Postpartum Heavy bleeding

I had my baby about 5wks ago. I am breastfeeding and have been having my period ever since really heavy at times. Is this normal? I have read that breastfeeding moms usually have hardly any bleeding.

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Dear Melissa,

You are correct that breastfeeding does help to contract the uterus and minimize bleeding. "Heavy bleeding" at 5-6 weeks postpartum is definitely not normal. By this time, the bleeding should be pink or yellowish but may return to red if you become very active. Think of the uterine placental implantation site as a large wound with a clot covering it. As the clot shrinks and the site heals, bleeding is minimized. If there is a lot of activity, a segment of the clot may be dislodged and red bleeding begins again.

Occasionally, a piece of placental tissue is left inside and the uterus is not able to fully involute or come down to normal size. This clot may still be connected and continue to release blood or compromise the uterus' ability to fully contract and stop bleeding. Sometimes these pieces pass on their own but sometimes they need to be removed by giving the mother a medication to help the uterus contract or a D&C could be done to eliminate the piece all together. If the placental fragment becomes necrotic, an infection could result.

I would recommend that you see your care provider to see if the uterus is almost back to normal size and assess the bleeding. In the meantime, you should make sure you are not running a fever, you do not have any malodorous discharge and are feeling OK.

I hope all turns out well.
Peg

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