can breastfeeding inhibit perineal repair?

[alright]

why arent i healing?? its doing my nut in now, didnt heal the first time had fentons repair, not healed properly again this time. someone mentioned bf-ing taking all my nutrients and immunity to heal myself. bullsh*t or wot?

Definately BS! People like to blame breastfeeding for all manner of post-natal problems!

Sorry to hear you are having trouble though.

That sounds like absolute rubbish. Maybe a trip to the doctor is in order to get some proper advice.

According to my gynae (and a friend's gynae at a different hospital) - YES. It's due to the hormones, although I can see the arguement that the breastmilk will take the lion's share of nutrients too. We were both prescribed oestrogen cream for the vagina to balance the hormones and promote healing. I finished BFing shortly after anyway (due to a biting issue - ouch!), and I noticed a big improvement in the scar.

Sorry, I know that it's not a great thing to hear. But there is a solution that doesn't involve giving up breastfeeding (the vaginal cream).
If you are worried about nutrients, then a maternity multivitamin could help. I've heard that vitamin C and zinc are both needed for healing.

My episiotomy scar took quite a while to heal. (it healed fine, but took months). My gynae thought it was down in part to bf but I wasn't told to stop. Scar healed fully within a month of stopping bf when I wanted to, ds was nearly 8 months.

I found BFing sort of compounded the stitches pain only in the sense that it involved sitting for long periods of time (I hadn't mastered feeding lying down) and it was really sore for me to sit! I think I heard something about the hormones impeding healing too. Don't know if there's any truth in it though.
Hope you get through this tough period asap.

does anyone know roughly how long after a repair i should heal??

Had an episiotomy with DS and an 'almost 3rd degree' tear (stitched in theatre) repair after DD.
bf both and healed fine each time - was about 6 weeks with DS and about 12 weeks with DD.
Have never heard that bf can inhibit repair? Sounds like a load of baloney!
As long as you are eating properly etc surely bf and healing are not mutually exclusive?
If you're not healing, sounds like you should check with your GP.
Hope you feel better soon.

I only had small episiotomy and I think it took about 4 weeks before it started to feel much better. I think it really varies depending on degree of tear/cut and how well it's stitched up etc. Check with your GP if you feel it's not healing properly.

"Nutrients and immunity" is baloney.

For a minority of women the hormones can slow down healing, though. Talk to doctor about oestrogen cream (get GP to refer you if necessary).

if i took say a multivitamin with extra iron or similar will it affect bf-ing? can u buy special bf-ing vits?

I think there is something in it. I'm convinced I only began to feel normal again once my periods returned at about 6 months. I was still breastfeeding mind.

To be honest, I think that the reason that most people haven't heard about breastfeeding affecting the hormones in the vagina and inhibiting perineal healing is because there is such a huge breast-is-best message around. I'm personally very about a lot of the stuff that is sprouted by health professionals, but not only do I know of several repair specialists who have given women with healing problems this advice, but it also corresponds with my experience and that of a RL friend and several other Mums on MN. If it was used as a way of stopping women from breastfeeding then why have we all been given another option (carrying on BFing and using the vaginal oestrogen cream)?

I can understand why all new Mums are not given this information - I can see how it might put women off who wouldn't ever have this issue (after all, I lot of women do BF and heal at the same time). On the other hand, I don't understand why this isn't more widely known amongst the women who do have problems healing.

MrsTittleMouse, the other possible reason for people not knowing this is that there is very little evidence that it is true...I can't find any studies on this, apart from one animal study (in rats) that suggests lactation speeds up wound healing generally (not just in the perineal area).

Observations of individuals is a basis for a proper study, and if there is one (or more), then I'd like to know about it. Maybe there is!

I don't think there is any conspiracy of silence about it!

There are a few papers which report that breastfeeding lowers the amount of vaginal lubrication. Oestrogen cream applied to the vagina will promote more lubrication - and if a lubricated vagina helps healing (and it may do)then clearly this is a better option than stopping bf.

I'd be interested in seeing any decent studies on maternal immunity during breastfeeding and its effect on wound healing in general.

I'll ask my gynae when I see her next month - it certainly fitted in with my personal experience though. I'm generally a bit grumpy about my experiences with the medical profession when I wasn't healing. Being told that it was all in my head, and that I had a bad attitude to sex wasn't very helpful when I was explaining that standing and sitting were very painful too. So that could well colour my views when I found someone who listened to what I said, examined me properly and provided things that helped me heal (somewhat) - i.e. vaginal cream and dilators.

Don't forget to report back, MrsTM

Not breastfeeding perse, but the lack of oestrogen it results in, definitely. Firsthand experience. There are ways around it, though.

tiktok -- there's

Judith TW Goh, Paul Howat, Caroline de Costa (2001) Oestrogen therapy in the management of vesicovaginal fistula
The Australian and New Zealand Journal of Obstetrics and Gynaecology 41 (3), 333?334

which I think at least discusses breastfeeding as a factor (not a study on breastfeeding, though, more "reasons you might have lower oestrogen levels and therefore benefit from oestrogen cream". It's pretty much established that breastfeeding leads to lowered oestrogen levels in the early months, isn't it? I thought that contributed to the lowered cancer risks, etc.?

Port - I know oestrogen levels are lower during breastfeeding. The issue isn't this. You'd then have to show that lower oestrogen levels contribute to slower healing.

But if using topical oestrogen results in faster healing (as per study, although I don't recall whether it was a proper double-blind study) doesn't that at least suggest that reduced oestrogen results in slower healing?

It's billed as a case report in PubMed, Port, so not a trial; does not deal with episiotomy but fistula.

I don't know - maybe bf does reduce oestrogen enough to affect epis. healing...but this study on the face of it does not tell us whether it does or not.