When Zoe Kuhndt gave birth to her stillborn son Beau, it felt like her world had stopped.
But her body continued to produce milk, wired to provide for her beloved third baby after carrying him for nearly nine months.
"[The nurses] started saying to me … your body is thinking that you have a child," Ms Kuhndt, from Clare in South Australia's mid-north, said.
"That's when I thought, maybe I could do something to help somebody else … so that they don't lose their child."
Most bereaved mothers are offered medication or advice to suppress lactation after a stillbirth.
Instead, Ms Kuhndt asked her hospital if she could donate her breastmilk to a bank where it would be given to premature or sick babies whose mothers could not produce enough of their own.
Staff were "supportive" but surprised.
"They didn't actually really know anything much about whether you could or couldn't, or how you did it," she said.
Ms Kuhndt rang the Red Cross to offer her milk but hit another hurdle — her regional town was outside the radius staff would visit to collect donations.
But they bent the rules when they heard about her stillbirth, and she was able to donate five litres of precious milk in July this year.
"It gave me something that I could concentrate and focus on, because at that time your thoughts sort of wander to places they are probably best not to be in," she said.
"You feel like you are doing something good in a situation that is not very good."
Despite the increasing popularity of donor milk, mothers and advocates are still pushing for donation to be offered routinely, as an alternative to suppression medication or advice usually offered by medical professionals.
Lactation an afterthought
In a three-year study published earlier this year, Australian National University (ANU) researchers found human milk donation after infant death could play an important role in parents' grieving processes.
All mothers interviewed said they wanted to be supported to make an informed decision on lactation management.
Despite this, bereaved milk donation was often not presented as an option and health professionals were unsure about the benefit of discussing the practice with bereaved parents.
"The bereavement care we provide to families has improved dramatically over what it was a generation ago … but lactation and breastmilk is often not thought about," ANU postdoctoral research fellow, Debbie Noble-Carr, said.
"It's a really challenging, sometimes confusing experience.
"Some of the mothers we spoke to leaked milk for not only days, but weeks and months following the loss of their infant."
Making meaning
Lactation often takes around three days to set in after birth, meaning for many bereaved mothers it begins once they have returned home and have less clinical support.
Dr Noble-Carr said health professionals advising mothers to suppress the process were generally trying to ease their patients' suffering, but the "one size fits all" approach did not work for every family.
"The idea of [breastmilk] being treated as waste was quite distressing for some mothers," she said.
"Most of the mothers we talked to wanted to use their milk purposefully, whether that was to share or donate it or keep it as a memorial.
"We found that for some mothers, bereaved breastmilk donation offered an opportunity for meaning-making that could assist them in their grief."
A lack of readily available information and specialised programs to support bereaved donors remain some of the biggest barriers to overcome.
"When you look on the websites of our human milk banks here [in Australia], you wouldn't really realise that bereaved donation is a thing," Dr Noble-Carr said.
"They don't advertise it — all of the information is referring to mothers who have a living infant and who have a surplus of milk for their own infant's needs."
Toowoomba-based My Midwives managing director Liz Wilkes said while bereaved donation was relatively uncommon in her experience, women should be presented with all options and supported to pursue them.
"It's a really personal decision ... quite a selfless act," she said.
"We need to get really good at having hard conversations and ... being sensitive to what women actually want to do under those circumstances."
'An honour' to receive
Lifeblood, a division of the Australian Red Cross, operates milk banks in Sydney, Adelaide and Brisbane and is frequently seeking donors.
National milk operations manager Christine Sulfaro said the organisation had accepted donations from 16 bereaved donors since 2018, which were given to vulnerable babies in Neonatal Intensive Care Units (NICUs).
Any mother who meets Lifeblood's eligibility criteria can donate milk up to one year after giving birth, although sometimes illness or medication can preclude bereaved women.
"Our target was never to go out and actively recruit bereaved donors," Ms Sulfaro said.
"[But] it's an honour to listen to their stories and to know that in some small way, you're helping them with their grief process.
"If it can help them through what it has to be an absolutely horrendous situation ... then that's just something that is so precious to be involved in."
For support with grief and loss, call Red Nose Australia's 24/7 service on 1300 308 307. For lactation support, call the Australian Breastfeeding Association's hotline on 1800 686 268.