Key takeaways: A postpartum hemorrhage can make it harder to start breastfeeding and may delay milk coming in. Rest, iron treatment if needed, early and frequent milk removal, and support help. Rarely, severe blood loss damages the pituitary gland (Sheehan syndrome), which can prevent milk production and needs medical evaluation.
Postpartum hemorrhage (heavy bleeding after birth) can be frightening and exhausting. It can also affect breastfeeding.
How It Affects Breastfeeding
- Separation and treatment in the first hours can delay skin-to-skin and first feeds.
- Exhaustion and anemia make feeding tiring.
- Milk may come in later. A 2010 Australian study by Thompson and colleagues found that women with significant hemorrhage were less likely to be fully breastfeeding in the first week.
- Retained placenta, a cause of bleeding, can also delay milk.
Protecting Your Supply
- Start milk removal as soon as possible, with skin-to-skin, feeding, hand expression, or pumping.
- Ask for help positioning your baby while you’re weak or have IVs.
- Express 8 or more times a day if your baby isn’t feeding well.
- Use a hospital-grade pump if you can’t feed directly.
Recovering From Anemia
- Take iron if prescribed.
- Eat iron-rich foods such as meat, beans, lentils, and fortified cereals.
- Rest as much as possible, with others handling non-feeding tasks.
- Stand up slowly, since dizziness is common.
- Iron supplements and IV iron are compatible with breastfeeding.
Sheehan Syndrome (Rare)
Severe blood loss can damage the pituitary gland, which makes prolactin and other hormones. Signs can include:
- Milk never coming in or very little milk.
- Extreme fatigue and weakness.
- Low blood pressure, dizziness.
- Not getting periods back later.
This is rare but important. If your milk doesn’t come in after a significant hemorrhage, ask your doctor about testing.
Emotional Recovery
A traumatic birth can affect your mood and how you feel about feeding. Talk with your care team if you feel anxious, numb, or have flashbacks.
Call your provider right away if you have: heavy bleeding (soaking a pad in an hour), large clots, dizziness, a racing heart, fever, or feel very unwell. Call 911 for fainting or severe bleeding.
The Bottom Line
Breastfeeding after hemorrhage may take extra support. Start milk removal early, treat anemia, rest, and ask for evaluation if milk doesn’t come in.
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Sources
- Thompson JF, Heal LJ, Roberts CL, Ellwood DA. Women’s breastfeeding experiences following a significant primary postpartum haemorrhage: a multicentre cohort study. Int Breastfeed J. 2010;5:5.
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 183: Postpartum hemorrhage. Obstet Gynecol. 2017;130(4):e168-e186.
- Lawrence RA, Lawrence RM. Breastfeeding: A Guide for the Medical Profession. 9th ed. Elsevier; 2022.
- National Library of Medicine. Sheehan syndrome. MedlinePlus. https://medlineplus.gov
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
