The arrival of milk after perinatal bereavement

by Claudia Ravaldi

After a perinatal loss, many women experience lactation. This occurs more frequently if perinatal death occurred in the second half of pregnancy, from the 20th gestational week onwards.

However, milk can also appear after losses in the first half of pregnancy, especially if you are already breastfeeding. No one can tell you with mathematical certainty how your body will react after giving birth, because every woman is unique. However, it is important to know that whatever happens to your breasts during the puerperium you can be supported and make the best choices for you and your health. psychic and physical. Taking care of your physical health will help you feel better psychologically as well. Ask for help, if you have any doubts, from operators and professionals who are experienced in breastfeeding.

I lost my baby: why can milk come anyway?

Maybe you’ve seen a few drops of colostrum coming out of your breasts in the last few weeks too. This happened because your body prepared to feed during pregnancy. The hormones, further activated by the expulsion of the placenta after childbirth, in fact start the production of colostrum and the subsequent milk supply.

The arrival of milk after perinatal bereavement can be an emotionally demanding and in any case a critical time.

The arrival of milk can in fact be very frightening, it can trigger feelings of anger and frustration and can be seen as yet another cruel mockery of our body.

For some women the arrival of milk is reassuring, because it is a physiological and natural aspect, in a moment that is not natural.

For still other women, milk is still a gift.

The milk could therefore arrive, or it is already arriving, and it is advisable to choose how to proceed. There are no rules that apply to everyone and there are no right or wrong decisions at all; every woman can choose the best way to take care of herself, respecting her pain and her body.

After the birth and the death of your baby, even if it is all absurd, you need to understand what is best to do to take care of your breasts and your milk.

The milk can arrive immediately but also up to a week after giving birth.

When an expected baby dies, the mammary glands are still ready to produce milk.

Below we list some possible alternatives, inviting you to talk to your hospital’s midwives and other competent breastfeeding figures .

Possible choices

Options:

TO) Natural inhibition of lactation

B) Pharmacological inhibition of lactation with cabergoline

C) Donating milk to the breast milk bank

A) Natural inhibition of lactation

You can wait for the body to self-regulate, keeping breast tension under control with simple tricks; if your breasts feel taut and shiny you can:

v to rest a lot;

v take a relaxing bath;

v express milk just enough to decrease discomfort;

v gently massage the painful area without applying pressure (caress);

v wearing bras that contain the breasts without leaving any marks or grooves on the skin

v if the pain is severe you can use an analgesic drug to be decided with your doctor

The obstetrician staff and the nurses were really kind in helping me in the manual” emptying “with a lot of patience because I alone, perceiving the pain, could not do it effectively”

Caring for your body after perinatal bereavement can be very difficult.

Why should i take care of my breasts?

Taking care of your breasts after childbirth is to help drainage of your mammary glands and avoid engorgement.

Remember that you can ask competent personnel for help even in case of mild discomfort or pain. Do not disturb!

B) Pharmacological inhibition of lactation with cabergoline

You can inhibit lactation with cabergoline.

It is administered immediately after childbirth to slow down the secretion of prolactin, so that milk production can decrease immediately.

Sometimes, despite taking the drug, lactation may still occur.

“The midwives gave me pills to stop breastfeeding (…) They didn’t even ask me if I was going to behave differently. They just said “take it, I’m to stop the milk”. I don’t know how to behave in these cases but I just took them, at that moment I didn’t have the clear mind to make any kind of decision “

C) Donating milk to the breast milk bank

Some mothers, especially if they have already breastfed other children and if they have experienced neonatal intensive care, wish to be able to donate their milk for some time, compatibly with their physical health and with the presence of a health bank. local milk.

To donate, it is necessary to follow the national protocols, which you can consult at the following address: https://www.aiblud.com/

“I would have liked to have been able to give that milk to some other child who needed it, this was my constant thought … I tried to ask the question, I was answered with a smile and so I don’t know if it is possible. in reality…. But it’s something that would have made me feel better, to be able to help some other child. “

“I was ready and my breasts too, I couldn’t wait. Jacopo, however, was born dead, my baby of over 4kg. “Madam, you have to take the pills for the suppression of the milk supply.” And I took them, like an automaton. I took a lot but my breasts didn’t seem to want to know, they were swollen, hot, in turmoil, ready to feed those who were not there. In the end he surrendered to the evidence, too. “

Scientific information by CiaoLapo’s multidisciplinary working group on breastfeeding:

Nicole Decurti, Daniela Nicolin, Anne Voyat, Chiara Pozzi, Consuelo Puxeddu, Claudia Ravaldi

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