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

Background. In the aftermath of perinatal loss, the physiological 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 ad-dressed by healthcare professionals, potentially compromising the physical and psy-chological recovery of the bereaved mother. Aim. The aim of this study is to investigate how Italian HCPs support mothers in managing lactation after a perinatal loss. Methods. This study is web-based and cross sectional. HCPs involved in perinatal bereavement care were asked to answer a survey consisting of three areas: sociodemographic information, knowledge and experience about perinatal loss and about lactation after perinatal loss. Findings. In this study, 1,227 healthcare professionals participated. 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, at 42.5%, reported having a protocol for bereavement care in their workplace. A notable 25% of the respondents did not provide lactation information when possible. Discussions predominantly centred on pharmacological suppression of lactation in cases of stillbirth (89.5%) and neonatal death (83.8%), as well as complications associated with these events. Post-discharge follow-up was reported as lacking by 78.2% of the sample. Conclusion. The discrepancy between HCPs' training and their practice reveals a critical need for enhancing the implementation of bereavement care protocols and follow-up support, reflecting the importance of inte-grating lactation management into the perinatal loss care continuum.