By PPH Foundation
For many mothers, the first moments after childbirth are filled with the joy of holding and breastfeeding their newborn for the first time. However, for women who experience postpartum haemorrhage, those precious moments may be interrupted by a fight for survival. Severe blood loss often requires urgent medical intervention, blood transfusions or admission to high-dependency care, delaying the initiation of breastfeeding and creating challenges that can persist long after leaving the delivery room.
The World Health Organization recommends initiating breastfeeding within the first hour after birth whenever the mother and baby are clinically stable because early breastfeeding benefits both maternal and newborn health (World Health Organization, 2023). Yet mothers recovering from postpartum haemorrhage may face physical, emotional and clinical barriers that make breastfeeding more difficult. Recognising these challenges and providing timely support are essential components of quality postnatal care.
Postpartum haemorrhage can leave mothers physically exhausted and severely anaemic, making it difficult to hold, position or breastfeed their babies comfortably. Women who have lost large volumes of blood may experience dizziness, fatigue and prolonged weakness, all of which can delay the establishment of breastfeeding. Recovery often continues well beyond hospital discharge, requiring ongoing clinical follow-up and family support.
In some cases, mothers and their babies may be separated immediately after birth while emergency treatment is provided. This delay can interrupt skin-to-skin contact and postpone the baby's first breastfeed, both of which are known to improve breastfeeding success and maternal-infant bonding. Evidence shows that early skin-to-skin contact supports breastfeeding initiation, improves exclusive breastfeeding rates and contributes to better physiological adaptation for both mother and newborn (Moore et al., 2016).
Severe postpartum haemorrhage may also affect milk production in a small number of women. Significant blood loss can reduce blood flow to the pituitary gland, the organ responsible for producing hormones involved in lactation. In rare but serious cases, this may result in Sheehan syndrome, a condition in which damage to the pituitary gland leads to insufficient milk production and other hormonal complications. Although uncommon, the condition highlights the importance of monitoring mothers who have experienced severe obstetric haemorrhage and providing appropriate endocrine assessment when breastfeeding difficulties persist (Matsuzaki et al., 2023).
Despite these challenges, many women who experience postpartum haemorrhage are able to breastfeed successfully with the right support. Lactation counselling, frequent skin-to-skin contact once the mother is clinically stable, assistance with positioning and attachment, treatment of anaemia and encouragement from healthcare providers and family members all contribute to improved breastfeeding outcomes.
Dr Eunice Atsali, Co-Lead at EndPPH Initiative and an experienced midwife, says mothers recovering from postpartum haemorrhage require compassionate, individualized care that addresses both their physical recovery and breastfeeding journey.
"Surviving postpartum haemorrhage is only the beginning of recovery. Many mothers are physically exhausted, emotionally overwhelmed and anxious about whether they will be able to breastfeed their babies. As midwives, our role extends beyond controlling the bleeding. We must provide continuous support, reassurance and practical guidance that helps mothers regain confidence and establish breastfeeding whenever it is clinically possible."
She adds that families should also understand that recovery takes time.
"A mother who has experienced severe bleeding may need additional rest, nutritional support and encouragement. Breastfeeding may not happen immediately, and that is okay. What matters is that mothers receive skilled care, patience and ongoing support throughout their recovery so that neither they nor their babies are left behind."
Healthcare facilities can improve outcomes by ensuring that breastfeeding support is integrated into postpartum haemorrhage management. This includes early lactation assessment, counselling before discharge, follow-up clinics for mothers recovering from severe obstetric complications and multidisciplinary care involving obstetricians, midwives, paediatricians and nutritionists where necessary.
As the world marks World Breastfeeding Week, it is important to remember that every mother's breastfeeding journey is different. Women who have survived postpartum haemorrhage have already overcome one of childbirth's most life-threatening complications. With compassionate care, evidence-based clinical support and understanding from families and communities, they can also be supported to give their babies the healthiest possible start in life.
References
Matsuzaki, S., et al. (2023). Sheehan syndrome: Current understanding of diagnosis, management and long-term outcomes. Journal of Clinical Medicine, 12(9), 3187.
Moore, E. R., Bergman, N., Anderson, G. C., & Medley, N. (2016). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, 11, CD003519.
World Health Organization. (2023). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: Guideline. Geneva: World Health Organization.
Image by magnific</a>