Brief Answer: Many causes possible Detailed Answer: Hello XXXXXXX and welcome to health care magic. I understand that she has stopped breast feeding now and is having mild bleeding and pain. The common causes of these are return of ovulating cycles. Usually the periods when ovulation does not occur are less painful while ovulating cycles are associated with some amount of pain. So this may be one reason. Second cause for backache may be calcium deficiency due to prolonged breast feeding if she has not been on supplements. Other reasons may be unrelated to breast feeding like endometrial polyps, fibroids, ovarian cysts, muscular pain, problems of spine etc or even pregnancy if she is not using contraceptives. Endometriosis is abnormal growth of uterine lining inside the abdomen and it also causes pain during menses. This is difficult to diagnose after a single episode of pain. The polyps and fibroids usually cause heavy menstrual bleed and pain during menses. Muscular pain increases or decreases in certain positions when the muscles are used. Spinal pain also has a positional component and will be more at back than in front. Pregnancy and abortion cause pain similar to menstrual. Please check what type of pain she is having. Hormones cause contractions during breast feeding as oxytocin is the hormone that is released during breast feeding. It expresses milk out of the breast and also squeezes the uterus. This type of pain is more common during the feed and when the uterus is big [ upto first 6 weeks after delivery or section]. Investigations like an ultrasound and an internal examination may be needed if the pain is severe. Please provide a history in more details regarding contraception and type of pain so that I may be able to provide a better answer. It was a pleasure answering your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

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