Breast care after baby loss
The loss of a pēpi (baby) or tamaiti (child) is very difficult for anyone. Managing your breast milk supply after loss is something you will need to think about. You have choices and it is up to you to decide what to do with your milk supply.
Your breasts start producing milk early
Your breasts start producing milk from as early as 16 weeks of pregnancy. Your body does not know the milk is not needed after pregnancy loss or if your pēpi has died.
You may notice colostrum (yellowish liquid) for the first few days after birth. It is unlikely your breasts become uncomfortable with this first, early milk. On days 3 or 4, your milk can start to come in, your breasts may become full and uncomfortable.
Choosing what to do with your milk
You can choose what to do with your milk supply. It is a good idea to discuss the options with your whānau and healthcare provider.
Stop your milk supply using lactation suppression
- Express a small amount of milk to make yourself comfortable. Releasing a small amount does not increase your milk supply too much. Having full breasts (not emptying them) sends hormonal messages to slow down milk production.
- Drink water as normal — cutting down fluids does not reduce milk supply.
- Medicines for suppressing milk supply can be given on the first day after birth — ask your healthcare provider if this is appropriate for you.
- If you have been breastfeeding or expressing for some time before the loss of your pēpi, and you decide to stop, you can wean off (stop) your milk supply.
Continue to express until you are ready
If you decide to continue expressing after the loss of your pēpi, try to keep a pattern of expressing each day and learn how to wean of your milk supply.
Donate your breast milk
You may think about donating your breast milk. Donating milk can be a healing process. Your local lactation consultants may be able to put you in contact with people who can help with this.
Weaning your milk supply
If you have already been breastfeeding or expressing and have an established milk supply, you should not stop expressing suddenly.
To wean your milk supply it is better to gradually cut down your supply when you are ready. To do this drop to one expression every day or so. This allows your breasts to become full and send signals to slow down milk production.
Do this gradually at a pace that suits you. You may need to express once every few days before stopping completely.
Discomfort due to milk production
When your milk comes in after birth or when you choose to wean your milk production, you may feel some breast discomfort from the fullness or engorgement. There are some things that can help, including:
- wear a supportive bra if it feels more comfortable
- avoid hot showers or massaging your breasts — this can increase milk production
- place ice packs against the breast (not the nipple) for swelling and pain for 10 minutes every 30 minutes, or as needed, to reduce pain and swelling
- ibuprofen can also reduce pain and swelling, and paracetamol can reduce pain — take as prescribed
- sage tea is thought to reduce milk production
- for very full and uncomfortable breasts, you can express a small amount of milk to make yourself comfortable — try not to take too much out, just enough for relief.
To hand express, place your thumb and finger 2cm to 3cm back from the nipple near the edge of the areola. Push straight back toward your ribs, then press your fingers together, compressing the tissue, then release.