One of the advantages of breastfeeding is that for many it may be months or even years before menstrual bleeding returns regularly. However, some mothers do experience heavy flow which needs to be treated. Tranexamic acid is usually the drug of choice at a dose of 1 g 3 times a day for up to 4 days, to be initiated when menstruation has started; maximum 4 g per day (BNF 2018). Mothers can continue to breastfeed as normal. There is one reported case of restless in the baby in a study of 21 mothers but in general it seems anecdotally, to cause few problems.
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