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 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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Causes of Late Postpartum Hemorrhage

Late postpartum hemorrhage is most commonly caused by retained placenta and membranes. About ten days after childbirth, the patient may experience significant bleeding due to the degeneration and necrosis of the retained placental and membrane tissues within the uterine cavity. When these necrotic tissues are shed, it can cause the blood vessels to open and lead to bleeding. Additionally, poor healing of the placental site on the uterus can also cause bleeding, as can infections, with endometritis being relatively common. Inflammation can lead to poor healing of the placental attachment site or poor uterine contraction, resulting in significant uterine bleeding.

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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 Liu Wei Jie
Obstetrics
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What are the warning signs of postpartum hemorrhage?

Postpartum hemorrhage generally does not have warning signs but usually has precipitating factors. These factors include maternal fear, psychological tension, macrosomia or twin pregnancy, as well as conditions like uterine fibroids, placental abruption, or placenta previa. In cases of placenta previa during a cesarean section, there is a high likelihood of severe bleeding. There is only one condition that might signal an impending postpartum hemorrhage, which is placental abruption. If placental abruption occurs, it can cause severe abdominal pain along with issues of hypertension during pregnancy. If a person with pregnancy-induced hypertension experiences severe abdominal pain, this could be a precursor to postpartum hemorrhage.

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Written by Zhang Lu
Obstetrics
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Is postpartum hemorrhage dangerous?

Postpartum hemorrhage refers to bleeding exceeding 500 milliliters within a short period after childbirth, or bleeding exceeding 1000 milliliters within 24 hours after childbirth. Postpartum hemorrhage is relatively dangerous because a large amount of bleeding in a short period of time after childbirth can cause the mother to experience hemorrhagic shock, and in severe cases, can lead to maternal death. Postpartum hemorrhage is currently the leading risk factor for maternal mortality. With increased understanding of the disease and improved treatment levels, the majority of postpartum hemorrhages can be managed successfully. The treatment of postpartum hemorrhage primarily involves early detection and early intervention. If symptoms of significant bleeding occur, it is essential to carefully identify the cause of the bleeding and provide targeted treatment. This can control the condition early and prevent worsening.