Discover the remarkable connection between early breastfeeding initiation and accelerated uterine recovery in postpartum mothers
Imagine this: After the intensity of childbirth, a newborn is placed on their mother's chest. As the baby nuzzles and finds its way to the breast, something remarkable happens—not just for the baby, but for the mother's body too. This first hour after birth, known as the "golden hour," sets in motion a biological cascade that significantly aids the mother's recovery.
While much attention rightly focuses on the benefits of early breastfeeding for infants, a growing body of scientific evidence reveals that this simple, natural act—known as Early Breastfeeding Initiation (Inisiasi Menyusu Dini or IMD)—plays a crucial role in helping mothers' bodies return to their pre-pregnancy state through a process called uterine involution.
For new mothers, the postpartum period brings dramatic physical changes as the body begins healing from pregnancy and childbirth. The most noticeable change occurs in the uterus, which must shrink from weighing approximately 1 kilogram immediately after delivery to a mere 50-100 grams over several weeks. When this process proceeds normally, it reduces the risk of potentially life-threatening postpartum hemorrhage.
Uterine involution refers to the process where the uterus returns to its normal size, shape, and position after childbirth. This remarkable transformation involves:
Healthcare providers typically monitor this process by measuring the height of the uterine fundus (the top of the uterus) relative to the belly button. In a normal progression, the fundus descends approximately 1-2 centimeters per day until it is no longer palpable above the pubic bone around 10-14 days postpartum 3 .
Early Breastfeeding Initiation (IMD) is the practice of placing the newborn on the mother's chest immediately after birth, allowing the baby to instinctively find the breast and begin breastfeeding within the first hour of life. This practice, recommended by the World Health Organization (WHO), provides benefits beyond nutrition:
Most significantly for maternal recovery, this practice triggers essential hormonal responses in the mother's body that facilitate physical healing 5 .
| Aspect | With Early Breastfeeding Initiation | Without Early Breastfeeding Initiation |
|---|---|---|
| Uterine fundus height on day 3 | Approximately 12 cm 5 | Approximately 15 cm 5 |
| Uterine fundus height on day 7 | Approximately 8 cm 5 | Approximately 10 cm 5 |
| Postpartum contraction intensity | Typically stronger, sometimes painful | Often milder |
| Risk of postpartum hemorrhage | Reduced 5 | Higher |
| Maternal confidence | Generally enhanced | May be lower |
To truly understand the relationship between early breastfeeding initiation and uterine involution, let's examine a 2022 Indonesian study that specifically investigated this connection. The research team employed a quantitative approach with a cross-sectional design, recruiting 30 postpartum mothers who had experienced normal vaginal deliveries. These participants were divided into two groups: those who had practiced early breastfeeding initiation (the IMD group) and those who had not (the non-IMD group) 5 .
| Day Postpartum | IMD Group Fundal Height (cm) | Non-IMD Group Fundal Height (cm) | Statistical Significance |
|---|---|---|---|
| Day 3 | 12 | 15 | p < 0.01 |
| Day 7 | 8 | 10 | p < 0.01 |
The findings revealed a statistically significant difference in uterine involution between the two groups, with the IMD group showing substantially smaller uterine fundal height measurements throughout the first postpartum week 5 .
Mothers with higher education levels were more likely to practice IMD 5 .
Strong support from partners increased IMD success rates 5 .
Mothers with previous breastfeeding experience were more likely to practice IMD 5 .
While this study provides valuable insights, it's important to acknowledge its limitations. The relatively small sample size (30 participants) and specific cultural context mean that larger, more diverse studies would strengthen these findings. Additionally, researchers noted challenges in implementation, as even in healthcare facilities that promote IMD, the practice isn't always maximized—sometimes skin-to-skin contact is interrupted too soon, or mothers aren't adequately supported during the process 3 .
The remarkable connection between early breastfeeding initiation and uterine involution centers on a powerful hormone: oxytocin. Often called the "love hormone" or "cuddle chemical," oxytocin plays dual roles in breastfeeding and uterine contraction. When a baby suckles at the breast, sensory nerves in the nipple carry signals to the mother's brain, prompting the pituitary gland to release oxytocin into the bloodstream 3 .
This oxytocin then performs two critical functions:
These contractions serve two purposes: they help compress blood vessels at the former placental attachment site (reducing postpartum bleeding), and they gradually guide the uterus back toward its pre-pregnancy size 3 .
Many new mothers experience afterpains—cramping sensations during breastfeeding—particularly in the early postpartum days. These sensations are actually a positive sign that the uterine involution process is working effectively. The same oxytocin that triggers milk release also causes rhythmic contractions of the uterus, which can range from mild discomfort to significant pain, especially in women who have had previous pregnancies 3 .
This biological feedback loop creates a natural efficiency: every time a mother breastfeeds her newborn, she receives built-in physiological assistance for her uterine recovery. The more frequently she breastfeeds in those critical early days, the more consistent this assistance becomes. This explains why researchers found that mothers who practiced early breastfeeding initiation showed more advanced uterine involution measurements throughout the first postpartum week 5 .
| Target Area | Oxytocin's Action | Result |
|---|---|---|
| Breasts | Contracts myoepithelial cells | Milk ejection ("let-down reflex") |
| Uterus | Stimulates smooth muscle contractions | Reduced bleeding, gradual return to pre-pregnancy size |
| Psychological State | Promotes feelings of calm and bonding | Enhanced maternal-infant attachment |
What makes early breastfeeding initiation particularly remarkable is how it harnesses natural physiological mechanisms that benefit both mother and child simultaneously 3 . The same biological process that provides optimal nutrition for the newborn also supports the mother's physical recovery.
The scientific evidence clearly demonstrates that early breastfeeding initiation provides significant benefits for postpartum uterine recovery. The practice triggers oxytocin release that stimulates uterine contractions, leading to measurably faster involution—with mothers who practice IMD showing substantially smaller uterine fundal height measurements throughout the first postpartum week. These physiological advantages translate to real health benefits, including reduced risk of postpartum hemorrhage, one of the leading causes of maternal mortality worldwide 5 .
Training on the importance of uninterrupted skin-to-skin contact
Proper implementation and support of IMD in delivery rooms
Building supportive environments for new mothers
Enabling mothers to continue breastfeeding after returning home
For expectant parents, understanding this connection provides powerful motivation to include early breastfeeding initiation in their birth plans and to seek out birth facilities that properly support this practice. Something as simple as that first magical hour of skin-to-skin contact does far more than foster bonding—it activates essential biological processes that safeguard maternal health and set the stage for smoother postpartum recovery.
As we continue to advance our understanding of postpartum physiology, the timeless wisdom of keeping mothers and newborns together immediately after birth receives ever-stronger scientific validation. By embracing and supporting these natural processes, we take an important step toward better maternal healthcare outcomes worldwide.