By PPH Foundation

As the world marks World Breastfeeding Week from 1 to 7 August, attention rightly turns to the life-saving benefits of breast milk for newborns. Yet breastfeeding also offers an important, though often overlooked, benefit for mothers. Initiating breastfeeding within the first hour after birth stimulates the natural release of oxytocin, a hormone that helps the uterus contract after delivery and reduces the risk of excessive bleeding. While breastfeeding is not a treatment for postpartum haemorrhage, it forms part of a package of evidence-based interventions that support safer childbirth and maternal recovery.

The World Health Organization recommends initiating breastfeeding within the first hour of birth whenever the mother and baby are clinically stable. Early breastfeeding complements essential newborn care and supports the physiological processes that help prevent postpartum haemorrhage by promoting uterine contraction and reducing blood loss after delivery (World Health Organization, 2023). This simple act, combined with active management of the third stage of labour, timely administration of uterotonic medicines and skilled obstetric care, contributes to improving maternal outcomes.

Postpartum haemorrhage occurs when a woman experiences excessive bleeding after childbirth, most commonly because the uterus fails to contract effectively after the placenta is delivered. These contractions are essential because they compress the blood vessels that supplied the placenta during pregnancy, preventing continued blood loss. If the uterus remains relaxed, severe bleeding can occur within minutes, requiring urgent medical intervention.

Breastfeeding plays a unique physiological role during this critical period. When a newborn suckles at the breast, sensory nerves in the nipple stimulate the mother's brain to release oxytocin from the posterior pituitary gland. While many people associate oxytocin with milk let-down, the hormone also causes the uterine muscles to contract, helping the uterus return to its normal size and reducing bleeding from the placental site. This natural response works alongside clinical interventions to support maternal recovery after birth.

Research continues to demonstrate the value of immediate breastfeeding and skin-to-skin contact. A Cochrane review by Moore et al. (2016) found that early skin-to-skin contact improves breastfeeding success while supporting maternal physiological adaptation after childbirth. Similarly, Uvnäs-Moberg et al. (2020) demonstrated that breastfeeding stimulates endogenous oxytocin release, contributing to uterine contractions and maternal recovery during the immediate postpartum period.

However, breastfeeding may be more challenging for women who have experienced severe postpartum haemorrhage. Significant blood loss can leave mothers weak, anaemic or temporarily separated from their babies while receiving emergency treatment. In rare cases, severe haemorrhage may affect the pituitary gland, delaying or reducing milk production. These challenges highlight the importance of continued breastfeeding support, compassionate postnatal care and follow-up after discharge.

Dr Eunice Atsali, Co-Lead at EndPPH Initiative and an experienced midwife, says the first hour after birth presents an important opportunity to support both maternal recovery and newborn health.

"As midwives, we know that the care provided immediately after birth can have lifelong benefits for both mother and baby. Early breastfeeding is more than a feeding practice. It stimulates the natural release of oxytocin, helping the uterus contract and reducing the risk of excessive bleeding after delivery. While it does not replace essential medical interventions used to prevent postpartum haemorrhage, it strengthens the body's natural recovery process and should be encouraged whenever the mother and baby are clinically stable."

She adds that women recovering from postpartum haemorrhage often require additional breastfeeding support.

"Some mothers may struggle to initiate breastfeeding because of fatigue, anaemia or temporary separation from their newborns during emergency care. These women deserve patience, skilled guidance and continued support throughout their recovery. Helping a mother breastfeed successfully is also part of helping her heal."

Healthcare providers, particularly midwives, nurses and obstetric teams, play a central role in ensuring mothers receive this support. Immediate skin-to-skin contact where clinically appropriate, assistance with positioning and attachment, monitoring for excessive bleeding and early recognition of complications all contribute to better maternal and newborn outcomes. Families also have an important role in supporting mothers by creating an environment that allows them to rest, recover and establish breastfeeding successfully.

As Kenya joins the global community in celebrating World Breastfeeding Week, the message is clear: breastfeeding is not only one of the best investments in child health but also an important contributor to maternal wellbeing. Every mother should have access to skilled care that supports early breastfeeding alongside the full package of evidence-based interventions for preventing postpartum haemorrhage.

Protecting mothers and newborns begins in the moments immediately after birth. By investing in skilled health workers, quality maternity care, breastfeeding support and strong health systems, we can give every child the healthiest possible start while helping every mother recover safely and confidently.

References

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.

Uvnäs-Moberg, K., Ekström-Bergström, A., Buckley, S., Massarotti, C., Pajalic, Z., Luegmair, K., Kotlowska, A., Lengler, L., Kielbratowska, B., Leon-Larios, F., Magistretti, C. M., Downe, S., Lindström, B., & Dencker, A. (2020). Maternal plasma levels of oxytocin during breastfeeding: A systematic review. PLOS ONE, 15(8), e0235806.

World Health Organization. (2023). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: Guideline. Geneva: World Health Organization.

World Health Organization. (2023). WHO recommendations for the prevention and treatment of postpartum haemorrhage. Geneva: World Health Organization.

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