When the Worst Happens:
Helping a Mother Who Has Lost a Baby
Lisa Stoneman
Roanoke, Virginia, USA
From: LEAVEN, Vol. 36 No. 1, February-March 2000, pp. 6-7.
We provide articles
from our publications from previous years for reference for our Leaders and
members. Readers are cautioned to remember that research and medical information
change over time
Why does a La Leche League
Leader need to think about miscarriage, stillbirth and infant loss?
Aren't our Groups full of healthy, happy mothers and babies? If these
were your thoughts upon seeing the title of this article, you're not
alone.
Unless you have been touched
personally by loss, you might assume pregnancy loss and newborn death
are uncommon. On the contrary, statistics for the United States
show that 15 to 20 percent of confirmed pregnancies end in miscarriage;
1 in 100 babies is still born; 1 in 1000 babies dies of SIDS; 1 in 250
babies dies due to prematurity, genetic abnormalities, illness or accident
before his or her first birthday (United States National Center for
Health Statistics, 1996). These are sobering statistics, yet they do
not begin to speak of the devastation experienced by the families of
these babies.
What do all of these numbers
have to do with you? It may be that you find a mother in your Group
has a breastfed infant who dies of SIDS, your Group Librarian's toddler
succumbs to pneumonia, or a Leader Applicant suffers a stillbirth with
her third child. Any of these incidents could immerse you in the
emotions and questions of someone looking to you for information and
support.
As a Leader, I first dealt
with loss when my own son died at 23 weeks gestation due to a neural
tube defect. That was six years ago and it taught me about grieving,
compassion and the need for support. In my LLL work since then,
I have encountered several incidences of miscarriage, two deaths of
a twin in which the other twin survived, one stillbirth and three deaths
due to anomalies. I think these occurrences were always there,
but suddenly I became aware of them and of how I could better serve
these mothers. I realized that as La Leche League Leaders we have great
experience as listeners which can be used to help these grieving mothers.
There are several ways in
which your expertise can be useful:
Give the mother information
about milk production and engorgement.
Mothers whose babies die
after the first trimester are likely to produce milk, which may be an
additional emotional blow. Make sure you have kept up-to-date
on milk production information. You can offer the mother information
about why she is making milk and how breastfeeding is a supply-and-demand
system. Ice packs, bags of frozen vegetables, and chilled or room
temperature green cabbage leaves are helpful for reducing engorgement.
Cabbage leaves are often the most comfortable and effective treatment.
It has been reported that cabbage inhibits milk production as well as
relieves engorgement.
If a nursing mother is very
uncomfortable, suggest that she sit in a warm bath and lean over into
the water, allowing the milk to leak out. She could also stroke
her breasts from the chest wall out toward the nipple to encourage milk
to flow. If she prefers, a warm shower may also serve this purpose.
Expressing or pumping a little milk - just enough to relieve the fullness,
even if it is only a few drops - can also help her feel more comfortable.
These measures will not increase her milk supply and may help to prevent
health complications like mastitis. Refer to the BREASTFEEDING ANSWER
BOOK for more information on engorgement relief.
Offer the mother information
about the benefits of breastfeeding.
A mother who has miscarried
or whose child has died may feel guilty about a thought, action or inaction
she thinks may have contributed to her baby's death. She will have a
voracious need for information pertaining to her situation. For
instance, the mother whose child dies of pneumonia or meningitis may
call wanting to know how she failed in caring for her child. After
all, breastfeeding protects babies from illness, right? Share
your knowledge about the advantages of breastfeeding with additional
emphasis on the fact that nothing is 100 percent effective at warding
off illness. You might also concentrate on the emotional benefits of
the breastfeeding relationship and how it allows mother and baby to
share a unique and intimate bond. Knowing she has provided the best
for her child and has been as physically and emotionally close as possible
will be a comfort to her as she deals with her grief.
Suppose the mother is nursing
a toddler when she miscarries. In addition to the potential for her
own feelings of guilt, she may even be told (or secretly feel) that
nursing contributed to her loss. This information can be heart wrenching
since she not only has lost the baby, but also may feel compelled to
give up breastfeeding the older child. You can help by guiding
her to accurate information on the role of breastfeeding in miscarriage
and preterm labor. (THE WOMANLY ART OF BREASTFEEDING, 1997 edition,
p. 253; BREASTFEEDING ANSWER BOOK, 1997 edition, p. 155, 345-46.)
Share the information, including all pertinent references, without giving
advice or making sweeping statements about her particular situation.
Consider the mother who,
for whatever reason, did not breastfeed her dying child. Maybe she breastfed
her first child, but this one was premature and she was not allowed
access, or possibly the loss was several years ago and now, when she
is nursing her next baby, she feels guilty about shortchanging the one
who had died. As in other situations in which a mother laments
her lack of breastfeeding, support her with comments about how hard
it is to overcome the hospital environment or doctor's objections to
her breastfeeding. Depending on her need, offer her correct information
and resources. Reassure her that she did the best she could at the time,
with the information and support she was given, and allow her to grieve
this additional loss.
Give the mother information
about nursing in the hospital for the short time she and her baby may
have together.
What about a really stressful
call from a mother who is nursing or trying to nurse a gravely ill baby?
If the baby is being given comfort measures only, then the mother will
have much easier access to her baby for holding and breastfeeding.
In this case, technique is less important than encouraging the mother
to let the baby nuzzle and latch on as he or she is able. Hopefully,
medical caregivers will have prepared the mother for the possibility
of baby's death at the breast or in arms. Don't be put off if the mother
mentions this possibility to you. Most parents derive comfort
from knowing they have provided comfort, warmth and love to their babies
for as long as they could.
When it comes to the seriously
ill baby who is undergoing potentially life-saving treatment, breastfeeding
may be much more challenging. You can assist these nursing mothers
with information about the advantages of breastfeeding, and with alternative
ways to bond with their babies such as stroking skin, holding a hand,
talking, or singing. If you are familiar with resources to which
parents can turn for specific information, share them. The baby's
health care providers may also know of helpful resources.
THE BREASTFEEDING ANSWER
BOOK includes information on milk storage guidelines (p. 252), helping
a mother with an ill baby (p. 254, 264-66, 287-90), and the special
needs baby (p. 295-316). Call your Professional Liaison Leader
and relay the particular circumstances of the situation. She may
have additional resources. Documented information can then be shared
with the parents which they may choose to discuss with the baby's doctor.
If you know of an LLL Leader with experience in the particular medical
situation, ask her for any information she has found helpful and then
review it to be sure that it is consistent with LLLI information.
Refrain from passing on word-of-mouth generalizations. These parents
need authoritative resources if they are going to present them to their
baby's doctor. In addition to factual information, you may offer
praise on how well they are advocating for their baby and how important
they are to their baby. They may not even feel like their own
baby's parents since they do not really have control over his care.
You can help them feel more empowered as parents.
Use listening skills when
a mother needs to talk about her grief or loss.
Just as important as any
technical information you can supply are the listening skills cultivated
through La Leche League leadership. Grieving parents need to express
their feelings. They may not acknowledge this need until they begin
talking and it all comes pouring out. Don't be surprised when
a call about drying up a milk supply turns into a deluge of emotion.
Just listen. If you comment, think carefully before you speak.
HRE skills are advantageous here. Reflect her feelings:
"It is really difficult for you to have your body making milk when there
is no baby to nurse." It is a relief to bereaved parents to know their
emotions are accepted and understood.
Use the listening skills
you learned through Human Relations Enrichment sessions and really hear
the mother. If she is going to pump, give her accolades and share
information on types of pumps and scheduling, as well as appropriate
storage of milk. You will find this information in several sources:
the BREASTFEEDING ANSWER BOOK; tear-off sheet #555-27 Storing Human
Milk, and pamphlet #388-19 The Hospitalized Nursing Baby.
Do not be surprised if the mother turns to hospital personnel for advice.
She is in a life and death
struggle for her child, and she needs to trust the people caring for
her child. She may still need your emotional support and willingness
to listen even if she chooses not to use the information you have provided.
As I found following my son's
death and in working with other grieving mothers, people need to be
heard and want to feel normal. Grieving mothers are not so different
from the other mothers who call you for information and support; listen
to them, offer information and support, and be the La Leche League Leader
you are trained to be!
How The Group Can Help
By Deborah Wirtel and
Christine Koeppe
St. Louis, Missouri, USA
Our Group recently
lost an important member. A Group mom's only child died from meningitis.
It was sudden and left us wondering how we could support the mother.
The NEW BEGINNINGS Column, "Toddler
Tips: Comforting a Grieving Friend," in the May-June 1999
issue aided us immensely. The following are a few tips that
helped us all.
- Ask a Group mother
or Leader to attend any services scheduled for the baby. This
will put your words of support into action.
- Keep in touch with
the mother, and let her decide if and when she is ready to return
to Group Activities.
- Line up meals. The
mother may have a lot of help in the beginning, but keep in
contact by offering to cook some meals in the future.
- Celebrate the baby's
life. Get the Group together to make a donation to LLLI
or a charity of the mother's choice. This will help the
mother to know how much her baby meant to the Group.
- Don't be afraid
to initiate conversations about the baby. The mother will
always want to talk about her baby.
This was one of the
hardest situations our Group has had to experience. We hope
that what we learned can help other Groups facing similar circumstances.
|
Additional Resources:
Allen, M. Miscarriage:
Women Sharing from the Heart. New York, NY: John Wiley
and Sons, 1993.
Horchler, J. The SIDS
Survival Guide: Information and Comfort for Grieving Family and
Friends and Professionals Who Seek to Help Them. Hyattsville,
MD: SIDS Education Services, 1994.
Ilse, S. Empty Arms. Longlake,
MN: Wintergreen Press, 1982.
Kohner, N. When a Baby
Dies: The Experiences of Late Miscarriage, Stillbirth and Neonatal Death.
Hammersmith, London: Pandora Press, 1995.
Limbo, R. When a Baby
Dies: A Handbook for Healing and Helping. Lacrosse, WI:
Resolve Through Sharing, 1986.
Additional information is
available from the following organizations:
Share; St. Joseph
Health Center, 300 First Capital Dr, St. Charles, MO 63301 (636) 947-6164
Phone (636) 947-7486 Fax
Information, education and
resources on the needs and rights of bereaved families.
Perinatal Loss Project;
2116 N.E. 18th Ave. Portland, OR 97212-2621 (503) 284-7426
The Department of Health
in your state or country may offer additional resources.
Last updated 11/17/06 by jlm.
Page last edited Sun Oct 14 09:31:14 UTC 2007.
