Lactation after Perinatal, Neonatal, or Infant Loss

Abstract

After losing an infant, grieving mothers may still have to cope with postpartum issues, including lactation. This article reviews and addresses care options for lactation concerns after pregnancy, neonatal, or infant loss. Currently, lactation care and advice after loss varies greatly. Lactation consultants are instrumental in providing mothers with anticipatory guidance and evidence-based care. Implementing system-wide training and education regarding this topic will help families receive the information they need to deal with the physiological aftermath of infant loss.

Taiwanese Women's Experiences of Lactation Suppression After Stillbirth

“…Researchers on this topic have focused on the emotional effects of stillbirth and women's adaptation (Hsu, Tseng, Banks, & Kuo, ) as well as supportive interventions (Koopmans, Wilson, Cacciatore, & Flenady, ). However, the issue of postpartum physical recovery is rarely discussed, particularly the demands of lactation suppression (LS) (Cole, ; Moore & Catlin, ; Pugmire, ).…”

“…Breast milk production is a normal physiological process that starts when the pregnancy exceeds 16 weeks and continues after childbirth, regardless of the birth outcome (Lawrence & Lawrence, ; Pugmire, ). When a fetus is stillborn, postpartum breast milk secretion and constant breast engorgement may remind a woman of the failed pregnancy and may cause sadness because the woman has no newborn to feed, rendering this natural body function meaningless (Cole, ). Furthermore, breast engorgement causes discomfort, pain (Smith, ), and possible mastitis that can be detrimental to subsequent conception and breastfeeding (Cole, ; Pugmire, ).…”

“…When a fetus is stillborn, postpartum breast milk secretion and constant breast engorgement may remind a woman of the failed pregnancy and may cause sadness because the woman has no newborn to feed, rendering this natural body function meaningless (Cole, ). Furthermore, breast engorgement causes discomfort, pain (Smith, ), and possible mastitis that can be detrimental to subsequent conception and breastfeeding (Cole, ; Pugmire, ). Therefore, LS is required during the postpartum period after stillbirth (Monari, Pugliese, & Facchinetti, ).…”

Is pyridoxine effective and safe for post-partum lactation inhibition? A systematic review

“…Furthermore, the lactating mother's use of some types of medications might necessitate avoiding breastfeeding, such as mothers undergoing chemotherapy . Lactation inhibition might also be needed following an infant death or miscarriage …”

“…5,6 When the decision to suppress lactation or not breastfeed an infant is made, the prevention of breast engorgement is essential to avoid associated complications, such as breast pain and mastitis. [5][6][7] Up to one-third of women who do not breastfeed and use nonpharmacological approaches, such as brassieres, binders, or ice packs, or analgesics to treat symptoms associated with lactation suppression may experience severe breast pain. 8 Several pharmacological agents for lactation inhibition have been studied.…”