RNCase ReportJournal of human lactation : official journal of International Lactation Consultant Association2026

Case Studies to Document Strategies Used by Mothers to Overcome Significant Maternal Morbidity Challenges to Successful Breastfeeding.

Penny Reimers, Anna Coutsoudis

PMID 41814495

WHAT IT FOUND

Two mothers with severe postpartum complications, including surgery and hemorrhage, sustained breastfeeding through hand expression, donor milk, and consistent private lactation support.

Hospital staff provided minimal assistance despite the mothers' complex needs. This illustrates strategies for extreme cases but does not prove these methods work for others.

Key findings

01Both mothers faced severe medical complications that made breastfeeding highly unlikely, including emergency surgeries, postpartum hemorrhage, and prolonged separation from their infants.

02The mothers relied on private lactation consultants and family support for guidance and practical help, as hospital staff provided little direct breastfeeding assistance.

03Strategies included hand expression during critical illness, using donor human milk, and alternating with formula when supplies ran low, until direct breastfeeding could be established weeks later.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This is a case series of only two individuals, so the findings cannot be generalized to other patients. The researcher was the private lactation consultant for both cases, introducing a significant potential for bias. The mothers were highly motivated, well-informed, and had access to private support and resources, which may not be typical for the general population. The study describes what happened in these specific instances but does not measure outcomes or prove that the strategies used caused the successful breastfeeding.

Declared interests

The author received no financial support for the research or authorship. The author was the International Board-Certified Lactation Consultant who provided private support to both case subjects.

The easy way to misread this

Do not interpret these cases as evidence that severe maternal morbidity can routinely be overcome by standard hospital care. Both mothers succeeded primarily because they had access to private, consistent lactation consulting and extensive family support, while hospital staff provided little help. This paper describes exceptional individual resilience and private resources, not a generalizable clinical protocol.

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