Donating breast milk after her son's death, mother helps another baby survive 
 
 Aiding other children can help moms through their grief, some experts say 
 
 She remembers going into another room to pump and weeping as the bottle filled, knowing the milk was no longer for her 7-week-old Phil. Instead, it would go to other babies struggling to survive. Peszat continued to pump for another week and donated that milk, as well as a freezer full of 4-ounce bottles she'd been saving for the son who never came home. 
 
 After Elizabeth Peszat's newborn took his last breath in the neonatal intensive care unit, her breasts swelled with milk despite her grief. 
 
 Elizabeth and Phil Peszat hold a photo of their son, Phil, who died last year when he was 7 weeks old. Elizabeth Peszat donated the breast milk that she continued to pump after his death. (Phil Velasquez, Chicago Tribune) 
 
 "It was still, in a way, comforting that other babies could use the milk even though Phil couldn't have it anymore," said 32-year-old Peszat of Hawthorn Woods, tearing up as she recalled the Feb. 5, 2013, death of her firstborn. 
 
 Lactation after infant loss has historically been a taboo subject in the halls of many hospitals. Medical professionals for so long had little guidance on how to approach that moment when milk comes in as a mother mourns her stillborn, or the pain in continuing to pump when there's no longer a baby to feed. But hospitals in recent years have been folding more lactation support into counseling for bereaved mothers, helping to ease postpartum mourning and adding to the coffers of milk banks around the country. 
 
 Thirty-four bereaved mothers donated milk in this part of the Midwest last year, compared to two in 2006, according to the Indiana Mothers' Milk Bank, which was established in 2005 and covers Illinois and four other states. 
 
 Some grieving moms like Peszat say they find comfort in donating their milk, for it extends their ability to mother after their baby is gone. 
 
 A few days after baby Phil died, Gladys Garcia Limmo of Des Plaines was rushed to the same hospital and gave birth to twin boys at 23 weeks and four days. Elijah James lived only about six hours, dying after an emergency baptism. 
 
 But Levi John, weighing just over a pound, was nourished by breast milk from a feeding tube and grew stronger in the neonatal intensive care unit at Advocate Children's Hospital in Park Ridge. Some of that milk, identified only by numbers on the bottles, came from Peszat. 
 
 Levi John turned 1 Saturday. He weighs more than 15 pounds. 
 
 Limmo, 38, believes the donor milk helped her baby persevere. 
 
 "I am so thankful for the one who gave the milk," she said. 
 
 'A way of bonding' 
 
 Peszat and her husband, Phil, met as counselors at a youth camp in Lake Geneva, Wis., and married about five years ago. 
 
 "This was definitely the person I wanted to mother my child," Phil Peszat remembers thinking as they dated. 
 
 Baby Phil was born Dec. 19, 2012, at 23 weeks and five days' gestation. 
 
 At 1 pound, 7 ounces, he had an arm thinner than his mother's pinkie. His hair was a striking shade of strawberry blond. Relatives said he had his mom's chin. 
 
 Peszat said her first drops of milk brought her joy. She triumphantly brought a bit of thick colostrum to the hospital, to be fed to baby Phil through a nasal tube. 
 
 She remembers the nurses cheered. Breast milk is considered the perfect blend of water and fat and protein and carbohydrates, laced with the antibodies of the mother, in a recipe that mysteriously alters based on the needs of the baby. The American Academy of Pediatrics in 2012 stated unequivocally that all preterm infants should receive only breast milk, either from the mother or pasteurized donor milk. ||||| There are many kinds of women who deserve to be honored on Mother's Day. Many nurture and care for their own children. Some, like Amy Hanson, 30, also helped nourish the children of others. 
 
 Preeclampsia had forced Amy to have an emergency C-section on March 15, 2015, delivering Adalyn Rose "Addie" Hanson at 27 weeks and 5 days gestation at Rush University Medical Center. The micropreemie weighed not quite a pound-and-a-half and was immediately taken to the neonatal intensive care unit. For the first days of her daughter's short life, Amy was only able to see her via Facetime. 
 
 So the Chicago mother started pumping, the rhythm of the machine and flow of breast milk connecting mom and baby when no other connection was possible. Amy, who also works as a pharmacist at Rush, had heard of the difficulties of nursing and wasn't sure pumping alone would work. She was a little surprised when her milk came in without a baby present to suckle. 
 
 "It's still incredible that your body knows and that it happens so soon," she said. 
 
 Addie was just 12 inches long with dark hair, her chin and toes resembling those of her father, Jeff Hanson. 
 
 Abel Uribe / Chicago Tribune Nurse Krystle Ekhoff, left, looks over Amy Hanson's baby album at Rush University Medical Center on Feb. 18, 2016. Hanson's baby was born prematurely last March and died in August, but she kept pumping milk and donated it for other premature babies. Nurse Krystle Ekhoff, left, looks over Amy Hanson's baby album at Rush University Medical Center on Feb. 18, 2016. Hanson's baby was born prematurely last March and died in August, but she kept pumping milk and donated it for other premature babies. (Abel Uribe / Chicago Tribune) (Abel Uribe / Chicago Tribune) 
 
 "Her diaper was the size of a Splenda packet, so small," Amy recalled, smiling at the memory of gingerly changing the newborn when they reunited. 
 
 Amy tried to put Addie on her breast when she was about a month old, but she was still too weak and couldn't nurse much. 
 
 So the mother kept pumping, in part to pass along her immunity through the milk, hoping it might make up for the third trimester in the womb her daughter had been denied. 
 
 Every two to three hours, six to eight times a day, Amy kept filling 4-ounce bottles, too focused on her baby's survival to keep track as the leftovers accumulated in a freezer at Rush. 
 
 Addie held on in the NICU for 160 days, a little over five months. 
 
 "She never turned that corner of getting better," Amy said. "The whole big picture was that she just wasn't meeting the milestones that her lungs needed to meet." 
 
 On Aug. 23, Amy held Addie for the last time, reciting Psalm 23: ... Though I walk through the valley of the shadow of death, I will fear no evil, for you are with me ... 
 
 "I read that to her and she passed away," Amy said. "She passed away probably within the hour." 
 
 Even after the burial at Sts. Peter and Paul Cemetery in Naperville, Amy continued making milk for a few weeks, until it finally tapered off to a trickle. 
 
 So the mother stopped pumping. It was time. 
 
 Abel Uribe / Chicago Tribune A nurse looks over Amy Hanson's baby album, showing Amy and her husband Jeff Hanson with their baby Adalyn Rose at Rush University Medical Center's NICU in 2015. Adayln, who was born last March, died in August. A nurse looks over Amy Hanson's baby album, showing Amy and her husband Jeff Hanson with their baby Adalyn Rose at Rush University Medical Center's NICU in 2015. Adayln, who was born last March, died in August. (Abel Uribe / Chicago Tribune) (Abel Uribe / Chicago Tribune) 
 
 In the back of her mind, Amy said she always knew she would donate the extra milk if her daughter couldn't come home, believing it would help another baby. The American Academy of Pediatrics in 2012 advocated that preterm infants receive only breast milk from either the mother or pasteurized donor milk, citing protection against infection as well as long-term health benefits. Preterm milk like Amy's is particularly nutritious for those tiniest of patients in the NICU. 
 
 Amy said she was stunned when a lactation consultant revealed just how much she had pumped: First she saw one large crate packed with more than 50 4-ounce bottles. Then she realized there were 21 more crates. She ended up donating 5,000 ounces — almost 40 gallons of milk — enough to feed about 22 preemies for a month, according to nurses at Rush. 
 
 The hospital held a small ceremony at the NICU in February to commemorate the donation as well as to remember Addie. 
 
 The first human milk bank in Illinois, which began pasteurizing in January, has had more than 90 donors so far, said Summer Kelly, executive director of Mothers' Milk Bank of the Western Great Lakes in Elk Grove Village, which serves Illinois and Wisconsin. Nine of them were bereaved mothers, including Amy, whose donation was divided between the new Illinois milk bank and one in Ohio. 
 
 Approaching a grieving mother about milk donation can be a delicate task, said Kelly, a former obstetrics nurse and NICU lactation consultant. But she said most women are grateful for the chance to make that choice, even if they decline to donate or decide to suppress their milk. Many say making this most intimate donation helps them heal. 
 
 "They just absolutely can't bear the thought of throwing the milk away," she said. "And they want to help other babies, that's very universal among bereaved mothers." 
 
 Abel Uribe / Chicago Tribune Amy Hanson, a pharmacist at Rush University Medical Center, speaks with Dr. Aloka Patel, during a small event at the hospital, as they prepared to send about 40 gallons of Amy's breast milk to an Ohio's milk bank on Feb. 18, 2016. Amy Hanson, a pharmacist at Rush University Medical Center, speaks with Dr. Aloka Patel, during a small event at the hospital, as they prepared to send about 40 gallons of Amy's breast milk to an Ohio's milk bank on Feb. 18, 2016. (Abel Uribe / Chicago Tribune) (Abel Uribe / Chicago Tribune) 
 
 Amy and Jeff never took down the pink elephant-themed nursery they'd prepared for Addie. 
 
 At first they were a little afraid to try and have another baby, with a 20 to 40 percent risk of recurring preeclampsia shrouding future pregnancies. But Amy said her fear was eclipsed by the joy of the prospect of motherhood, another chance to hold and feed and care for a child. 
 
 "I loved being a mom," she said, tearing up. 
 
 The Hansons are expecting another baby girl, due July 23. The pregnancy has been healthy with no troubling symptoms. 
 
 They plan to tell her all about her big sister Adalyn Rose, whose milk helped feed so many other babies fighting for survival. 
 
 eleventis@tribpub.com 
 
 Twitter @angie_leventis ||||| “I decided to donate Bryson’s milk and turn my tragedy into a blessing,” states Amy Anderson, from Caribou, Maine. 
 
 In the fall of 2010, Anderson lost her son Bryson at 20 weeks gestation. Trusting her intuition, she disregarded her physician’s advice to “bind your breasts and take Sudafed.” Instead, she began to pump the breast milk that would have nourished Bryson. 
 
 “At the time, I didn’t know what I would do with the milk, but I knew I needed to stop trying to prevent my body from lactating,” remembers Anderson. 
 
 She began to research and quickly discovered there was a great need for donor breast milk, especially with regard to the best practices of care employed to save the lives of prematurely born babies. 
 
 As we celebrate the holiday season, and in honor of the newly opened breast milk bank at the Children’s Hospital of Philadelphia (CHOP), the following interview with Anderson provides important reflections on gratitude and grief. 
 
 Furthermore, Anderson’s experience of being discriminated against at work when seeking to have breastfeeding laws apply to her situation necessitates the need for legislative change. Certainly, lactating surrogates and bereaved mothers who pump breast milk deserve not only respect but also legal protection. 
 
 Amy, tell me about yourself. 
 
 I live in Caribou, Maine -- up north by the Canadian border. I married my high-school sweetheart. We have two living children (ages 8 and 2-and-a-half) and four “angel babies” in between them. Currently, I am a work-at-home mom. I also volunteer online for Mothers’ Milk Bank Northeast (MMBNE) while working toward completing my certification as a breastfeeding consultant. 
 
 "I pumped for 8 months to the day. Just imagine how many lives his nearly 92 gallons of milk saved!" -- Amy Anderson 
 
 
 
 Tell me about your son Bryson. 
 
 We lost our third child, whom we named Bryson, in 2010. We discovered at 15 weeks gestation that our son had a lower urinary tract obstruction (LUTO). Tragically, the morning before our appointment to finally schedule his surgery, Bryson died in utero. His heart couldn’t handle the pressure that was building up in his bladder. I delivered his body at the age of 20 weeks. 
 
 I am so sorry to hear about your loss. Your son died right before the fall and winter holiday season, right? 
 
 Yes. Bryson’s body was delivered on Oct. 30, and the holidays that year were simply unbearable. My grief was heavy, and while I found comfort in expressing milk in his name, no one in my family dared to talk about my baby. However, that is actually what I needed the most. 
 
 A mother’s love is a mother’s love regardless of whether or not her child lives or dies. 
 
 What inspired you to begin pumping breast milk following Bryson’s death? 
 
 No one prepared me for what would happen to my breasts after Bryson was born. In fact, I was told that it was way too early for breast milk to be produced by my body. But this was a horrible misconception. Within a couple days after delivering Bryson, my milk came in. My rock-hard chest was throbbing, and milk saturated everything. No one suggested the option of donating Bryson’s milk. 
 
 I knew I wasn’t supposed to pump, as breastfeeding is based on a supply-and-demand relationship. But I was in horrid pain, so I decided to pump “just a little” to relieve my body. Six ounces of colostrum milk were expressed during a couple minutes of that first pumping session. I felt such relief. 
 
 As I expressed the milk, a real sense of calm descended. I felt a powerful closeness to my Bryson, which reminded me how much I loved the breastfeeding relationship I had shared with my eldest son. Pumping milk in Bryson’s memory felt so very right. All life has meaning, and my son’s life was no different. I decided to embrace his life’s purpose. 
 
 Tell me more about “his life’s purpose.” 
 
 At first, I couldn’t understand why Bryson was taken. I would hear of parents who didn’t want their children, who would beat them, and nothing made sense. Yet, through pumping and donating his milk, I came to see that Bryson’s death held a blessing in disguise. 
 
 Because Bryson was so early, my milk was deemed “preterm breast milk” and was very nutrient-rich. In fact, it was considerably healthier than full-term breast milk, as my body made it to sustain the life of a significantly premature baby. It is normal practice for the milk bank to combine the milk of three or more donors, but they kept Bryson’s milk separate and gave it to the highest of high-needs babies. It really was off the charts how phenomenal his milk was. I pumped for eight months to the day. Just imagine how many lives his nearly 92 gallons of milk saved! 
 
 How do you hold space for both your grief and gratitude? 
 
 The grief of losing my son is a reflection of the love I have for him. I couldn’t give my love or milk to Bryson, as he wasn’t there in the physical sense. Yet I was able to express my love for him through expressing and donating his milk. It was very healing both physically and emotionally. 
 
 While there are definitely still tears, my heart fills with mother’s pride as I share his story. Through my grief, I have found gratitude, and my sense of gratitude continues to multiply. I’ve learned to always look for the blessing in a situation, though it quite possibly is disguised. Honestly, I could, and will, talk about his legacy forever. 
 
 What specific benefits do premature babies receive through donor breast milk? 
 
 I wanted to do everything I could by donating Bryson’s milk to help families avoid the heartbreak of baby loss. As I researched, I learned about necrotizing enterocolitis (NEC), which is an excruciatingly painful bowel disease that causes parts of the intestines to die. NEC is the second-leading cause of death for premature babies. 
 
 According to the NEC Society, the use of a human milk diet [mother's own milk or donor milk] can lower the risk of necrotizing enterocolitis by 79 percent. As Diane L. Spatz [Ph.D., RN-BC] writes: “In the NICU, human milk must be viewed as a medical intervention that is just as important as IV nutrition or a ventilator.” 
 
 Premature babies suffer when given formula, which is incredibly unhealthy for their immature digestive system. Human breast milk is by far the better option. It absolutely saves lives. In this sense, donating breast milk isn’t so different from organ donation. Bereaved lactating women can offer irreplaceable life-saving nutrients in honor of their precious angel babies. 
 
 You pumped for eight months and worked outside of the home during this time. As a lactating bereaved mother, how were you treated? 
 
 My former employer insisted that rights protected under the Break Time for Nursing Mothers law didn’t pertain to my situation. 
 
 “Your baby is dead,” the administrators told me. 
 
 These words stung like a second grief. Whether or not I had a baby, I was a lactating woman with physical needs. 
 
 The terminology in our federal law relating to the rights of breastfeeding mothers at work is a real problem. Federal law stipulates that breaks to express milk only apply to “nursing mothers” who pump “for her nursing child.” While I wasn’t expressing milk for a living, nursing child of my own, I was expressing milk for many high-risk infants who may otherwise die without a supply of healthy donor milk. 
 
 While I have completely moved forward from this workplace experience, I am dedicated to changing the terminology of the federal law to be formally inclusive of all lactating women. Currently, bereaved and surrogate mothers who chose to express breast milk can be excluded from the protection of the federal mandate due to the terminology used. However, all lactating women deserve the same rights. 
 
 In addition to contacting our legislators about this topic, what more can be done to support bereaved mothers? 
 
 I am trying to encourage professionals involved in caring for pregnant women to discuss lactation following birth -- including lactation after loss. I realize that donating through grief is not right for everyone. But for bereaved women to make an informed choice about the matter, they first need to know that pumping and donating their baby’s milk is an option. 
 
 Amy, I’ve so enjoyed speaking with you, and I thank you for your time. Do you have any final thoughts to share before we conclude? 
 
 As Bryson’s mother, it is such an honor to have this opportunity to bring support and advocacy to mothers faced with lactation following the devastation of baby loss. Equally as important is the education of individuals about the benefits of this unique form of organ donation that can be completely life-changing for the many precious recipients of donor milk. 
 
 To learn more about Amy Anderson’s work, visit her Facebook page “Donating through Grief.” 
 
 
 
 The Anderson family. Photo credit Sha~Lam Photography. ||||| What do I need to know? 
 
 Breastfeeding is great for all newborns, but it's even more important if your baby arrives early. That's because your body will automatically produce milk that's specially designed to nourish your premature baby, with extra calories, vitamins, and protein. What's more, the live cells in breast milk that protect babies from infection can be even more important for premature babies: Preemies face a higher risk of infection because their immune systems are particularly immature. You will find artificial formulas and supplements made just for preemies, but they can't provide the antibodies and other protective factors that are in your breast milk and are so beneficial to a fragile premature infant. 
 
 Whether or not your baby is ready to nurse at your breast right away will depend on his gestational age and overall health. At many hospitals it's standard practice to start off feeding very premature babies expressed breast milk through a nasogastric (NG) tube (known as gavage). This is to make sure the baby gets as much nourishment as possible if he's too immature to suckle from breast or bottle. 
 
 You'll work closely with the hospital staff overseeing your baby's care on a plan to feed your pumped breast milk to your baby. Many preemies simply aren't ready to start breastfeeding in the hospital right away, and won't be released until they've started to gain weight from breast- and/or bottle-feeding. 
 
 Once your baby is able to start nursing at the breast, be prepared to nurse frequently, although preemies may not take in much milk at each feeding until they're closer to term. For this reason, you'll need to pump after feedings to keep up your milk production as well as have milk for any necessary supplementary feedings. You may need to use different breastfeeding holds for your preemie. Hospital staff, including lactation professionals, may be helpful when you start breastfeeding. 
 
 What challenges could I face? 
 
 If your baby is too immature to breastfeed right after birth, your initial challenge will be to stimulate and maintain your milk supply. The most efficient and convenient way to do this is to use a hospital-grade pump with a double collection kit (a hospital nurse or lactation consultant will get one for you and show you how to use it). You'll also eventually want to rent one to use for the first several weeks at home, until you're sure your baby is feeding well at your breast. 
 
 Once your baby is ready to move on to the breast, learning how to latch on and suck can be difficult. Most babies don't develop the suck-swallow-breathe reflex that's critical for feeding until about week 32 in the womb, eight weeks before they're considered full-term. It can also be challenging to figure out whether your baby is getting enough by breast alone if you're used to supplementing feedings. 
 
 A common rule in taking care of preterm babies is to limit how much they cry, on the theory that crying wastes precious energy better devoted to growing. Of course, it's harder to care for a baby when you can't wait for him to cry out to say he's hungry or uncomfortable. You'll have to learn to anticipate your baby's hunger, which takes time. 
 
 How can I solve these problems? 
 
 You can start by tuning in to your baby's cues. To minimize crying and maximize intake, you must figure out when your baby wants to eat, and when he'll be ready for the next feeding. This isn't easy because premature babies tend to be quieter when asking for food than their full-term peers. Wakefulness may be the only clue that he's getting hungry, instead of the full-throated wail heard in most nurseries. 
 
 You'll also want to continue to pump after you nurse to make sure you're keeping up your supply. You may want to hire a lactation consultant to help you check your baby's weight gain, or consider renting an electronic scale so you can weigh your baby before and after nursing sessions to see how much he's taking in. 
 
 Aim for feeding your baby at least every three hours or so, about eight feedings every 24 hours. This schedule is flexible, and if he seems hungry only two hours after eating, by all means let him try again. It's also okay to wake him up to nurse. In fact, disturbing a nap may actually trigger the suckling instinct. 
 
 The life of a preterm baby is little more than eating and sleeping, and when your baby's not eating, you need to think about how to get him to eat. This may mean, for example, unwrapping him, or even taking off his clothes to stimulate his need for comfort, and for suckling. 
 
 Where can I get more help? 
 
 La Leche League International (LLLI) is a great place to direct all your breastfeeding-related questions, and they'll probably be able to introduce you to other moms who are nursing premature children. You may want to hire a lactation consultant to help you through the early weeks. Doctors and nurses will certainly be able to answer a lot of your questions, but you may need more hands-on help. LLLI also has books and other resources for moms of preterm babies.
– Pre-eclampsia forced Amy Hanson to have an emergency C-section at just over 27 weeks gestation. Her daughter, Adalyn "Addie" Rose, measured just 12 inches long. "Her diaper was the size of a Splenda packet, so small," Hanson tells the Chicago Tribune. In the first days of Addie's life, Amy was only able to see her via FaceTime. Still, she began pumping, "the rhythm of the machine and flow of breast milk, connecting mom and baby when no other connection was possible," the Tribune writes. Addie died after 160 days in the NICU; a few weeks later, Hanson pumped for the last time, then gave away all her excess milk: 5,000 frozen ounces—that's nearly 40 gallons—or enough to feed about 22 preemies for a month, nurses say. And it's the perfect food for them, per BabyCenter, which explains the mother's body in these cases produces milk with "extra calories, vitamins, and protein." The executive director of the newly opened Mothers' Milk Bank of the Western Great Lakes tells the Tribune that nine bereaved mothers have given since January. "They just absolutely can't bear the thought of throwing the milk away," she says. Elizabeth Peszat's 7-week-old son, Phil, died in 2013 after being delivered at 23 weeks gestation. She donated the milk she had pumped, telling the Tribune in 2014 that it was "comforting" that other babies could use what her son couldn't. One of those babies was Levi John Limmo, who, born at about 23 weeks, went on to survive. PhillyVoice has the story of another mother who pumped for eight months after her son's death at 20 weeks; she donated 92 gallons.