Does postpartum breastfeeding cause bleeding?

Written by Zhang Yin Xing
Obstetrics
Updated on April 02, 2025
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Bleeding caused by postpartum breastfeeding generally occurs within 42 days after delivery, during which the mother has lochia secretion. Breastfeeding promotes the secretion of oxytocin, which acts on the uterus and causes it to contract, facilitating the expulsion of lochia and aiding in the recovery of the uterus. Typically, by 42 days postpartum, the uterus has returned to its non-pregnant size and the expulsion of lochia is essentially complete. Subsequent breastfeeding is not directly related to vaginal bleeding. Another situation is due to the increase in prolactin during lactation; menstrual periods may not have fully resumed in women who are breastfeeding, and abnormal uterine bleeding may occur. As long as the amount and duration of bleeding do not exceed normal menstrual flow, no special treatment is needed.

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Written by Zhang Yin Xing
Obstetrics
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Does postpartum breastfeeding cause bleeding?

Bleeding caused by postpartum breastfeeding generally occurs within 42 days after delivery, during which the mother has lochia secretion. Breastfeeding promotes the secretion of oxytocin, which acts on the uterus and causes it to contract, facilitating the expulsion of lochia and aiding in the recovery of the uterus. Typically, by 42 days postpartum, the uterus has returned to its non-pregnant size and the expulsion of lochia is essentially complete. Subsequent breastfeeding is not directly related to vaginal bleeding. Another situation is due to the increase in prolactin during lactation; menstrual periods may not have fully resumed in women who are breastfeeding, and abnormal uterine bleeding may occur. As long as the amount and duration of bleeding do not exceed normal menstrual flow, no special treatment is needed.

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Written by Zhang Lu
Obstetrics
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Does postpartum hemorrhage require a blood transfusion?

The definition of postpartum hemorrhage is bleeding greater than 500 milliliters approximately 24 hours after vaginal delivery. Whether blood transfusion is necessary for postpartum hemorrhage mainly depends on the specific amount of bleeding. For average women, if the hemoglobin level is normal before delivery and the bleeding is between 500-1000 milliliters, the body can compensate for the anemia through normal adjustments, and generally, a blood transfusion is not required. However, if the bleeding exceeds 1000 milliliters, this situation is considered massive hemorrhage and must be treated with a blood transfusion, otherwise it may lead to hemorrhagic shock or DIC (Disseminated Intravascular Coagulation).

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Written by Zhao Li Li
Obstetrics
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How long will postpartum bleeding last until it stops?

Generally, in normal childbirth or after cesarean section surgery, there is usually a small amount of vaginal bleeding, which typically subsides completely within about a week. If there is heavy bleeding after delivery, it is crucial to closely monitor the vaginal bleeding to rule out the possibility of delayed postpartum hemorrhage. If the uterus contracts well and there is no retention of placental fragments, the area will generally be clean within about a week, albeit with some bloody discharge. Therefore, if there is abnormal vaginal bleeding postpartum, it is recommended to promptly re-examine to exclude the possibility of late bleeding, so as to avoid endangering life.

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Written by Zhang Lu
Obstetrics
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Causes of Late Postpartum Hemorrhage

Late postpartum hemorrhage refers to a significant amount of vaginal bleeding that occurs two to three weeks after a cesarean section or natural childbirth. The causes of late postpartum hemorrhage include the following aspects. First, the presence of residuals in the uterine cavity, such as when the placenta or membranes remain within the uterine cavity after childbirth, can repeatedly stimulate the endometrium causing bleeding. Second, poor healing of the uterine incision during a cesarean section can lead to post-cesarean bleeding, a condition that easily causes late postpartum hemorrhage. Third, poor healing of episiotomy or perineal laceration wounds after natural childbirth can also potentially lead to late postpartum hemorrhage.

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Written by Yue Hua
Obstetrics and Gynecology
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What should be done for late postpartum hemorrhage?

If there is a small or moderate amount of vaginal bleeding, high doses of antibiotics should be administered, along with medications to induce uterine contractions. This can reduce the amount of bleeding after the uterus contracts. If there is suspicion of placental remnants or other residues in the uterine cavity, then a dilation and curettage (D&C) surgery may be necessary. Before surgery, it is essential to prepare blood for transfusion in case of excessive bleeding. Additionally, the tissue removed during the procedure needs to be sent for pathological examination. After the D&C, it is important to continue treatment with anti-inflammatory medications and drugs that promote uterine contraction.