According to the Office of National Statistics (2019), 2 636 infant deaths (aged under one year) occurred in England and Wales in 2017, and one can assume that almost all of these cases were accompanied by overwhelming parental and extended family grief. In a Spanish study of parents who had experienced gestational loss, Martínez-Serrano et al (2019) found that parents failed to recognise their loss and parenthood; that the midwife was the highest valued professional; and that parents ‘referred to in-hospital logistic barriers that complicated the process, as well as the fact that these births occurred in the same place where healthy deliveries were attended’.
How might a grieving mother be helped to address some of the stressful challenges that accompany an infant death? Hospital-based lactation consultants Britz and Henry (2013) acknowledge that when perinatal or neonatal loss is anticipated, breast milk is seldom considered in the care plan. The authors point out that they have been challenged by well-intentioned colleagues who do not support the use of breast milk for infants who are likely to die. Nevertheless, Britz and Henry (2013) argue that ‘in many of these cases, the use of breast milk can be a wonderful experience for the mother and her infant. By creating a sense of normalcy in tumultuous times, the use of breast milk can contribute to creating positive memories’. They note that grieving mothers may experience unexpected breast changes that accompany lactogenesis and suggest that mothers should be given an informed choice in relation to lactation – apart from suppression – like breast milk donation, citing the case of an infant in the neonatal intensive care unit whose mother derived physical and emotional comfort by giving her son a little breast milk before he died.
In her study of bereaved mothers’ donation of human milk to non-profit human milk banks following their infant's death, Oreg (2019) highlights ‘women who had lost their babies and chose to engage in a demanding, often painful, and repeated act of expressing and donating their human milk’. Oreg (2019) analysed the personal testimonials of 80 bereaved mothers who chose to donate their milk as a possible means of coping with their loss, thus helping to empower them as bereaved mothers.
Carroll et al (2014) also endorse the value of lactation and breast milk in helping to provide meaning for grieving mothers who have experienced the death of an infant, and they also suggest that donation to a human milk bank is one way of respecting the value of breast milk. The authors cite the case of Australia's House of Representatives Standing Committee on Health and Ageing, which, in 2007, published a report on their inquiry into the health benefits of breastfeeding, which highlighted important issues associated with donation following bereavement. These issues included the despair of mothers with excess milk disposing of it due to lack of information on donation options, and noting the positive feelings associated with donation. Yet Carroll et al (2014) state that in 2014, when the Commonwealth Department of Health published a document on Donor Human Milk banking in Australia, ‘the cohort of bereaved mothers as potential and actual donors of milk was overlooked’.
The nature of human altruism – acting out of concern for the wellbeing of another – is often debated, with many sociobiologists attributing it to a biological imperative that views altruism as an ultimately selfish act concerned with gene preservation. It's a legitimate point of view, but I lean away from the idea that scientific reasoning must always imply logical infallibility. Oreg (2019) discusses the notion of altruism born of suffering, with individuals motivated to help others because of the enhanced empathy such individuals experience, and she cites research showing that giving at times of crisis is reflective of the extent of similarity between victim and donor.
It seems to me that those who choose to donate breast milk whilst grieving for a lost infant embody one of the finest aspects of what it means to be human.