Why Do I Get Cramps When Breastfeeding? Understanding Afterpains after birth

Estimated read time: 4 mins

I wish I'd known...

The first time I experienced afterpains, I assumed something must be wrong because nobody had warned me how painful they could be. Looking back, I wish I'd known that these cramps, although uncomfortable, were actually a sign that my body was healing. Knowing that wouldn't have taken the pain away, but it would have taken away the worry.

💡 I didn't know that...

Afterpains are often significantly more intense for mothers who have had more than one baby. While first-time mothers may only feel mild cramping, mothers with subsequent babies often experience pains that mimic early labour contractions [1].

After my third baby, I vividly remember wishing I still had some gas and air for those first few breastfeeds. The cramping felt almost as intense as labour. I hadn't expected it at all and was genuinely surprised when my midwife told me this was completely normal after subsequent pregnancies.

Even with my first baby, I remember trying so hard to get the breastfeeding latch right, only to be hit by a wave of intense cramping every time my baby started feeding. As a doctor, I always like to understand why something happens. I hope that understanding what's causing these cramps will help you worry less and manage them with a little more patience.

What is it?

Afterpains are the contractions your uterus makes as it shrinks from roughly the size of a watermelon back to its pre-pregnancy size (a process called involution). These contractions are an important part of recovery because they compress the blood vessels where the placenta was attached, preventing excessive bleeding. This is also one of the reasons postpartum bleeding gradually becomes lighter over the first few weeks.

Why does it happen?

The intensity of afterpains during breastfeeding is driven by a single hormone: oxytocin. Often called the "love hormone," oxytocin is responsible for the milk-ejection reflex (let-down). However, oxytocin also has a direct effect on the uterine muscle, causing it to contract rhythmically [2]. Although the cramping can be uncomfortable, it's a sign that your uterus is doing exactly what it should to heal after birth. In other words, every time your baby feeds, your body is also helping your uterus heal.

For first-time mothers, the uterine muscle tone is usually high, meaning the uterus often stays contracted without much effort. In subsequent pregnancies, the muscle has been stretched before, so it must work harder and contract more forcefully to achieve the same result. This is why many women find the pains get progressively worse with each baby [3].

What can I do?

Empty Your Bladder

A full bladder pushes the uterus up and out of place, making it harder to contract efficiently and increasing pain.

Heat Therapy

A warm heating pad on your lower abdomen can help relax the muscle wall and ease the intensity of the cramps.

Simple Pain Relief

Simple pain relief such as paracetamol or ibuprofen is commonly used after birth and is generally considered compatible with breastfeeding. Take it as advised by your midwife, GP or pharmacist [4].

Try taking pain relief 20–30 minutes before a feed if your cramps are particularly severe. Many women find this means it's working by the time oxytocin is released during breastfeeding. Speak to your healthcare professional if you're unsure what's appropriate for you.

Breathing Techniques

Using the same deep, slow breathing you used during labor can help you stay relaxed during a "let-down" contraction.

Feed lying down if you need to

If sitting upright makes the cramps feel worse, try feeding in a side-lying position if it's safe and comfortable for you and your baby. Many women find this helps them relax during feeds.

When should I seek help?

While afterpains are a normal part of recovery, they should gradually decrease in intensity over the first 3 to 5 days. You should contact your midwife or GP if you notice any of the following:

Red Flags (Seek medical advice if):

• The pain isn't controlled with simple pain relief
• The pain becomes constant rather than coming in waves
• Your uterus feels very tender to touch
• You develop a fever or chills
• Your bleeding suddenly becomes much heavier

Frequently Asked Questions

How long do afterpains last?

Afterpains are usually worst during the first two to three days after birth and gradually improve over the first week. Women who have had more than one baby often notice them for a little longer.

Do afterpains mean breastfeeding is causing damage?

No. Although they can be painful, afterpains are a normal response to oxytocin and help your uterus return to its pre-pregnancy size.

Will afterpains affect my milk supply?

No. Although breastfeeding triggers the cramps, the contractions don't reduce your milk supply. They're simply a sign that oxytocin is doing two jobs at once: helping milk flow and helping your uterus recover.

Further reading

For more information on getting established with breastfeeding:

NHS: Breastfeeding - The first few days

References

1. Taffazoli, M., et al. (2014). "Assessment of Factors affecting Afterpain in Multiparous Women." Journal of Midwifery and Reproductive Health.
2. Uvnäs-Moberg, K., et al. (2020). "Maternal plasma levels of oxytocin during breastfeeding—A systematic review." Frontiers in Psychology.
3. Lopez-Gonzalez, D. M., et al. (2022). "Postpartum Care of the New Mother." StatPearls [Internet].
4. Zhou, L., et al. (2025). "Pain Management for Postpartum Pain: A Narrative Review." Journal of Pain Research.

Looking for more support?

If you're navigating the early weeks after birth, my Six-Week Postpartum Recovery Programme provides calm, evidence-based guidance through each stage of recovery, with weekly videos and easy to browse resources to help you feel confident about what's normal.

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