This is a story about what to do when your milk comes in after giving birth. What makes this story different is that there is no baby. This story is for anyone for whom, by whatever tragedy of circumstance, had milk come in right on schedule, but is meant for a baby that didn’t survive to term.
When I lost my daughter at 23 weeks gestation, I was given some afterthought advice from my care providers on how to handle the inevitable milestone of my “milk coming in.” I had never been pregnant before and therefore had no idea what to expect or how to handle it in real time. What I learned from my experience is that lactation support in the instance of losing your baby is almost nonexistent. The literature online and in all my pregnancy books was almost exclusively catered to mothers who got to bring their baby home. And as I have discovered time and time again in this season of being postpartum without my baby, wading through resources meant for mothers with living babies to find breadcrumbs of answers or support only made me feel more lonely, uninformed, and disempowered.
But I wasn’t alone. With the help of my bereavement doula and a friend who is a budding herbalist and postpartum doula, I came up with a strategy for getting through that week of having Tomb Raider quality breasts without ever developing mastitis or having to bind my breasts (um, ow?) until my brain finally got the message that the show was over. Even though having my milk come in was an incredibly painful reminder that my baby was gone from my body, yet not in my arms, I now cherish that I allowed myself to experience the process of what my body was capable of, and connect with my daughter through that in a way that felt healthy for me both mentally and physically.
The advice I received (if you can call it that) on what to do when my milk came in was pretty simple. Wear the tightest fitting sports bra you have basically nonstop, put cold green cabbage leaves in your bra because it feels nice and the enzymes in the leaves help dry up the milk, and don’t, under any circumstance, for any reason whatsoever, express any milk or let anything (including water) touch your nipples in a stimulating way. “It’ll confuse your brain to keep producing milk,” they said. Forty-eight hours or so after receiving this advice, my breasts exploded in size. Although I was mesmerized to learn what my body was capable of, I was in such an extreme amount of discomfort. This was on top of still being in complete shock and in the earliest days of extreme grief over losing my first and only baby. So, I opted for ditching the plan I’d been given and coming up with a new strategy. I wanted a plan that emphasized the importance of my short and long-term breast health, as well one that nurtured the emotional rollercoaster of my experience.
MY SUPPLY LIST FOR GETTING THROUGH THOSE MILKY DAYS WITHOUT BABY
- A nursing bra made from a breathable natural fiber that is fitted, but not too tight. It’s tough to know exactly how much your breast size will increase once your milk comes in, but for me, I went up about two cup sizes from my pregnancy size. I wore this exact one in an XL almost 24 hours a day. If my breasts needed a break from being confined or needed some air, I would pull the part that covered my breasts over and under my chest just like if I were actually nursing. There was enough room to comfortably fit the frozen gel packs in each cup without everything being too tight or too loose.
- Round Gel Ice Packs with Cloth Back – These ice packs were everything for keeping me comfortable most of the day. They are round and fit perfectly inside my bra cups. They also have a soft backing, so you don’t have the gel pack plastic sticking to or directly touching your sensitive nipple. I bought extra so that when the pair I was using cooled down (which happened every 1-2 hours) I wasn’t having to wait for them to refreeze to use them again. My breasts were incredibly hot to the touch while they were engorged, making my overall chest very warm. Keeping them as cool as possible was essential.
- These organic bamboo nursing pads did two important things. One, they protected my nipples from getting too cold or touching the gel packs in a way that caused additional discomfort. I just popped them in my nursing bra behind the gel pack. Additionally, they caught any milk leakage during the phase where I was expressing some milk (more on that below!), and then once the engorgement subsided after five days (in my case) and I wasn’t needing to express anymore they were still occasionally leaky for the next 2-3 weeks.
- My friend who is the budding herbalist and postpartum doula made me a dropper bottle of literal magic that did two things: One, it had peppermint essential oil in it which has both a cooling effect and properties that help with drying up milk supply. It also had sage essential oil, which is also known for aiding in drying up milk. She mixed one ounce of castor oil (which she says is the deepest penetrating carrier oil to aid in delivering the essential oils to the bloodstream) in a dropper bottle with five drops each of the peppermint and sage essential oil. I’d ask your naturopath or a trusted herbalist to recommend which essential oils to use and how much.
- I also came to rely on this let-down bottle after I would hand express enough milk to comfort. I would generally start with one breast and go through my routine (found below!) of massaging with the carrier oil and then hand expressing until I felt enough relief and would gently suction the bottle onto that breast while I started on the other one. Each breast tended to leak for a bit after massage and expression. This bottle caught all of that and kept me from being a total milky mess.
- Keeping hydrated with an infusion of high quality dried sage leaves (again, sage is a go-to herb for drying up milk supply). I mixed one cup dried sage to one quart of hot water which I let steep for no less than an hour, but if you can stay on top of it, let it steep closer to eight hours for a stronger concentration of the sage. If you don’t like the taste of sage, adding a bit of good honey can help. If you have a local tea shop that makes their own blends, I’d see if they had a good quality “No More Milk” blend. It’ll likely have sage, peppermint, and parsley leaf blended in. Earth Mama also makes a similar tea.
MY BREAST CARE ROUTINE
After some trial and error the first day or two, I quickly found a routine for breast care and milk management that worked well for me. My goals were to be as comfortable as possible without encouraging my body to produce more milk, to avoid developing an infection in my breasts, and to be present throughout the experience because for me it was a way to continue sharing a connection with my daughter.
I generally kept the nursing bra on (with a button down pajama top as well) at all times. I was mostly sitting propped up in bed or on the couch when I wasn’t sleeping. I used the frozen gel packs with the nursing pads all day (rotating them as they cooled) and slept with just the nursing pads in the bra at night. When my breasts needed a break, I’d pull back the cups on the bra and let those babies breathe.
About two times a day I would go through a routine of breast massage and hand expression. From everything I’ve read, touching your breasts and nipples as little as possible is essential. Stimulation can often be confused by your brain as a baby rooting for or sucking your nipple. This is why I limited how often I was touching them but made it count when I did. I would start by dropping 3-5 drops of the carrier oil blend onto the tops of each breast. One breast at a time I would gently massage directly on the milk ducts, which feel like clusters of grapes when engorged, and remember to always draw the massage (and some of the milk) down towards my nipples without touching them. The goal here was to get those essential oils into my bloodstream to aid in drying up the milk and to prevent my milk ducts from clogging to the point of infection. Doing the massage warms up the breasts for expressing and gives you a chance to get your eyes and hands on those milk ducts you want to protect. If any of the ducts, in particular, felt more sensitive than others I would focus massage in those areas in efforts to draw some of that milk down towards the nipple.
From there I would proceed to hand express colostrum and/or milk until I began to feel some relief. I would put a medium sized towel in my lap to catch the drips and keep both of my hands free for the massage and expression. Sometimes I would massage a duct with one hand while using the expressing technique with the other hand. I would generally do this for 5-10 minutes on each breast or until I had relieved some of the engorgement, and my ducts no longer felt painful. Once I switched to the other breast, I would attach the let-down bottle to the first breast to catch any additional flow. I often found that if I were struggling to express on one side, if I switched to the other breast, the first one would get the hint and start leaking. I would alternate the massage and expression on each breast until I felt an acceptable enough amount of relief on each overall breast and in the milk ducts. Again, I only did this two or maybe three times a day as long as they were very engorged and let the feeling in my breasts dictate that frequency.
I also took one shower a day and let the water run directly over my breasts. For me, it didn’t encourage much, if any, leakage, but it felt very relieving and therapeutic. If the shower water is encouraging what feels like too much drainage of your breastmilk, just try and keep your actual breasts from coming in contact with the water so you can still enjoy your shower. You can also wear your bra in the shower if they need the support and protection.
WHAT DID I DO WITH THE MILK?
To be honest, I was never really expressing very much milk. It was generally about a shot glass full between both breasts each time. It was enough expression for me, but I don’t know if that is sufficient (or too much!) for someone else. It’s all about what is most comfortable, relieving, and safe for you. When I did finish expressing the milk I almost always drank it. It was very sweet, rich, and delicious. It made my heart break to know my daughter would never taste the milk I made for her, but it made me feel closer to her to try it myself. This was a personal choice, and it was right for me.
When my breasts (and brain) finally got the hint that we didn’t need to be a milk factory, I felt almost immediate relief. As quickly as it came, there it went. In total, the worst of it for me lasted about five days. From there I was just a bit leaky now and then until it subsided completely. As grateful as I was that my breasts no longer felt so large, heavy, and painful, my milk supply ending was one of the many ways I have lost my daughter. Nearly every second of every minute I longed (and still do) to smell and kiss the top of her sweet head while she nurses. But I got through it, and in the process, I learned so much more about how incredible the female body is.
All of the information provided above is based on my personal experience alone with the help of trusted friends and medical professionals. This is by no means an offering of medical advice. Consult with your midwife, doctor, or lactation support person to come up with a plan that works best for you and your health.