving an infant in the neonatal intensive care unit (NICU) involves the physical and emotional comfort of a mother who gave her son drops of breast milk, prior to his death. In difficult loss situations, mothers should still have information about the use of breast milk. Maternity and NICU nurses should be familiar with all options and refrain from making judgments for these families. Lactation consultants can be supportive team members who can assist with the care of these special patients. Educating the mother who elects not to use her breast milk should include engorgement management and the normal process of breast involution so she does not encounter unexpected changes alone.