Early return of menses

Did my milk supply go down because my periods came back early?

If a mother’s period returns before her baby is six months old, she may notice that her milk supply is decreased and her baby is showing signs of not getting enough milk. In rare cases, the milk supply may only be low for a few days before the period is due. The return of periods is often brought on by ineffective breastfeeding. Mothers should review their breastfeeding patterns, consider options to increase their milk supply, and supplement their baby with milk until they have a full milk supply.  

A) Describing an early return of periods

Mothers who breastfeed exclusively to around six months, when they start solid foods, and continue breastfeeding on demand thereafter, can expect their periods to return once their baby is 9 months or more.

Periods can return early when milk removal from the breast is not effective. Common reasons include:

However, some mothers get their periods back early without a reason.

Once the periods are back, they will continue.

B) Period-related decreases in milk supply

Around six weeks of age, this baby started sleeping six to eight hours at night. At eight weeks, his mother’s menses returned. The mother’s milk supply soon decreased and by three months, the baby’s feeding patterns and behaviour and changed and the baby stopped gaining appropriately. The mother’s milk supply increased dramatically after starting domperidone and the baby began behaving and growing well.

1) Early return of periods may bring a drop in milk supply

A mother whose period returns before the baby is six months old may notice that her milk supply is decreased and her baby is now showing signs of not getting enough milk. It is less common to see period-related decreases after the baby is six months old.

The relationship between an early return of periods and a decrease in milk supply is not well understood. When used as contraceptives, the hormones estrogen and progesterone can decrease milk production. Similarly, with the return of periods, the amount of estrogen and progesterone produced by the mother’s body rises and falls during each cycle and may be how early periods affect milk supply.

2) Babies may fuss before a period is due

In rare cases, the milk supply may be low for a few days before the period is due. Mothers may notice that the baby is very fussy during this time but behaves normally for the rest of the month.

C) Dealing with a reduced milk supply

Mothers should work with their health-care providers during this time and monitor the baby’s growth.

1) Increase the milk supply

It may be possible to increase the milk supply in this situation. Consider:

  • Breastfeeding normally and regularly.
  • Eliminate all of the possible barriers to breastfeeding.
  • Expressing after feeds when possible for several weeks.
  • If unable to breastfeed: 
  • Consider medication to increase milk supply. We have often found domperidone to be effective in this situation.

2) Feed the baby

Babies may need to be supplemented with milk. Another way to increase the baby’s food intake is to offer more solid foods if they have already been introduced, but most babies who are not growing well in this situation need more milk.

For those babies who are only fussy for a few days before the mother’s periods, the mother can express at other times of the month and use this milk for the fussy days. 

Supplements should be reduced or stopped if the mother returns a full milk supply.