Hormonal Changes with Breastfeeding

Thank you so much for all of the support after my last post.  I really appreciate the positive feedback and tips from my little community of readers.  I usually take a week off every few months to maintain my sanity, and at the time of my last post, I was on my last week of work before my vacation.  I was definitely feeling it, and it came through in my post.

I would like to say that after a week of vacation I’m all refreshed and ready to take the bull by the horns again.  I’m not quite there, but nevertheless it was a nice week off.  We had our first night away from WZW.  We drove to Sacramento on Friday and stayed with our friends who watched him over the weekend.  It helped for us to be there the first night so he could acclimate to them and their house.  Then early Saturday morning, we headed to Lake Tahoe (about 4 hours away from home) where we spent a night before heading back to pick up our little guy on Sunday.

It was so nice to do simple things.  We went hiking, which was tough given the elevation and how out of shape I am, but I did it!  And going out to dinner without worrying about the baby trying to touch everything and knock everything down was great.  Of course, we missed our little guy and it was nice to see him again.  Thankfully, he had lots of fun with our friends.

During my week off, I continued to breastfeed and pump, but have grown increasingly weary of it.  It’s frustrating to want to relax, do stuff, and enjoy myself, but every 4 hours I have to remind myself to pump or feed.  Often, I’d be engrossed in whatever I was doing and forget.  And then I’d feel upset.  WZW’s schedule often doesn’t match mine, so I don’t end up breastfeeding directly much.  Plus my husband knew how hard of a time I’d been having, so even though I was off work and he wasn’t, he still took care of nights so that I could rest up.  So I was going for longer stretches at night.

Not surprisingly, my supply has decreased now that I’m back at work this week.  For a while now, I’d been thinking of stopping around 10 months.  Partly because it’s been such a daily struggle, and partly because I’m going to a friend’s bachelorette for a weekend next month.  Even though there will be other moms there who would understand, I just don’t think I can stomach having to worry about pumping the whole weekend.

One of the comments after my last post mentioned this article:

Why Didn’t I Lose Weight While Breastfeeding??

(Couldn’t figure out how to undo that large space)  It talks about the hormonal changes that occur with breastfeeding that prevent weight loss in some women.  Namely, the low estrogen and progesterone.  Now, I’m the first to admit I’m not that knowledgeable about hormones and the nitty gritty of how they work as described in the article.  What I do know is common knowledge amongst obstetricians that breastfeeding causes a low estrogenic state.  That low estrogenic state causes such fun things like vaginal sensitivity and pain.  With that said, I’ve also had patients who aren’t breastfeeding who have vaginal pain for months postpartum, which must be from the lacerations or something.

After reading the article, I feel better.  Although I’ve felt like my body has been hijacked since I became pregnant, I thought a large part of the weight gain postpartum was from the chronic sleep-deprivation.  But maybe more of it has to do with breastfeeding than I thought.

What I’m not sure about is the progesterone.  The article says that if you are not ovulating (which is generally the case if you haven’t gotten your periods back), then it lowers progesterone levels.  But I’m taking the progesterone-only birth control pills, which inhibit ovulation, but also are adding back progesterone.  So I’m not sure how that factors in.  Progesterone-based birth control methods, most notoriously the Depo-Provera injections, can cause weight gain.  So based on what I already know and what the article says, both added progesterone and low progesterone can lead to weight gain?

In any case, I’m looking to stop breastfeeding soon.  It’s interesting, because I’ve found it pretty terrible for the most part.  My husband has seen how difficult it’s been, and has said he wishes he could pump for me.  But I’m sure he’s relieved he can’t!  He fully supports stopping now- at this point, the little benefit from the few ounces of milk I’m able to provide our little guy isn’t worth the huge hassle.

So you’d think after all of my bitching and moaning that I’d be excited to finally stop breastfeeding and be free of my invisible shackles.  Well, I’ve found that I have some hesitations and fears as well.

At this point, it’s all I’ve known since WZW was born, so it’s a little scary thinking about how it’s going to be when I stop.  There’s the reaction from habit- the amount is decreasing?  Must pump more!  Also, as I see my milk supply diminishing further, there is a disappointment to it.  In general, I feel a sense of accomplishment when I get a lot of milk, and it’s disappointing to see only an ounce or two.  As it diminishes even further, there is some sadness to that.

I’m a goody goody who likes to follow the rules.  So I’d always hoped to practice what I preach.  Every single pregnant patient of ours hears the recommendation from the American Academy of Pediatrics- to breastfeed exclusively for 6 months, and breastfeed total of a year or more.  I do feel slightly disappointed to not quite make the year.

Also, in the last month or two, I have found that WZW seems to get some comfort from breastfeeding.  He is still all over the place, frequently coming off the breast, getting distracted by other things, pulling on my clothing & hair, etc.  But the fact is that he still takes the boob.  Even though it takes more time and work to get a couple of ounces, as opposed to chugging down 8 oz in a bottle, he still keeps breastfeeding.  So there must be some inherent benefit/comfort for him, which has made me enjoy breastfeeding a little more lately.  Just a little.

I wonder if I will feel significant changes.  My dental hygienist said she felt depressed when she stopped breastfeeding, even though she’s normally not a moody person at all.  And part of my fear is that even when I stop breastfeeding, I’ll still have a hard time changing my eating habits.  I decided to weigh myself recently, and sure enough I’ve continued to gain weight- so now I am close to the weight I was at the end of my pregnancy, nearly 30 lbs. heavier than I used to be.  Yikes!

Despite all of this, as the comments on my last post reminded me, I am grateful for all that I have.  When I hear about bad outcomes with patients and their babies, or see patients who are having difficulty conceiving, it reminds me how lucky I am to merely have one healthy baby.  Though it hasn’t been easy, I have a normal baby who was able to breastfeed, and somehow or another I’ve managed to make it to nearly 10 months.  I’m sure it helps that he’s not in daycare, but he hasn’t gotten sick yet.  And neither have I, even though my husband and nanny have.

Many of my patients end up with more significant physical changes postpartum.  Not just bad stretch marks.  I’m talking about significant vaginal lacerations (sometimes involving the rectum), urinary incontinence, vaginal prolapse.  Things that aren’t as easily corrected as weight gain.  If gaining 30 lbs in exchange for my beautiful little guy is all I have, it’s not that bad in the scheme of things.  And despite the stress and long hours, I have a stable job that provides personal fulfillment and financial security.

I am most grateful for a husband who might be secretly superhuman, as he continues to go above and beyond to help take care of WZW and me, especially when I’ve been having a rough time lately.  He has insisted on taking most of the nights, despite his own rigorous work schedule.  Without him, I would go certifiably insane.

So we shall see- as I stop breastfeeding and move onto the next chapter, it will be interesting to see how things go.