Almost anything is considered normal when it comes to your periods while breastfeeding. All women experience a time of postpartum bleeding following birth which is not considered a menstrual period. If bottle-feeding, most mothers will have their first real period not long after this. Breastfeeding, however, suppresses menstruation at least for a while. For some mothers, there may be an absence of menstruation for weeks, months, and even years while still breastfeeding. Some mothers will even need to completely wean before they see their first period. Others, once their babies begin taking supplemental foods or sleeping longer periods at night, will see the first period. Once menstruation returns it may continue to be irregular during lactation. It’s not uncommon to have a shorter or longer than normal period while breastfeeding. It’s also not abnormal to skip a period or see the first period return and then find that months pass before the next one.
When the first period returns depends upon several factors: how frequently the baby is nursing, how often the baby is supplemented with bottles, whether or not the baby takes a pacifier, how long the baby is sleeping at night, whether or not solids have been introduced, and the mother’s own individual body chemistry and the way it responds to hormonal influences associated with breastfeeding. Any time the stimulation to the breast is decreased, especially at night, menstruation is likely to return soon after.
When menstruation does return, you should consider yourself fertile and take precautions against pregnancy if desired. Some women consider their first period as their “warning period” that they are now capable of becoming pregnant. However, it IS possible to become pregnant before the first period returns, although quite rare.
The return of menstruation does not mean the end of breastfeeding. The milk does not sour or “go bad” when you are having a period. The milk is no less nutritious when you are menstruating than when you are not. Some women do notice a temporary drop in milk supply in the days just prior to a period and for a few days into one. 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.
Nipple tenderness occurs for some women during ovulation, during the days before a period, or at both times. Some mothers report a feeling of ‘antsey-ness’ while nursing at these times, too. As with the drop in supply this is also hormonally influenced and therefore temporary.
Some babies may detect a slight change in the taste of the milk just before a period, again, due to hormonal changes. These same babies may nurse less often or less enthusiastically during this time as a result.
For some women, the drop in milk supply and nipple tenderness associated with menstruation becomes more of a challenge. An effective treatment for these symptoms associated with the return of periods is to add a calcium/magnesium supplement to the diet upon ovulation and continue it through the second or third day of a period. 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.
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Becky is a board certified, registered lactation consultant (IBCLC, RLC) in practice with Breastfeeding Essentials in Kingsport, TN.