Lactation following pregnancy or infant loss

You may wish to receive support to:

• Stop producing breastmilk
• Continue to express your breastmilk
• Decide what to do with breastmilk you have already expressed

Will my body produce breast milk?

Your body will naturally start making colostrum (first milk) at around 16 weeks of pregnancy. After birth, your body will undergo hormonal changes which will then lead to breast milk production.

Some parents find this experience very painful, as it can remind them of their loss, and they may wish to stop producing breastmilk as quickly as possible. Others find expressing and continuing to make milk comforting. There is no right or wrong way to feel and no right or wrong decision.

Natural suppression

The amount of milk produced in the breast will vary from person to person and will reduce naturally over a period of time. It will take longer to stop producing milk if you have already been breastfeeding or expressing.

Sometimes, breast engorgement can be experienced, which is when the breasts become swollen, firm, and painful. It usually happens between 2-5 days after birth.

Some suggestions to help include:

• Take regular pain relief such as paracetamol and ibuprofen
• Wear a supportive bra day and night
• Use cold compresses or gel packs on the breasts for 15-20 minutes
• Heat should be avoided as this can encourage the leakage of milk
• If you already have an established milk supply, a gradual reduction in expressing is preferred to stopping abruptly. This will reduce the risk of blocked milk ducts and mastitis and can be achieved by:
  • Gradually reducing the length of time you express for e.g., shorten expressing times by a few minutes at a time
  • Reducing the number of times you express each day e.g., reducing by one session a day

If you have any signs of mastitis, which can include fever, breast pain or redness, please contact your bereavement midwife, local maternity unit or GP.

You may find that your breasts may leak small amounts of breastmilk at times that are emotional or difficult. If this is ongoing and you would like further support with lactation suppression, please contact your healthcare provider.

Could I be offered medication to stop my milk supply?

You may be offered a medication called Cabergoline which helps stop the body producing milk quicker, although it may not stop your milk supply completely.

Like all medicines there may be side effects and it may not be suitable for everyone. Please discuss this with your healthcare provider.

Cabergoline may be given in different doses depending on if you have an established supply of breast milk or not. If you are breastfeeding another infant, cabergoline is not recommended as this will stop or reduce your milk supply.

What can I do if I already have expressed some breast milk?

If you have already expressed some breastmilk, you may wish to consider:

• Donating your milk to a milk bank. Donated milk may be given to premature or unwell babies (recipient donation) or used for research purposes (research donation)
• Keeping a container of milk for a keepsake
• Using some of your milk to be turned into a keepsake e.g., for breastmilk jewellery (there are companies online that make these for a fee)
• Asking the hospital to dispose of your milk safely on your behalf, if you do not wish to keep or donate it

Can I donate my milk?

Some parents find that continuing to express breast milk can be comforting. This may not be a choice for everyone. If you decide you want to continue expressing, you may wish to consider milk donation. You can also consider donating you have already expressed.
There is no minimum amount required to donate for research.

If you have over 200mls of milk, this can be used for recipient donation i.e. given to premature or unwell babies.

If this is something you wish to consider, a neonatal nurse or midwife will complete an initial screening form for you, to determine if your milk will be donated for research or recipient milk donation. Questions will include any medication, health conditions, smoking status, consumption or alcohol and time of expressing. You will then be contacted by the milk bank for more in-depth screening and information. There may be a blood test involved following this screening.

You can either self-refer for milk donation or speak to your healthcare team to refer you. You can find further information regarding milk donation on the following website.

www.milkbankatchester.org.uk/donationafterloss

Contacts and support