"Grief and love are conjoined - you don't get one without the other." - Jandy Nelson

This is it, one of the moments you have been dreading ever since you walked out of the hospital empty handed; as if that wasn't cruel enough.  Lactation after loss is another reminder that your baby died and another layer of physical and emotional pain.  From my experience, this is not a widely discussed/educated topic by medical professionals and you are left alone in the dark, yet again.  

Now is the time to be extra vigilant in watching for signs of [postpartum] depression.  You can find more information on managing your mental health here.  *IF YOU ARE EXPERIENCING SUICIDAL THOUGHTS, PLEASE CALL 911 IMMEDIATELY *  

Milk production typically begins around weeks 16-20 during pregnancy and comes in 2-5 days after you give birth.  The separation of the uterus and placenta results in the drop of progesterone which causes prolactin to increase and stimulates the mammary glands to produce milk.  As your milk comes in, you may experience engorged breasts, tenderness, and leaking.  Unfortunately, there is no longer a medication (in the US) that is safe due to possible side effects.  This leaves a grieving mother with two options: suppressing lactation or donating breast milk.

Making the decision on suppressing lactation or donating breast milk may be an easy decision for you, or it may be a difficult decision.  For me, suppressing lactation was the best option for my mental health and my family.  I knew I needed to be on anti-depressants and as a result, donating break milk would not be an option.  In addition, this would have caused me extra emotional stress in grieving the loss of Abigail, despite the thought of providing such a wonderful gift to a baby that could use it.  On the flip side, you may decide that donating your breast milk will be therapeutic for you and a special way to honor your baby.  Your decision on lactation is yours alone, do not let anyone pressure you into choosing an option that does not feel right.

Suppressing lactation: Dancing in the Sky provides a breast cream containing cabbage enzymes that helps with engorgement and the cessation of lactation.  You can request a bottle of breast cream here.  To receive the full benefit of the breast cream to suppress lactation prior to milk coming in, apply the cream within 48 hours of delivery.  Apply liberally over entire breast every 2-4 hours or more often if uncomfortable fullness occurs.  To suppress milk production after it has started, apply the cream liberally every 2-4 hours.  Reapply as often as needed.  Please note: if you have a cabbage allergy, this breast cream may not be suitable for you.

• You may use ice packs (not required if using the breast cream provided by Dancing in the Sky).
• Over the counter pain management such as rotating between Tylenol and Ibuprofen.
• Placing cabbage leaves in your bra (if you are using the breast cream provided by Dancing in the Sky, you do not need to do this).
• Wear a snug/supportive fitting bra (such as a sports bra).  It is important that the bra is not too tight, as this can block milk ducts and may lead to infection.
• Avoid nipple stimulation (do not let shower water directly wash your breasts).
• Avoid warm/hot showers on your breasts (or any other heat source) as this will increase circulation and encourage let down.
• If engorgement becomes unbearable, you may hand express a small amount of milk for relief (keep in mind that you want limit this to avoid extra stimulation to avoid milk production).

Herbs that aid in lactation suppression:

• Sage
• Peppermint

*Please note, I am not a lactation consultant and am providing information from my own experiences along with knowledge I have gained in my journey of becoming a mother.  If you have additional questions regarding lactation, please consult with your doctor or lactation consultant.

Milk Donation: Donating breast milk after your baby has passed away, often referred to as bereavement donations, may be a special way for you to honor the life and legacy of your baby.  It is helpful to notify a milk bank if you are interested in making a bereavement donation as they may have additional resources and support available to help you through this journey.  When you have fulfilled your journey of donating breast milk, Dancing in the Sky would be honored to provide you breast cream containing cabbage enzymes that helps with engorgement and the cessation of lactation.  You can request a bottle here. 

Please note: if you have a cabbage allergy, this breast cream may not be suitable for you.

The Human Milk Banking Association of North America (HMBANA) accredits nonprofit milk banks in the US and Canada and sets international guidelines for pasteurized donor human milk.  Upon donation, breast milk is screened, pooled, and tested so that it can be dispensed to hospitals and outpatient families.  All donor mothers must go through a screening and approval process.  To begin the process of breast milk donation, you can review a list of member milk bank locations and contact the one most convenient for you (if you are outside the US, you can review a list of member milk bank locations here).  It doesn't have to be in your home state, as many milk banks work regionally and nationally.  The milk bank covers the cost of screening donors and shipping, and many have drop off sites called donor milk depots where the collected milk is transported to the milk bank for processing and distribution.