The LISTEN (Lactation Support afTer pEriNatal loss) Project: Pathways of Loss and Lactation Care in Italy

Introduction: In the aftermath of perinatal loss, the physiologic onset of lactation presents a complex array of emotional responses for women, including grief and despair. Effective lactation management is essential for maternal health, yet it is often inadequately addressed by health care professionals, potentially compromising the physical and psychological recovery of the bereaved mother. The aim of this study was to investigate how Italian health care providers support women in managing lactation after a perinatal loss. Methods: This study employed a web-based, cross-sectional design. Participants involved in perinatal bereavement care were asked to answer a survey consisting of 3 areas: sociodemographic information, knowledge and experience of perinatal loss, and lactation after perinatal loss. Results: A total of 1227 health care professionals participated in this study. A significant majority (60.2%) had received formal training on perinatal loss care, expressing high satisfaction with an average score of 4.7 out of 5. However, less than half (42.5%) reported having a guideline for bereavement care in their workplace. Despite the opportunity, 25% of the respondents did not provide lactation information. Discussions predominantly centered on pharmacologic suppression of lactation in cases of stillbirth (89.5%) and neonatal death (83.8%), as well as complications associated with these events. Postdischarge follow-up was reported as lacking by 78.2% of the sample. Conclusions: The discrepancy between the training of health care professionals and their practice highlights a critical need to enhance the implementation of bereavement care guidelines and follow-up support, underscoring the importance of integrating lactation management into the perinatal loss care continuum.