In 2010, Amy Anderson found out that her baby boy, Bryson, had passed away in utero at 20 weeks’ gestation. His heart couldn’t handle the pressure that was building up in his bladder as a result of lower urinary tract obstruction (LUTO), a rare birth defect. On Oct. 30, Anderson gave birth to Bryson, who was, as she puts it, 13 ounces of complete, tiny perfection.

A blur of events followed: the choosing of a crematorium, the final goodbyes, the discharge from the hospital. Meanwhile, Anderson says, health-care professionals had failed to prepare her for the physiological changes that would happen to her breasts after Bryson was born.

The body naturally starts the process of making milk around the 16th week of pregnancy. Many mothers experience breast engorgement in the days after giving birth, particularly if they don’t breastfeed. At 20 weeks, Anderson had started to produce preterm milk, rich with extra nutrients designed to sustain the life of a significantly premature baby. Anderson, who at the time was a mother to a healthy 3½-year-old boy, says that she understood she wasn’t supposed to pump, because of the supply-and-demand nature of breastfeeding. She ignored her doctor’s recommendations, which were to take allergy medication, bind up her breasts and use cabbage leaves to help ease engorgement, opting instead to express enough breast milk to relieve her discomfort.

Anderson says that her first experience expressing milk “altered my perspective forever”: “I suddenly realized that I still had a purpose as Bryson’s mom, and he still had something invaluable to share: his ‘liquid platinum,’ or preterm breast milk, and a chance at life for other babies.”

She soon discovered the abundant need for donor breast milk, especially for premature infants, whose health, research has proved, benefits from human milk. A mother’s own milk is widely recognized as the optimal feeding for preterm infants, but when mother’s milk is unavailable or in short supply, donor milk is recognized as the second-best alternative by the World Health Organization.

So Anderson decided to donate through her grief. “My grief was so immense because I had an abundance of love for my baby, but he was unable to receive it. Yet I was able to express my love for him through expressing and donating his milk,” she says, nearly 11 years later.

About 24,000 U.S. women’s pregnancies end in stillbirth every year. The topic is often not talked about; even less openly discussed is breast milk donation in the aftermath, a little-known phenomenon around which awareness is slowly rising.

As Tanya Cassidy, a professor at Dublin City University who has conducted extensive research on breast milk donation among grieving mothers, explains, the earliest known cases of human milk donation in the United States took place in Boston around 1910 by Irish and Canadian immigrants, though these mothers were probably compensated for their donations. Today, Brazil is the leader in breast milk banking and has established an effective donor milk system that is being replicated across the world.

“When we’re pregnant, the last thing we expect, or our worst nightmare, is the loss of our child,” says Cassidy, who lost her own firstborn son years ago. “If you’re a parent whose child dies, that stays with you for the rest of your life.” For some women, donating breast milk is a way to help process that death. But, she says, a parent’s grief is highly complex, and she stresses that “there is no right way to grieve.”

There are many physical and emotional changes associated with milk production during the postpartum period. The two hormones involved in breastfeeding, oxytocin and prolactin, are neuromodulators, which means they can lower levels of stress, anxiety and depression, as well as improve mood and well-being. According to Cassidy, though, the key “benefit” of milk donation is “to put choice and control back in the mother.”

Olaya Rubio, who lives in northern Spain, agrees. She says she was given neither choice nor control in the days surrounding the death of her baby, Rubén, who passed away 12 hours after he was born on Jan. 14, 2018, at 42 weeks’ gestation. According to Rubio, without first being consulted or informed by doctors, she was prescribed medication to suppress milk production. She ultimately declined taking the medication and contacted a milk bank instead. Rubio had planned to donate her milk alongside breastfeeding her child: It was meant to be a tribute to her two babies who had died in the first trimester before this birth. Now, it would be a tribute both to them as well as to her baby Rubén. Donating milk was for her “to honor and give meaning to life,” she says.

The ritual of expressing milk every two to three hours brought her joy in a time of pain: “It was like occupational therapy.”

As she saw it, this was Rubén’s milk, not hers — “I’m just the puppet,” she says. Rubio, whose milk was consumed entirely by one baby girl, says that a grieving mother's milk is not the upsetting inconvenience that many health professionals deem it to be.

Instead, she says, expressing milk eased the phase of guilt she went through in her grieving process: The physical presence of the milk served as a reminder that her body worked, that she would have been able to feed her baby.

She went on to start a WhatsApp group, “Donors with a star,” which encourages moms who wish to do so to donate their breast milk. And in 2020, she published a book, “Madres También: Alimento para el Alma,” filled with testimonials of mothers like her, who, having suffered the death of their baby, donated their milk. It is now distributed in hospitals and milk banks across Spain, according to Rubio.

For Sierra Strangfeld, a 27-year-old who lives in Wisconsin, donating her breast milk “was the only physical thing connecting me” to her baby boy, Samuel Lee. She says that it wasn’t easy to pump “for a baby that wasn’t here,” and she sometimes questioned whether to keep going, but the thought of stopping was more heartbreaking. “I felt when I stopped, I would lose that connection.”

Strangfeld lost Samuel on Sept. 5, 2019, having given birth to him via emergency C-section in an attempt to save his life. Samuel had been diagnosed with trisomy 18, or Edwards syndrome, a rare condition in which a baby has three copies of chromosome 18 instead of two, which can be accompanied by heart problems. Born at 27 weeks’ gestation, Samuel weighed 1 pound 7 ounces and was 12.5 inches long. “We spent three hours with Samuel in our arms,” Strangfeld says. “He was and is so loved.”

Like Rubio, Strangfeld knew she wanted to donate; she had previously relied on donor milk for her daughter, Porter. “So when I couldn’t breastfeed him, I decided to pump, in hopes that I could give back to another mama and her baby,” she says. “My milk was going to come in regardless if Samuel was here or not, so I pumped because that’s what my milk was there for.”

Strangfeld donated her milk until the date when Samuel had been due to be born. On Nov. 13, 2019, she made her final donation of 500 ounces to the hospital where baby Samuel had been delivered.

Since losing Bryson, Anderson has earned her breastfeeding counselor certification, which allows her to educate others and advocate for breast milk donation. She wants to encourage professionals involved in caring for pregnant women to discuss lactation after birth, including lactation after loss.

“I realize that donating through grief is not right for everyone,” she says, “but for bereaved women to make an informed choice, they need to know that pumping and donating their baby’s milk is an option.”

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