By PPH Foundation
The birth of a child is often marked by the first embrace between mother and baby, followed by the first breastfeed. However, for women who experience postpartum haemorrhage, these precious moments are sometimes interrupted by a medical emergency. While the immediate priority is to stop the bleeding and save the mother's life, the journey does not end there. Many mothers face unexpected challenges in initiating and sustaining breastfeeding, making continued support an essential part of recovery.
The World Health Organization recommends that mothers initiate breastfeeding within the first hour after birth whenever both mother and baby are clinically stable. Early breastfeeding improves newborn health and supports maternal recovery, but women who have experienced postpartum haemorrhage may require additional medical care before they are physically able to breastfeed (World Health Organization, 2023). Recognising these challenges and providing timely support can make a significant difference to both maternal and newborn outcomes.
Postpartum haemorrhage can leave mothers physically exhausted due to significant blood loss. Many experience severe anaemia, dizziness and fatigue, making it difficult to hold, position and breastfeed their babies comfortably. Others may require emergency surgery, blood transfusions or admission to high-dependency units, leading to temporary separation from their newborns during the critical first hours after birth.
These delays can interrupt skin-to-skin contact and the early initiation of breastfeeding, both of which are known to improve breastfeeding success and strengthen maternal-newborn bonding. A Cochrane review found that early skin-to-skin contact increases the likelihood of successful breastfeeding while supporting maternal physiological recovery after childbirth (Moore et al., 2016).
In rare cases, severe postpartum haemorrhage may also affect milk production. Extensive blood loss can reduce blood flow to the pituitary gland, which produces hormones responsible for lactation. Although uncommon, this can contribute to delayed or insufficient milk production in some mothers, highlighting the importance of continued clinical assessment and breastfeeding support following severe obstetric complications (Matsuzaki et al., 2023).
Despite these challenges, postpartum haemorrhage does not mean a mother cannot successfully breastfeed. With skilled guidance from healthcare providers, adequate nutritional support, treatment for anaemia and encouragement from family members, many mothers establish breastfeeding successfully once they recover.
Dr Kireki Omanwa, President of the Kenya Obstetrical and Gynaecological Society and Co-Lead at EndPPH Initiative, emphasises that maternal care must continue long after the emergency has been managed.
"Successfully treating postpartum haemorrhage is only one part of quality maternity care. Our responsibility extends to supporting mothers through recovery, helping them regain their strength and ensuring they receive the guidance needed to initiate and sustain breastfeeding where clinically possible. Every woman deserves comprehensive postnatal care that addresses both her physical recovery and the wellbeing of her newborn."
He adds that healthcare systems should ensure that breastfeeding support is integrated into postnatal services for women recovering from obstetric emergencies.
"When we invest in skilled health workers, postnatal follow-up and family-centred care, we improve outcomes not only for mothers but also for newborns. Supporting breastfeeding after postpartum haemorrhage is an important step in giving every child the healthiest possible start while helping mothers recover with dignity and confidence."
Healthcare providers play a central role in this process by facilitating skin-to-skin contact as soon as the mother is clinically stable, providing lactation counselling, monitoring mothers for anaemia and other complications, and ensuring continuity of care after discharge. Families also contribute by offering emotional support, assisting with newborn care and allowing mothers adequate time to rest and recover.
As the world marks World Breastfeeding Week, it is important to remember that every breastfeeding journey is unique. For mothers recovering from postpartum haemorrhage, compassion, patience and evidence-based support can help overcome early challenges and ensure that a life-threatening complication does not define the beginning of motherhood.
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.
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