Breastfeeding Mothers Grieve
Cynthia Good Mojab, MS, IBCLC
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.
for helping a breastfeeding mother who experiences a decrease in milk supply
after a loss might include:
Feed the baby.
Protect the milk supply.
Help the mother grieve her loss.
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.
do mothers need to grieve a loss? A few things might be:
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.
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.
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
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.
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
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.
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.
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).
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.
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.
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.
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.
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.
Good Mojab, PO Box 5803, Aloha, OR 97006 USA; http://home.comcast.net/~ammawell