You may have heard the rumor that you may finally see healing from diastasis or other postpartum-related dysfunction after you stop breastfeeding.
But how true is this rumor?
Let’s explore a few things that may influence your postpartum recovery if breastfeeding!
The Role of Estrogen
After you give birth, estrogen levels are much lower. This helps to make room for prolactin and oxytocin to support breastfeeding, but the level should regulate when your menstrual cycle returns.
Our menstrual cycle returning may fluctuate depending on several factors, such as whether you are exclusively breastfeeding, your overall nutritional intake, and overall health. It may even vary from postpartum to postpartum.
After my first, I didn’t get my period back until I was closer to a year postpartum. But, with my second, my period returned closer to 5 months postpartum. I don’t know how different my two postpartum periods were regarding my health, as I exclusively breasted both babies.
Estrogen is an important hormone to maintain bone and muscle mass and function [1]. If estrogen levels are low, such as early postpartum and during menopause, it could affect bone density, and we may see an effect on muscle mass and function.
So, when thinking about how important of a role estrogen plays in our body for repair and recovery, it may be a logical conclusion that low estrogen levels may affect early postpartum healing.
Breastfeeding and Estrogen Levels
In the early months postpartum, everyone’s estrogen levels are lower. If you exclusively breastfeed, your estrogen levels may remain decreased, but typically will return to normal levels once your menstrual cycle returns.
If breastfeeding causes lower estrogen levels, could this decreased level of estrogen affect pelvic floor function or inhibit healing postpartum?
The short answer is probably not, but also maybe!
Let’s explore what research says!
Low Estrogen Levels and Pelvic Floor Function
Two studies looked at breastfeeding and pelvic floor, and both concluded that breastfeeding did not appear to correlate to inhibition of healing or increase pelvic floor issues.
One study by Iris et al. did a questionnaire of postpartum women starting within 24 hours of birth and then 3 months postpartum.
They concluded there was no difference between exclusively breastfeeding groups and those who did not after birth [3].
However, the question is, what were the estrogen levels at three months compared to at six months in the study participants.
Were estrogen levels still decreased in both groups at this point, or was there a substantial difference between the two? This study also did a questionnaire. Had someone had an in-person assessment by a pelvic floor physical therapist, they may have found a difference in pelvic floor function or the presence of pelvic floor issues.
Another study, however, looked at women 1-2 decades after birth to assess for pelvic floor function. They hypothesized that the exclusive breastfeeding group would have the most pelvic floor issues, but actually found there was no difference [4].
In the study by Lovejoy et al, there were three groups. One group were participants who did not breastfeed at all, and another group breastfed for more than 1 week but less than 12. And the final group exclusively breastfeed for greater than 12 weeks. They found that there was no difference between groups and the prevalence of pelvic floor issues [4].
But, there were studies that looked at pelvic floor function after birth up to a year postpartum and they found breastfeeding to be one of the factors potentially correlated with urinary incontinence [5]. In the study by Burgio et al., they found that seven factors seemed correlated to urinary incontinence postpartum:
- Smoking
- Incontinence During Pregnancy
- Length of Breastfeeding
- Vaginal Delivery
- Use of Forceps
- Frequency of Urination
- Body Mass Index
So, breastfeeding was one of the SEVEN factors that seemed related. But, another study found that cesarean birth was correlated to urinary incontinence [6].
In the study by Quiboeuf et al., they found that the following four factors were associated with urinary incontinence at 24 months postpartum:
- Higher parity (multiple births, but the study by Burgio found this was not a factor at 12 months)
- Breastfeeding
- Short pregnancy intervals
- Cesarean Birth
So, again, breastfeeding was one of four factors that seemed to be associated with urinary incontinence.
Does breastfeeding inhibit healing postpartum?
Probably not, but if you have multiple factors (which vary from study to study), it may be important to work with a pelvic floor physical therapist as a preemptive strategy to support your healing postpartum!
Counter the Effects of Low Estrogen
What are some things we can do to counter the effects of low estrogen, such as the decrease bone density and muscle mass/function?
We can exercise! Exercise has been associated with increased bone density, particularly with lifting weights and increasing muscle mass and coordination [1].
If you are experiencing a plateau in your postpartum healing, it may not be due to breastfeeding but rather not enough of a demand! We will only be as strong as the demand we put on our bodies.
If we are doing floor-based, body weight movements, and our diastasis or prolapse or other pelvic floor issues are not improving, we may need to make the movement harder as opposed to ease off!
Our postnatal strength and conditioning program helps you navigate your return to fitness after the birth of your baby! Start with a rehabilitation program, then progress towards lifting weights. Feel stronger and lift heavier than ever before!
- 16 Week Program
- 64 Training Days
- Teambuildr App Access
Stand up, and increase the demand for gravity. Add some weights. Add some resistance or bands to make the movement more difficult. Increase the intensity of the exercises.
Make the workout harder, as opposed to easier, so that we can increase the density of the tissues, muscles, and bones to enhance your healing postpartum.
Lifting weights could increase the challenge and help you overcome a plateau in your postpartum healing.
Breastfeeding and Postpartum Healing
Does breastfeeding affect or inhibit postpartum healing? It seems to potentially be one factor of many that may contribute towards prolonged pelvic floor issues, but not the sole contributing factor.
Studies seem to be conflicted on whether or not breastfeeding inhibits healing, though. If you are planning to breastfeed, it could be worth connecting with a pelvic floor physical therapist before you start experiencing issues, as it may be a factor associated with pelvic floor issues.
If we breastfeed for a prolonged period, estrogen levels may be lower. Lower estrogen levels may be associated with decreased bone density, muscle mass, and function. But lower estrogen levels may not necessarily be associated with decreased pelvic floor function or an increase in pelvic floor issues.
We can overcome the side effects of low estrogen levels by exercising! Our postpartum healing may be inhibited not due to breastfeeding but due to the lack of demand and challenge in our rehabilitation exercises.