A breastfeeding journey after a preeclampsia, eclampsia, or HELLP syndrome experience can be overwhelming. It is important to remember that you’re recovering from a serious medical condition while also caring for a newborn. If you're hoping to breastfeed, you may be wondering if it's even possible. The answer is yes! For many families, breastfeeding after a hypertensive disorder of pregnancy is possible with the right support.

The breastfeeding journey can look very different than you expected, and that is okay. If you choose not to breastfeed or cannot due to various circumstances, know that you are not alone and it is okay. Breastfeeding is only one part of caring for your baby. Sometimes due to ongoing maternal health concerns, baby’s medical needs, sleep deprivation, or mental health needs, can make exclusive breastfeeding difficult.

Recovering from a hypertensive disorder of pregnancy is a journey. Be patient with yourself, lean on your healthcare team, accept support from loved ones, and know that there is no shame in asking for help. You have already been through so much, and you deserve compassionate, evidence-based care every step of the way.

I speak from personal experience as a preeclampsia survivor, preemie and NICU mom. I delivered at 35 weeks due to preeclampsia with severe features and signs of intrauterine growth restriction (IUGR) with my first-born child. My daughter was in the NICU for fifteen days, needing support through a nasogastric feeding tube and time to grow. I expected to breastfeed, but my experience turned out different. My daughter needed a high-calorie formula due to her medical needs, and I struggled to produce due to many circumstances. You are not alone if you experienced something similar to me! Many in our community choose not to breastfeed from personal preference or medical needs for them or their baby. Know that you make the best choice for you and your baby!

If you choose to breastfeed. . .

The Impact Preeclampsia has on Breastfeeding

Mothers who experience preeclampsia, eclampsia, or HELLP syndrome often experience breastmilk delay.¹ There are numerous factors that impact this, such as early formula supplementation, prematurity, emergency surgery, and other medical needs for mom and baby. Stress plays a role in breastmilk production, and the preeclampsia experience itself can be a stressful and traumatic time for the mother and the whole family unit.

Another layer is lack of clarity among professionals about medication safety and breastfeeding. Mothers can safely breastfeed their babies while also being treated for high blood pressure.

From our Community. . .

“We were rushed to the OR and due to an ineffective epidural, I was put under general anesthesia for my baby’s birth. She needed a little oxygen support and was taken up to the NICU for monitoring. My husband knew I wanted to breastfeed (my eldest was breastfed for her first two years), so he authorized them to collect colostrum from me. I woke up from my c-section to a nurse hand expressing my breast for milk for my baby. [. . .] I collected colostrum in syringes for her and sent it via nurses to my husband who fed her. I wish I had more support during this time. I was experienced, but still wasn’t totally confident hand expressing and collecting. They never offered me a pump. When she joined me in the mother baby unit, she latched on again and I continued to breastfeed her. A couple days later I had postpartum preeclampsia, and we went back to the hospital together and I continued to breastfeed her during my couple day stay. In the end I exclusively breastfed her until about her 2nd birthday.” -Katie

Breastfeeding While on High Blood Pressure Medication

Many mothers are concerned about the wellbeing of their baby while on antihypertensive medication. Treatment of high blood pressure while breastfeeding requires agreement among the mother, obstetrician, and pediatrician. It’s critically important that the mother’s blood pressure be controlled, and the benefits of early breastfeeding are recognized and prioritized. If the mother chooses to breastfeed, she should be given all the support and resources she needs.

From time to time, strongly held opinions may err on the side of “protecting the newborn” from exposure to medications. However, high blood pressure medications have no or minimal risk to the newborn. In general, drugs – and often combinations of drugs – should be chosen for their effectiveness. Provider choices will largely be driven by their clinical experience.

For severe hypertension, combinations of drugs with different mechanisms of action may be needed: 1) ß-blockers that effectively lower heart rate, 2) vasodilators that open small blood vessels, and 3) diuretics that help get rid of excess fluid through urination.

Specific drugs

Nifedipine has been used in pregnancy for reduction in contractions without apparent adverse effects on fetuses. It’s used in some practices to alleviate painful “nipple spasm” in breastfeeding women² 

Labetalol: Because of the low levels of labetalol in breast milk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in full-term breastfed infants. No special precautions are required in most infants.³

Furosemide is a diuretic that works to decrease the circulating blood volume. Treatment is particularly important for women with life-threatening conditions such as pulmonary edema, heart failure, and very severe hypertension. Concerns have been raised that reduction in maternal blood volume might reduce the volume of breast milk. This concern is increased by the need in pregnancies where the baby may have delivered preterm and breastfeeding is challenging to establish. In response to these concerns, furosemide has been studied as an agent to suppress lactation – and there is no evidence to suggest it suppresses milk production in low doses. Because more information is needed on the use of furosemide during breastfeeding and significant fluid loss from high doses might decrease lactation, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Low doses of furosemide (20 mg daily) do not suppress lactation (LactMed).³

Angiotensin Converting Enzyme Inhibitors are agents that open blood vessels to reduce pressure. They have special beneficial properties for women with diabetes or renal disease. There are many choices of these inhibitors, but studies have shown Enalapril use during breastfeeding may be most effective with minimal exposure to the baby.⁴

From our Community. . .

“My daughter was delivered at 31 + 6 at 3lbs, 9oz due to Preeclampsia and HELLP. I tried SO HARD to breastfeed and ultimately, it was determined that my body “didn’t respond to the pump”. I produced milk right away, but my supply dwindled FAST. I tried everything - supplements, power pumping, letting my daughter latch even though she wasn’t strong enough to get anything, all of it. I ended up drying up (for lack of better words). It was heartbreaking.” -Sammi

“I had preeclampsia with my first born at 37 weeks. I tried to breastfeed and she did latch but because she was so tiny and had issues regulating her blood sugar we were advised to formula feed and to bump up her dose of formula to ensure she would gain. I tried pumping but my supply never fully came in. I tried power pumping I pumped at night, I drank so much water and ate all the foods but nothing really changed. We ended up formula feeding to save my mental health because I was mentally and physically exhausted.” -Ashley

Breastfeeding and a Prematurity Delivery or NICU stay

Many survivors give birth to their babies early and/or their baby is in the NICU. Worldwide, preeclampsia is responsible for up to 20% of the 13 million preterm births each year.⁵ This can make breastfeeding challenging due to numerous circumstances.

Babies who are born early may not have the sucking reflex which is developed around 32 weeks gestation This reflex is an automatic, involuntary survival response where a baby starts to suck when something such as a finger, nipple, or pacifier, touches the roof of the baby’s mouth.⁶  Due to the lack of development of the sucking reflex or other medical needs, babies may need a feeding tube for them to get the nutrition that they need. Ask the NICU staff or the pediatrician how you can encourage breastfeeding with skin-to-skin time and non-nutritive breastfeeding (this means breastfeeding knowing that the “breast is empty” or knowing that the baby will not get much milk). Be sure to express desire to breastfeed and advocate for yourself, or your loved one advocate for you.⁷

Some babies may also experience Intrauterine Growth Restriction (IUGR).  According to a National Institute of Health study, “Infants with Intrauterine Growth Restriction (IUGR) frequently experience a weak or uncoordinated sucking reflex due to low muscle tone, overall physical fatigue, and delayed central nervous system maturation from placental stress. This often leads to difficulties with the crucial suck-swallow-breathe coordination required for safe and effective oral feeding." ⁸ Of the 30 million IUGR infants born worldwide each year, 15% (4.5 million) are associated with preeclampsia.⁵

Many survivors start their breastfeeding journey through the use of a breast pump since their baby can only take in breastmilk through a feeding tube. Pumping breastmilk can be an effective way to start the journey, however, it can be emotionally difficult for survivors as they may never expected to feed their baby that way. Many times, survivors need to pump around the clock as if a newborn was with them and then label their milk according to the NICU’s guidelines. Some survivors need to start the breastfeeding journey while they are still hospitalized themselves.

All these different layers can make the journey difficult for survivors. Sometimes breastfeeding does not work out due to maternal health issues such as poor blood pressure control, mental health and poor sleep and recovery, which can all impact milk supply. Additionally, breastfeeding may not work out due to the infant’s medical needs, such as needing high calorie formula (or fortified breastmilk) or medical needs that may arise due to prematurity. Please know that there is no shame in how survivors feed their baby.

From our community. . .

“My daughter was stillborn at 23 weeks after preeclampsia with severe features and HELLP. I chose to pump for 4 months until her due date and donated all milk produced to Mother’s Milk Bank in Colorado. I was able to donate over 1,500oz and provide to NICU families.” -Breanna

“I wanted to breastfeed so bad with my first. I had to deliver him via csection at 32 w + 4 d due to severe preeclampsia. I started pumping after I finished the mag drip (because I physically couldn't stay awake for more than 5 minutes). After a week in the NICU, I was able to hold my son for the first time and try to breastfeed. Due to his size, he was never able to latch properly. We tried many times, but ultimately, I pumped. My supply was so low, maybe half of what he ate in a day if I was lucky, so he was on formula for all the feeds I couldn't provide for him with pumping. We made it a little over 6 months exclusively pumping before I stopped for my mental health. I still carry a lot of guilt for not being able to breastfeed properly.”-Calista

“I wanted so badly to nurse, but I had to exclusively pump for my son. I developed severe preeclampsia and delivered at 34 weeks. In order to help him gain weight, we had to add a small scoop of formula to my pumped breast milk for the entire first year of his life. I ended up exclusively pumping for 18 months.” -Kailey

“I had severe preeclampsia and HELLP at 30 weeks, and my son was in the NICU for 57 days. I exclusively pumped for 5 weeks with the support of the amazing nurses and lactation consultants. I was ultimately able to breastfeed for two and a half years, and it was incredibly healing for me after a birth experience where I felt my body had failed me. I now serve as a Patient Family Advisor for the hospital and am on the lactation committee, where I help NICU staff find ways to support breastfeeding parents and remove barriers and challenges to their feeding journey.” -Jen

“I had wanted to breastfeed but could not due to medical reasons. I had a liver rupture and lost a lot of blood. I was on a ton of pain medications that were not compatible with breastfeeding. I did try to cut them all out cold turkey but due to the pain, I could not. I chose to heal and it was the best thing for me. However, I felt a lot of shame and guilt for not being able to provide for my preemie son in that way. It took a long time for me to accept that this was the position we were in. We are also incredibly thankful for all of the donors who helped my son get breastmilk in the NICU for the first four weeks of his life.” -Kat

Breastfeeding while on Magnesium Sulfate

Magnesium sulfate (given intravenously) is the treatment of choice for severe preeclampsia to prevent eclampsia, or after eclampsia develops to prevent more seizures. Many, but not all, providers will also treat every preeclamptic patient with magnesium sulfate during labor, even when the disease may only have mild features. Eclampsia can occur even without the presence of severe preeclampsia symptoms. Magnesium treatment is generally continued for 24-48 hours after the last seizure or beyond delivery. You may receive magnesium sulfate in an intensive care unit or a labor and delivery unit. While magnesium is given, you will be observed closely, receive intravenous fluids, and may have a catheter placed in your bladder to measure urine output.

Magnesium sulfate can be used by a skilled healthcare provider with appropriate support facilities. Overdoses can occur and lead to harm to your kidneys, so you should be closely monitored.

Side effects of magnesium sulfate may include drowsiness, redness, flushing or overheating, muscle fatigue or weakness, dizziness, and trouble concentrating. Symptoms typically go away shortly after the medication is stopped. Its use can be very uncomfortable, but your provider has likely included it in your treatment to prevent a worse outcome - seizures. Postpartum eclampsia can occur up to six weeks after delivery.

It can be difficult to breastfeed while on magnesium sulfate due to the side effects. Magnesium sulfate itself does not impact breatmilk production. However, it’s side effects may delay the start of breastfeeding or increase the need for pumping during treatment. Mothers who choose to breastfeed should receive every opportunity and the support needed to do so.

 According to this study titled, “The Effect of Magnesium Sulfate in the Treatment of Maternal Postpartum Hypertensive on Breastfeeding: An Integrative Review,” published in January 2026, “ Findings indicate that extended postpartum magnesium sulfate administration is associated with delayed breastfeeding initiation, delayed maternal perception of secretory activation, and greater reliance on milk expression. Most researchers did not report maternal side effects or quantitatively measure the frequency of breastfeeding or pumping. Studies reported hospital policies that restricted rooming-in and breastfeeding during magnesium infusion.” ⁹ In short, magnesium sulfate may delay the introduction of breastfeeding and hospital policies that restricted rooming-in with baby and breastfeeding while receiving magnesium.

According to American Family Physician, the breastmilk of women who receive magnesium sulfate contains a higher amount of it in the breastmilk when compared to breastmilk of those who did not receive magnesium. It is shown that babies fed with breastmilk of mothers who receive magnesium sulfate have minimal higher levels of magnesium. These levels are back to normal 24 to 48 hours after the mother is done receiving magnesium sulfate. Magnesium sulfate is said to be safe medication for breastfeeding women. ¹⁰

Breastfeeding while being treated with magnesium sulfate is safe to do so and mothers should be given every support by their providers, the baby’s medical team and lactation to do so.

From our Community. . .

 “I breastfed after HELLP syndrome. My daughter was underweight and had difficulties latching, I had to get admitted back into the hospital after postpartum preeclampsia, I had to triple feed for a month, but after that, and thanks to the medication, I was able to breastfeed for 15 months. I was fortunate to get donors milk.” -Marie

“I had postpartum eclampsia and was separated from my baby most of the week I was in the hospital. Before that she spent a couple days in the NICU. She was small and had latch issues. I was on antihypertensives for a few months. I had mastitis twice. I pumped and breastfed the entire first year. It was difficult but I’m happy I could breastfeed.” -Danielle

Support for the Breastfeeding Journey

If the preeclampsia, eclampsia, or HELLP syndrome survivor chooses to breastfeed, she should be given all the support and resources she needs. There needs to be agreement among the obstetrician, pediatrician, and mother.

Breastfeeding after experiencing a hypertensive disorder of pregnancy is possible. The support of a lactation specialist can be helpful in navigating breastfeeding. A lactation specialist familiar with hypertensive disorders of pregnancy and/or a NICU baby may be helpful in the breastfeeding journey. The lactation specialist may have helpful suggestions based on you and your baby’s personalized medical needs. You or your support person can advocate for you. ¹¹

A hypertensive disorder of pregnancy, including preeclampsia, eclampsia, or HELLP syndrome, can be a life-changing patient experience that goes beyond pregnancy. Be patient with yourself, lean on your healthcare team, accept support from loved ones, and know that there is no shame in asking for help. You have already been through so much, and you deserve compassionate, evidence-based care every step of the way.

We at the Preeclampsia Foundation know many in our community who were able to breastfeed and others who did not have the breastfeeding journey they expected or wanted to have due to numerous factors. We know how emotionally difficult it can be. Remember, a fed baby is best!

To join our private Facebook group for encouragement and community called Preeclampsia Foundation Community Connection, click the link and answer the security questions to join: https://www.facebook.com/groups/pfcommunityconnection.

References: 

1. https://www.medela.com/en/lactation-professionals/scientific-knowledge/breastfeeding/preeclampsia-and-breastfeeding-challenges-impacts-and-best-practices   
2. https://pubmed.ncbi.nlm.nih.gov/15601802/ Hebert, M. (2005). Pharmacokinetics and Pharmacodynamics of Atenolol During Pregnancy and Postpartum. Journal of Clinical Pharmacology, 45: 25-33.
3. LactMed: Drugs and Lactation Database. (n.d.). Retrieved from Toxnet:https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm
4. https://www.acc.org/latest-in-cardiology/articles/2026/07/02/15/04/antihypertensive-medications-in-pregnancy-and-lactation
5. https://www.preeclampsia.org/faqs
6. https://my.clevelandclinic.org/health/articles/23265-newborn-reflexes
7.  https://pmc.ncbi.nlm.nih.gov/articles/PMC6458048/
8. https://pmc.ncbi.nlm.nih.gov/articles/PMC10943319/
9.  https://journals.sagepub.com/doi/10.1177/15568253261415867
10. https://www.aafp.org/afp/2001/0915/p981
11.  https://www.medela.com/en/lactation-professionals/scientific-knowledge/breastfeeding/preeclampsia-and-breastfeeding-challenges-impacts-and-best-practices