how to stop lactation when there is no baby
A few of us have had the unfortunate and in multiple ways painful experience with having to stop lactation after stillbirth or neonatal death. Here we pull together what we know, what has worked for us, what we learned later. If you have a reason to need this information, we are deeply, deeply sorry. If you are looking this up for your friend, your sister, your daughter, your wife, your patient, thank you for doing that, and please, tell her that we are sorry. And that when the milk being spilled was meant for your baby, there is every reason to cry over it.
Our experiences were different to some degree, so below, where applicable, we identify the person whose experience is relevant.
after stillbirth or very early neonatal death
[julia] Nobody can tell you how long it will take to stop lactation, and it's different for everyone. It took me three weeks. Constant binding pressure was essential. I used a very tight bra, cabbage leaves therein, with another binding mechanism over the bra to provide the ability to put cold compresses in (I recommend bendable ice packs they sell for sports injury or frozen vegetables). And yet, that was not enough until over two weeks later I added sage tea. Around a week later, it was finally over.
Sage tea can be found at stores such as Whole Foods, with the herbal teas in the natural remedies aisle. It's not as stinky as you would think. After the first couple of sips it's even sort of pleasant.
It will be very tempting to let the hot water in the shower get directly onto your breasts, but please don't—this will stimulate milk production.
While you will likely want lactation to stop, it is not uncommon to experience deep sadness as it is finishing. That milk was the last tangible proof that your baby was here, and it is hard to see your body let go of it. I had a nightmare the night before my milk stopped for good that was unambiguously connected to the stop of lactation. As with everything connected to this experience, let yourself feel what you feel. Nothing about this means you are doing it 'wrong'.
[tash] You will likely leak when your milk comes in. It's ok to leak right into the cabbage in your bra, and change it frequently. You can also use pads. If you are not up to buying breast pads at the store, you might consider just putting some maxi pads in your bra (cut them in half to fit). Please make sure to change them out every few hours when they get damp or you may increase your risk of infection. It's fine to just leak, but again, keeping wet clothes —especially cotton—up against your nipples like this could lead to a yeast infection. If you end up needing to express a bit, It's good whenever you do that to let yourself air dry and take the opportunity to put on a dry bra or shirt.
A quick and cheap way to make hot/cold compresses: take two washcloths, dampen them, and put them in separate zip lock bags. Put one in freezer, and microwave the other as necessary.
Although you want to try and avoid warm water (hot showers), there are times when little warmth can be a big relief. You may feel lumps forming in your breasts; these are clogged milk ducts and are incredibly uncomfortable and can become infected. Place a warm washcloth over the area for a couple minutes, and then massage the lump gently for another few. When finished, apply the cold compress.
[janis] My midwife also said to add peppermint oil to the water, then make compresses and put on the breasts. That made me really cold and did not help. What worked for me- vitamin B6, 200mg for at least 5 days. it did not work immediately (and I don't think anything does)... took about 3-4 days to stop feeling like my breasts were going to explode, and after 5-6 days I was ok.
[A note from Julia: according to my search of the medical literature, you have to take high doses of B6, and if possible find the product that is mostly the pyridoxine form of this vitamin-- it is this form that in high doses helps to suppress milk prouction. Normal amounts of B vitamins in your multi do not work because they represent the normal amount needed for healthy development and therefore, do not influence the volume of lactation.]
I have also had luck with homeopathic meds for many things and I found out that BYRONIA ALBA, 9C, three pellets three times a day helps with engorgement. And PULSATILLA 9C, three pellets three times a day for overabundant milk supply.
a note on the pharmaceutical solution
Drug Parlodel (bromocriptine) has in the past been widely used to stop lactation both by choice and following a stillbirth or neonatal death. Most doctors and hospitals have now stopped prescribing the drug for lactation suppression because of a number of studies showing high rate of side effects. In one study for example, adverse events related to bromocriptine given to inhibit postpartum lactation (in women who experienced stillbirth) were reported by 22% (60/314) of the subjects.
In addition, early return of ovulation has been reported with this drug. There are medical and emotional concerns relating to short interpregnancy intervals in general, and following stillbirth or neonatal death in particular. Thus, if you do use this drug to stop lactation, please discuss with your partner your intentions regarding subsequent pregnancy. If you would rather not become pregnant immediately, consider using one or more methods for preventing pregnancy.
when pumping or breastfeeding has commenced—after a later neonatal death
[tash] Ending lactation after having pumped or even breast fed has its own set of issues. Your body is now programmed (even if you only did this briefly—in my case, six days) to produce milk to feed a child every 2-3 hours. You can go cold turkey, but it's painful. A more comfortable way is to wean your body off, let it know you need less, less often, and gradually it will reach that conclusion as well. Start immediately by reducing the time you pump (if you've been pumping 15 minutes per breast, go down to 10 for starts), and increasing the time in between pumps (if you've been going 2 hours, try stretching it to 3).
Depending how much you produce, you may need a day per change, or you may be able to stretch time in between from your morning sessions to your afternoons. Sometimes you may find if you simply let down (the ejection reflex that occurs after a minute or so of starting the pumping action) you'll feel some relief and can now go another few hours. Often when pumping consultants tell you to envision your baby or look at his/her picture to increase flow. Obviously it will be impossible at this point in time NOT to think of your child, but distracting yourself to the best of your ability will also signal to your body that you're not interested. I read a really graphic murder mystery during weaning myself off. A mindless tv program would probably work equally as well.
If you don't have a pump, you may want to occasionally bring the same relief by manual expression. There are some good graphics and instructions here (with no pictures of babies) if you are interested in this.
donating your milk
If you find yourself with milk that your baby didn't get a chance to eat, either stored in NICU or in your home freezer, you may be interested in donating it. Unfortunately, it is not always as easy or as straightforward as it should be. While some hospitals run their own donation and pasturazition programs that use the milk exclusivery for other NICU babies, others work with milk banks or do not offer this service at all. Here is a fairly comprehensive, if longish, summary of the different options available to you. While we present a mix of a short summary and our own commentary below, please read the full writeup linked above carefully if you decide that milk donation is something you want to pursue.
Three options are available for donating your milk: informal mother-to-mother, donation to an HMBANA milk bank, or donations to organizations that pose as something very much like a milk bank (and sometimes call themselves that as well), but in reality sell your donated milk to a company called Prolacta Bioscience, allowing the company to make considerable profit. While donating to an HMBANA milk bank comes with hoops to jump and certain restrictions apply (such that some women are excluded from donating—check their policies), you can be sure that once you donate your milk, it will go to benefit NICU babies. Mother-to-mother donations are much easier, and are greatly facilitated in the age of the internet—just go here to start. I (Julia), for example, was very touched when a close friend donated some of her milk in my son's name to a family in a nearby city.
Donating to milk depots (organizatons that sell all or part of the donated milk to Prolacta Bioscience) is something you should consider very carefully. Contracts signed with such organizations are often rather restrictive of your rights to your milk or the information learned from it. In addition, whether or not you are comfortable with someone making a profit on your donated milk is something you will have to decide for yourself. One prominent organization acting to a large degree as a milk depot is The International Milk Project. Their front page avertises the charity work of sending breast milk to Africa. However, if you dig around, you will find that 75% of the donated milk is sold to Prolacta Bioscience (although the chart does not disclose that the milk is sold to Prolacta, or that Prolacta makes a nice profit on it), and only 25% makes its way to Africa.
This is also the organization running the Madison Cassady program, a program that allows mothers who experienced neonatal death to donate their milk. Unfortunately, their web page is somewhat deceiving, stating "The gift of giving this donation of life through our Madison Cassady Program can be emotionally healing and fulfilling to both the grieving mother and life saving to the receiving baby." However, unless the mother goes through the entire qualification process and enters the regular pool of donors, no milk donated by her through this program actually reaches any babies. Instead, all milk donated through the relaxed qualification requirements ends up with Prolacta Bioscience and is used for research.
Only you can decide whether you are comfortable with milk depots in general and The International Milk Project in particular, but we urge caution. If you are not interested in undergoing extensive milk bank qualification procedures, we encourage you to consider the person-to-person donation.
Finally, everything works differently for everyone, and you may need to go through a few steps or suggestions before something works for you. If you find something that worked for you that's not included here, please let us know so we can add it to the list of suggestions.
Reader Comments (45)
I had the opposite issue - my baby died and I wanted to pump milk for the milk bank for as long as I could - it just felt better for some good to come from the situation - but my boobs gave up the ghost about 6 weeks after.
Ellie that's amazing that you even wanted to and did for so long. I wanted to shut everything down and forget any of it ever happened. As fast as possible. I was able to donate my week's worth, and there was no way I was continuing to pull out that pump any more. Good for you.
i pumped for a month after olive died just to prove that my body could function as it should. i could not give my milk to a bank because of my blood transfusions but just had to do something to get past the feeling of total failure. the lactation specialist at the hospital said "whatever helps us get through it" which made me feel like less of a freak. eventually my supply dwindled and i stopped. but some nights i would sit there with the pumps on my breasts and imagine it was draining the sadness from me in little milky tears. how dramatic! but it felt right at the time.
Oh wendy, my heart. I could see you there, that link to olive, that link to what's ordinary and normal, and it just filled up my heart tonight for you.
I remember those early days, and feeling like it was just another reminder of what I'd lost. It felt like being kicked while I was already down...that my body would continue to go on with the "living process" even though my world had stopped. It was rough and lasted about a week for me after Nathaniel was stillborn. I remember hugging a HUGE bag of frozen peas for as long as I could handle it....and crying...so much crying.
This is an amazing site. It's so necessary for Mother's experiencing loss to know that they are not alone...to know that someone else uderstands what they are thinking and feeling and going through. Thank you for pulling this together.
I had heard of donating breast milk for sick babies, and so I asked at the hospital if someone could help me make arrangements. I was at a smallish suburban hospital, and no one there knew anything about it. I was so determined that there had to be a way to make it happen that I asked them to bring me a breast pump anyway, so I could start my body on a regular pumping schedule. Looking back I must have seemed crazy.
With some help from my mother and husband, I tracked down Mother's Milk Bank of North Texas. There is quite a bit of screening, as you mentioned, but it was comparable to being a blood donor and nothing unreasonable. They are non-profit, and donations go to actual babies and not to labs, they require a doctor's prescription.
I pumped every 6 hours around the clock for the last 6 weeks, and I just weaned this past week in preparation for going back to work. As I read that, it seems sort of obsessive. But I am so grateful I did it. I had been very committed to breastfeeding Oliver and am a huge believer in the value of it, it broke my heart to waste the milk my body was working so hard to make for my lost son. I also work in a large county hospital with a huge NICU, and so many of the babies can't tolerate formula but their moms are unable to pump enough milk for them due to premature delivery or other problems. My boss's daughter was born at 24 weeks, and she tells heartbreaking stories of her NICU physicians and nurses explaining again and again how much her weak, sick baby needed breast milk, and that she would pump and pump until her nipples bled only to get one ounce, or maybe two on a really good day. What an incredible gift I had to offer, then, that I could pump 8 ounces in a sitting without any trouble or complications. And what better way to honor my son. And I hope, had we suffered a different tragedy and had a need like that that I could not fill, that another mother would have reached out anonymously to help me and my child.
It's obviously not for everyone, and as the milk bank volunteers told me "if it brings you more pain than peace, don't do it." But feeling that I might ease some other family's suffering or help strengthen a frail baby was probably my greatest comfort immediately following Oliver's death. It was one tiny, good thing that could be pulled from something so horrible, and it helped me forgive my body for what felt like the ultimate betrayal.
I'm sorry if this is more than anyone wanted to know about milk banking or if I've offended anyone for whom it was not the right choice. I am not posting the link to the organization I donated to, their website is covered in smiling, healthy babies. If, however, there is anyone out there interested in this I am happy to help in any way I can on a more private basis.
I found sudafed helped.
The reason I am sharing this is to suggest another resource for mums that may want to donate: the Milkshare community on Yahoo. After researching milk banks and finding it all very impersonal and business-like, I was very happy to find a place to speak to other mothers about private donation. I received dozens of gentle, appreciative request's for Julia's milk. I ended up donating to a family whose baby girl was born just a few days after I started pumping. Her mother is HIV+ and couldn't breastfeed. It felt so right and I felt equally blessed to have met them and been part of that little one's nurturing. The lovely part is that while some women package and ship their milk, they do encourage local donation, so that you may get to know the recipient family.
Through all of it, reading all offers from donors, I was very surprised to see there weren't more loss mums doing this. Though I understand the painful, sad aspect of giving your dead baby's milk to someone else, I honestly felt, for me, there wasn't any other way. It was obviously a harrowing time, but the two things doing this offered me were priceless: a focus through those sleepless, blurred-together, zombie-like days and nights, and even more importantly: I learned quickly that trying to find a reason or meaning in our daughter's death was impossible, frustrating, and very painful, but the fact that something, even a little something, good could come of it, was the ultimate way I could honor her short, but very meaningful life.
Aside, thank you all of you beautiful women for sharing yourselves and your lives so openly, from the bottom of my scarred, but hopeful heart.
Light and peace to you tonight, and thanks for being here.
xo
Thank you so much for the tips and to the women who shared their wonderful stories here. It's so sad that we all have to go through this but they're all in a better place now.
Another consideration with stopping lactation is the hormone drop, especially if one has been pumping or nursing. Lactation releases oxytocin, the "feel-good" hormone, and oxytocin withdrawal can lead to depression. As if it wasn't depressing enough to lose a baby, the hormones make it even worse. So, that's something to keep in mind when abruptly stopping lactation: be prepared for the sudden drop in oxytocin and its after-effects.
http://theduncansonline.blogspot.com/2009/05/losing-child-while-breastfeeding.html
I took Lecithin, as it helps the body emulsify fats, and can reduce clots and the mastitis infections clots can cause. It helped reduce the painful clots. I also only pumped as minimally as necessary to work out clots and relive pressure, spreading out the time between pumps for as long as I could stand.
As mama jen mentioned, I think the affect of the hormone release during lactation is *really* important to understand, as well. It didn't really help me feel any less utterly miserable, but knowing that the supreme misery during pumping was hormones messing with me helped a little.
I was so glad to find this site tonight.
Sending hugs to all the mothers who have to face this!
Thank you for providing this space it has helped me greive the loss of my nephew.
I lost my daughter one week ago today. I delivered her stillborn at 27 weeks.
Here are all the things I did:
When I came home that night I immediately started my sage tea drinking regiment. I mean I drank almost only this tea everyday.
I used ice packs and cabbage leaves. I used ice packs as well as frozen wash clothes because they mold well to your body.
I also wore my sports bra exclusively for this entire week. I didn't have a pump to express a bit of milk out.
At night I was the most uncomfortable. I am already a large breasted woman and having my breasts engorged was difficult to even sleep. I also leaked a lot at night so I cut maxi pads and put them on my nipples for the evening.
When my breasts were so sore I couldn't stand it I used ibuprofen to help with swelling and pain. And would massage some of the knots just enough to feel a bit of relief.
Today, My breasts feel pretty good. I am still a little tender but I can feel my milk is almost dried up. I thought it would take longer. I can't tell you what of ALL the things i did worked the best. I just did them ALL and that helped i think.
Good luck sweet mamas. And again I am right there with you feeling your loss.
Still in sadness,
Alicia
Thank you so much for this site, it has been so helpful. My breasts are so swollen and sore since my milk came in yesterday. It's another constant physical reminder that my baby is not with me.
http://breastfeeding.blog.motherwear.com/2012/07/review-lactation-support-for-the-bereaved-mother.html
and thought it might help someone out there. Is there a chance of adding it to the main post? It looks like some mamas would find the information contained helpful....
I felt like I was mad, my freezer is filling up fast and I have someone to donate to but just can't let go yet - have this single mindedness to fill the freezer. Wendy said to prove her body can do something right and that's how I feel.
This need to hang on to Bryn just that little bit longer. I sent in my pump to be fixed last week and borrowed a friends.
I do feel like I have a lid on thsi volcano and if I stop pumping it's going to errupt.
I am going to come back here and read some more. I feel there shouldn't just be an option for 'stopping lactation' but a bit about 'the noramcly of keeping lactation going' as well.
Bryn was born with a chromosone issue called Trisomy 18 so we knew everyday was precious.
La Leche League was a wonderful support and connected me with a lactation consultant who was very gentle with me and gave me very specific instructions (much of which is already noted above) of how to handle. It took awhile, but we were successful.
Sending support and love to you all.
I donated milk after the death of my daughter in 2009 and had very good support from this organisation.