Postpartum Preeclampsia and Breastfeeding

By Tiffany Adams

This article was originally published on BabyCenter.com

and was medically reviewed by SMFM experts.

Postpartum preeclampsia is a high blood pressure condition that happens shortly after childbirth. The biggest concern is preventing life-threatening health complications for the mother, but it doesn’t affect the baby. Most medications used to treat high blood pressure are usually safe for your baby and very small amounts are actually transferred to breast milk. Talk to your doctor about the medications you’re taking and reach out for breastfeeding support if you need it.

  • Postpartum preeclampsia is a serious high blood pressure disorder that occurs after childbirth. Any woman who gives birth is at risk for postpartum preeclampsia, even those who didn’t have high blood pressure during their pregnancy. Although postpartum preeclampsia is likely to occur within 48 hours after giving birth, women can also develop it up to six weeks or later.

    Some common postpartum preeclampsia symptoms include excess protein in the urine, extreme swelling in the hands, legs, and face, severe headaches, vision changes and nausea and vomiting. If you are experiencing postpartum preeclampsia symptoms, reach out to your healthcare provider right away, as it can cause life-threatening complications if left untreated.

  • Yes, breastfeeding has many health benefits for you and your baby, even when you have high blood pressure. Breastfeeding won't make your condition worse, and might even improve it over the long term. The American Academy of Pediatrics recommends breastfeeding exclusively for the first six months of your baby's life.

    Generally, most high blood pressure medications have little or no risk for your baby, but if you have any concerns, talk to your healthcare provider about minimizing your baby’s exposure. Some research shows that preeclampsia may affect your milk supply, but you can reach out to your doctor about taking alternative medications or a lactation consultant for breastfeeding support. For example, diuretic medications used to treat high blood pressure are considered safe for a baby when breastfeeding, but they could affect your milk supply.

  • Having preeclampsia and breastfeeding shouldn’t affect your baby. While preeclampsia during pregnancy can cause health complications for your baby, including fetal growth restriction and preterm birth, postpartum preeclampsia doesn’t affect your baby. However, in some cases, women with postpartum preeclampsia may need hospitalization, which can affect how often you're available to breastfeed.

  • Most high blood pressure drugs pass into breast milk in very small amounts. Many drugs used to treat high blood pressure during pregnancy are considered safe to take when nursing, but they're not all the same. For example, some beta-blockers are found in breast milk in higher amounts and may not be ideal to take when breastfeeding.

    Talk to your doctor about the medications you’re taking and how much of the drug could be transferred to your breast milk. You can also search LactMed, a database with information on drugs and chemicals that can have potential negative effects for breastfed babies.

  • Postpartum preeclampsia won't make it harder to breastfeed, but the consequences of having high blood pressure during pregnancy might. For example, when you have high blood pressure, you're more likely to have a preterm birth, and a premature baby may not be able to latch on to your breast right away. In this case, you may have to pump, which can make breastfeeding difficult for other reasons. If you have severe preeclampsia, you may be treated with magnesium sulfate, which can cause nausea and make it more challenging to feed.

    Also, when a baby is born early, it can take longer for your milk to come in. But don't give up – the colostrum your breasts produce at first has important antibodies for your baby. Continue feeding or pumping so your baby gets the nutrition he needs, and your milk supply will gradually increase.

    If you've had a cesarean delivery, the pain can make breastfeeding more of a challenge. Ask your provider for support, and try different positions until you find one that's comfortable. (The football hold is one good option.)

    Remember to talk with your hospital or doctor about any breastfeeding concerns, as a lactation consultant can help you navigate any obstacles that come with trying to breastfeed while having preeclampsia.

Last Updated: April 2024

References

Society for Maternal-Fetal Medicine. Preeclampsia. https://www.highriskpregnancyinfo.org/preeclampsia [Accessed February 2022]

March of Dimes. Postpartum preeclampsia. https://www.marchofdimes.org/it-starts-with-mom/postpartum-preeclampsia.aspx [Accessed February 2022]

Mayo Clinic. Postpartum preeclampsia. 2021. https://www.mayoclinic.org/diseases-conditions/postpartum-preeclampsia/symptoms-causes/syc-20376646 [Accessed February 2022]

Preeclampsia Foundation. Postpartum preeclampsia. 2021. https://www.preeclampsia.org/postpartum-preeclampsia [Accessed February 2022]

BMC Pregnancy and Childbirth. Delayed Lactogenesis II and potential utility of antenatal milk expression in women developing late-onset preeclampsia: a case series. 2018. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1693-5 [Accessed February 2022]

Mayo Clinic. Breast-feeding and medications: What’s safe? https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breastfeeding-and-medications/art-20043975. 2020. [Accessed February 2022]

Centers for Disease Control and Prevention. Prescription Medication Use. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/prescription-medication-use.html 2020. [Accessed February 2022]