Helping Breastfeeding Mothers Grieve

by Cynthia Good Mojab, MS, IBCLC

Loss is an integral part of life. Grief is the natural, normal and healthy response to loss. Breastfeeding is the biologically normal means of nurturing human babies and young children. Because of its survival value, breastfeeding is necessarily robust. Because breastfeeding is necessarily robust, fluctuations in supply due to loss and other psychosocial stressors can be expected to be temporary.

"Rules" for helping a breastfeeding mother who experiences a decrease in milk supply after a loss might include:

1. Feed the baby.
2. Protect the milk supply.
3. Help the mother grieve her loss.

I include "Help the mother grieve her loss" because I see a connection between the release of emotion and the release of milk. Anytime a mother experiences a drop in milk supply after a loss or other psychosocial stressor, I encourage facilitating the opportunity for a greater release of emotion.

What do mothers need to grieve a loss? A few things might be:

1. Time: By this, I do not mean just the passage of time. Time heals the wounds of a loss as well as time heals a broken washing machine. I mean that mothers need time in which to do the work of grieving.

2. Privacy: By this, I do not mean isolation. We are not meant to grieve alone any more than we are meant to mother alone. I mean that a mother needs a safe space in which to express what she really is feeling to people who can bear to fully be with her in her grief. That means she may need to somehow "get away" from the listening ears of a young child, a spouse, a relative, etc. Note that the "getting away" can involve a great deal of nearness. Someone can cuddle a baby or keep a young child happily engaged in a project in just the next room while the mother talks on the phone or in person with someone about her grief.

3. Practical help: Grief is physically and emotionally depleting. A grieving mother needs help with the housework, time off from paid employment, help with the children, etc. Someone other than the mother can arrange a few weeks (or whatever amount of time is needed) of practical help: relatives, friends from a La Leche League Group, members of her religious community, and neighbors can bring a meal each day, wash dishes, fold laundry, pull weeds, play ball in the back yard with an older child, etc. The grieving mother should not be expected to arrange this care. The person who coordinates this practical help should make a point of telling the helpers what the mother needs (after finding out from the mother), as the mother may be unable to do so herself. Since grief can come in waves, a mother might need such practical help periodically--and well into the grieving process. Anniversaries of the death, an expected due date for a baby that was lost prenatally, birthdays, holidays, other special days, and very ordinary days can all be difficult for a bereaved mother to make it through without help.

4. Rest: Grief is physically and emotionally depleting. Sleep is often disturbed. On a good day, many mothers do not get enough rest. During grief the exhaustion can be incredible. The chance to lay down or actually sleep in the middle of the day may be much needed. This need can be met by the people who are providing practical help for the mother.

5. Validation: Common platitudes expressed to the bereaved often have meanings and results quite different from our good intentions. We try to offer comfort by saying things like "At least she led a full life" or "At least she died quickly" or "She wouldn't want you to feel sad." The underlying meaning of such expressions is, however, "Don't feel bad." This leaves us feeling as though there is something wrong with us for feeling what we are feeling. We try to console with advice like "Time heals all wounds" or "You've got to keep busy" or "You need to stay positive." Time in and of itself does not heal anything. It's what we do while time passes that matters. And mothers have more than enough to keep them busy just with mothering. More busyness will only delay their work of grieving. Mothers can "stay positive" with just about anyone at just about any time. What they sorely need is the chance to share how badly they are feeling with someone who has the courage to listen. Our saying just about anything other than "I'm so sorry for your loss" results in mothers spending their energy stifling their grief instead of fully grieving. Our listening will do far more than our talking.

6. Companionship: Crying silently in the middle of the night and writing in a journal are helpful for many mothers, but they are worlds apart from sobbing in someone's arms. Grieving mothers need the chance to share their grief with others, to have social recognition of their loss, and to know that they are not alone.

7. Respect for the individuality of grief: No matter how similar the loss, no one truly knows how anyone else feels because personal histories differ, relationships differ, beliefs differ, responses differ, etc. "I know how you feel" is neither comforting nor accurate. Models of the grieving process (e.g., stages), are just one way of conceptualizing what people commonly experience. Much variation is to be expected. Every loss is unique.

8. Physical care: Grief is physically and emotionally depleting. Grieving mothers need nourishing foods, physical exercise, and healing touches from people they trust (e.g., an embrace, a massage, a hand on their hand).

9. Respect for grief: Many people, including mental health care professionals, do not understand the normalcy and healthiness of grief. A crying mother who is having difficulty sleeping after a loss is normal and mentally healthy. A sad mother who does not feel energetic after a loss is normal and mentally healthy. Yet because the symptoms of grief and clinical depression can overlap, others may believe that pharmacological treatment of grief is necessary. Because grief is not the same thing as clinical depression, the attempt to eliminate symptoms of grief via medication can actually delay grief to the detriment of the mother's physical and emotional health. A mental health care professional with specialized training and experience in grief counseling will be better able to make the distinction between grief and clinical depression than a professional without such training. She will also be better able to facilitate grief in the context of counseling than a professional without such training.  Grieving mothers may need to be told over and over again: "It's all right to cry" or "Whatever you are feeling is OK" or "It's all right to need care" or "It's all right to accept care" or "You have the right to grieve" or whatever it is that the mother seems not to believe is OK about grief. Many people have never heard anyone say anything supportive of grief. That is a loss worthy of grieving in and of itself. It may not be enough to say "How are you?" in societies where grief is not well supported. We may need to say "How are you? And I really want to know how you really are." Or we may need to ask specific questions like "What was the hardest part of the day today?" so mothers know that we do not expect them to say they are "Fine" when they are not. Mothers are often unable to express what they need when asked "What can I do to help?" because they have been socially trained to believe that needing help is unacceptable. An accurate answer may not come until the mother realizes that her grief is respected and accepted--and that it is deserving of her own respect and acceptance.

10. Recognition that there may be more to a mother's grief than meets the eye: New losses can trigger the grieving of old losses. A mother may not know that this often happens and may feel there is something "wrong" with her for feeling badly about something else, too. A mother may need the chance to talk about other losses in addition to the current one. She may feel overwhelmed by the complexity of her loss and her feelings and have difficulty speaking about them because she doesn't even know where to begin.

Those who offer support to grieving mothers must realize that breastfeeding is worth protecting and supporting--even during grief. Perhaps especially during grief. Not only is breastfeeding the foundation of normal development and health, it provides comfort and loving connection between the mother and her nursling during a difficult time. Mothers who are grieving the loss of a nursling may choose to donate their milk to a human milk bank for a time. They may feel that their doing so gives that much more meaning to their deceased child's life. Bereaved mothers have the right to know about this possibility whenever a human milk bank exists in their area.

© Cynthia Good Mojab, 2002. All rights reserved. This essay may be printed once for individual use.

This text was first posted on July 8, 2002 to LACTNET, a netlist for professionals working in the field of breastfeeding and human lactation. It has been edited slightly here.

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Cynthia Good Mojab, MS clinical psychology, IBCLC, is a private researcher and author focusing on issues related to culture, psychology and the family–-particularly the area of breastfeeding. She also works as Research Associate in La Leche League International's Publications Department, is a member of the LLLI Editorial Review Team for THE BREASTFEEDING ANSWER BOOK (3rd ed.), has been a La Leche League Leader since 1998, and is Senior Editor at Platypus Media. She has experience providing both psychological and breastfeeding counseling. Ms. Good Mojab has taught and guest lectured for undergraduate psychology and statistics courses, and has spoken about breastfeeding, parenting, culture and psychology to groups, organizations, and the media. She is an award-winning researcher whose work was recognized in 1995 by the American Psychological Foundation. Her website, Ammawell (http://home.comcast.net/~ammawell), offers breastfeeding and parenting information and support.

Cynthia Good Mojab, PO Box 5803, Aloha, OR 97006 USA; http://home.comcast.net/~ammawell (website)