MENSTRUATION WHILE BREASTFEEDING©


By Ann Faust, BA(Hons), IBCLC



It is normal for all women to have some postpartum bleeding following birth (including the moms who have delivered through cesarean –C-section-). Although this is not considered a menstrual period, if you stop lactating within days of birth, most mothers will have their first “real” menstruation shortly after. The World Health Organization (WHO) considers any bleeding 56 or more days after birth to be menstruation.

If you are breastfeeding, starting back to your menstruation and the continuity of it becomes very complex. Many breastfeeding mothers do not get their regular menstruation for the duration of exclusive breastfeeding. The absence of a period during breastfeeding is called “lactational amenorrhea.” Once their babies begin taking supplemental foods or sleeping longer periods at night, mothers may see the first period. Some mothers may even need to wean completely before they see their first period. It is usual to see irregularities with your menstruation during lactation.  This can be the period between the two menstruations, the duration of the periods; your flow could be heavier or lighter. It is also common to skip a period or see the first period return and then find that months pass before the next one.

Here are some of the factors that will effect your periods;

  • How frequently the baby is nursing : The longer and more often the baby nurses, the less chance you will get your period back.
  • Baby’s longest sleep period: When the baby starts to sleep through the night, (usually 5+ hour stretches) you may start to look for the telltale signs of your first period.
  • How much nursing taken at the breast: Supplementing with formula or solid foods will decrease the nipple stimulation and changes the hormone responses. Some studies suggest even mothers who pump more often than nurse their babies do see some decrease in their milk production and returning of their menstruations.
  • Pacifiers/ Dummies /Binkies: These all suppresses the baby’s natural need for suck, and communicate his/her hunger to the mother. This will increase the time between feedings and your menstruation is likely to return sooner.
  • Hormone-receptor relation: Mother’s own individual body chemistry and the way it reacts to the hormonal responses will determine your menstrual periods.

Fertility;

Presence of menstruation is not always a good way of determining if you are ovulating –i.e. if you are fertile or not - .  Nevertheless, it is very good idea to take precautions against unexpected pregnancy. Using breastfeeding as an exclusive form of birth control is known as the lactational amenorrhea method (LAM). This method, although efficient when used correctly, you may need to master it before use it as the only form of birth control. Please remember even though quite rare, it is possible to become pregnant before the first period returns.

Tender Nipples;

Nipple tenderness is a common problem for some women during ovulation, during the days before a period, or at both times. Some mothers report a feeling of emptiness while nursing at these times, too. As with the drop in supply, this is hormonally influenced and therefore temporary.  Please note that this is different from postpartum depression and if it is lasting more than 10 days please contact to your healthcare provider for an evaluation.

Sour Milk?

Some mothers worry that once they start having their period their milk turn sour and it is no longer good or sufficient for their baby. Please be assured this is not the case.  Some babies may detect a slight change in the taste of the milk (usually saltier not sour) just before a period, due to hormonal changes. These babies may nurse less often or less enthusiastically during this time.

Milk Supply;

It is not unusual to notice a temporary drop in milk supply in the days just prior to a period and for a few days into one. Mothers who are over 30 seem to be more prone to this. This is due to hormonal fluctuations. Once the period begins and hormone levels begin to return to normal, the milk supply will boost back up again. Most babies can compensate well for this temporary drop in supply with more frequent nursing. If you are pumping regularly and getting less milk, you may consider adding one or two extra pumping sessions a day to catch up. If you have supply issues to begin with, speak to your healthcare provider or a lactation consultant if you feel you need help during this time.

Some mothers find nursing while their milk supply is low and nipples are tender a big challenge.  Many mothers find adding a calcium/magnesium supplement to the diet upon ovulation and continue it through the second or third day of a period an effective way to deal with these symptoms. *The supplement should be 1500 calcium/750 magnesium but can be as low as 500 calcium/250 magnesium (the higher the dosage the more effective and quicker the results). It should be a combination pill. This much calcium should never be taken alone. If your cycles are not regular and you do not know when you ovulate, you can take the supplement the entire month until you begin to see a pattern to your flow. This type of supplement seems to work as it prevents the drop in blood calcium levels, which occurs mid-cycle and continues through the second to third day of a period. It is this drop, which is associated with the nipple tenderness and drop in milk supply as well as the uterine cramping so often experienced with menstruation. You only need to take one pill a day.

The herb, Evening Primrose, is also reported to alleviate nipple soreness brought on during ovulation or before a period. The dosage is one capsule per day.*

As any medication or supplements please make sure, you consult your healthcare provider if the above-mentioned treatment is suitable for you.

 




*By Becky Flora, BSed, IBCLC

 

 

The above information is true at the time of update (10/29/2009). The information on www.BabyAndMeLC.com  is for general information only. If you have serious concerns about your baby or breastfeeding, speak to your healthcare provider as soon as possible.