Is breastfeeding causing my post baby issues...possible tmi sorry but I can't get a straight answer....

[YouMaySayImADreamer]

Just wondering if anyone has any advice or experience on this/felt like posting would help me get it off my chest...

Am currently bf nearly 13mo ds - I am down to just morning and bedtime feeds now through ds's own choice. Just for info, ds has had two bottles of formula three days a week since 7.5mo due to me returning to work but I continued to bf mornings, evenings and nights on work days and on demand on days off. Night feeds stopped at around 11 mo, and we have been down to just morning and bedtime feeds for about 6 weeks now.

Pretty much since ds was born (he was a big baby) I have been passed from pillar to post with gynae issues mainly related to weak pelvic floor and pain/discomfort during sex. I have never been given a diagnosis and have been told a range of things from having a slight laxness in vaginal tissues, to weakened pelvic floor, to things look normal, and back to possible slight prolapse again - but they want to look again to confirm! Have seen physio, gynae, and urologists at various intervals.

Things have improved quite a lot but still not back to normal and in the apparent abscence of nothing glaringly wrong, I am beginning to wonder if it is bf related. I have read online that bf could cause painful sex and lax pelvic tissues but I have asked various health professionals and only two have given a definate confirmation that this true, whilst the rest seem unsure. The gynae i saw today said bf can lead to an almost menopausal vagina and suggested that it may be time to stop to get my oestrogen levels back up. If this was a well documented fact though, surely they would volunteer this information rather than me having to make the link and ask the question myself?

I feel so so guilty about the thought of giving up. I have cried all afternoon because if i'm honest, I want to see if stopping helps me get back to normal as it is really making me depressed, but I feel so selfish because I feel like I am literally putting my own health concerns ahead of my babies' health. I am just at a loss what to do and feel I cant get the information I need to help me decide. Thanks for taking the time to read.

Hmm I had similar to this (plain from about 2 months post partum to 7 months post partum when I had an internal examination), and it turned out to be a nasty case of thrush. I was breastfeeding too.

Sorry I can't help you more!

Could it be psychological as well? Ie you're expecting it to hurt, so tense up more?

I don't know about the pelvic/vaginal issues and I'm sorry that u r going through so much worry and discomfort about them, but what I came to say is u have done a GREAT job feeding your little one to nearly 13months and it is absolutely fine to stop now.
Most of the mums I know who continued bfeeding past the early months started praying for their little ones to self wean from about this time on! Your little one can have regular milk, u don't have to bother with formula, can go straight to cup if u want to. I know the end of bfeeding is really emotional but u have done brilliantly getting this far. Whether u were having issues or not u would probably be looking at stopping in the next several months? And u have got him through his babyhood. Good luck!

Just a bit of anecdata - I definitely found sex v painful for the first 10 months or so, and can only blame the hormonal changes due to BFing, since I had a C-section. Also did a bit of googling and found reports from women 10 months+ post-partum complaining of the same.

Things have only started to return to 'normal' in the last few monhts, and DS is 17 months now. I was still BFing, but as of yesterday have stopped. Please don't feel guilty for wanting to stop - 13 months is a long stint, and why shouldn't you put your health first, especially if it's making you miserable? By 13 months of course BFing is still beneficial, but I doubt that your baby's health will actually suffer at all from you stopping!

Thanks for replying love. I have had a fair few examinations now but everyone seems to be umming and ahhing so I can assume from this that things arent 100% but there is nothing really obvious causing it.

I have wondered if it's psychological but I have had it where I'm really relaxed and feel like it is going to be fine, but we have had to stop. Rather than pain it is like an irritation or a friction which makes me feel physically sick sometimes. I also feel general irritation down there in day to day life sometimes, very hard to describe but sort of like the whole area is general sensitive and irritable.

Sorry, couple of cross posts there, but thank you both so much for your replies. I am feeling incredibly emotional about all of this and especially because I have recently returned to work full time from a phased return so I feel like I am giving up my last bit of mine and ds's special time. Your lovely words have made me feel better about possibly stopping though.

cupof yes I probably would have stopped around 18 months possibly, but ds has been starting to lose interest already in his morning feed so possibly a little sooner. I just dont want to be the one to take it away if you see what I mean?

Habitual I suppose you're right but I just worry that I am giving ds the best possible start and if anything health wise ever happened to hkm I would worry that I could have done more but chose to stop for the sake of my own health - probably sounds a bit silly from the outside!

Bless you, I understand not wanting to stop. Once back full time at work I also found BFing time was the main opportunity for some quiet cuddles. I think BFing is a lovely positive thing for mothers, not just for babies. But it it can stop being a postive thing, for many reasons (I'm in that position myself right now, have started a thread on stopping just today!), and you CAN give yourself permission to stop.

You have already given your DS a wondeful start!

Habitual thank you so much, some lovely kind and encouraging words are just what I needed to hear today. I can never make a decision to save my life at the best of times so was kind of hoping ds would make this one himself!

I think i'd find it so much easier if I just knew for definate that stopping would make the difference...don't want to regret it

I don't have direct experience of this, but my MIL has experienced terrible vaginal dryness since her menopause (and, yes, that was one hell of a weird conversation...) Anyway, I have done quite a bit of googling on behalf of her and you may want to try oestrogen creams (applied vaginally) and/or pessaries to see if they make a difference. They didn't make a massive difference to my MIL, but it might be worth a try. Even if they make only a very small improvement then at least it would confirm that the lack of oestrogen is the problem.

Whatever you decide to do, well done on breastfeeding for so long. It's hard to stop, but you'll quickly replace those milky cuddles with something just as lovely. I promise!

You need GussieGrips on the pelvic floor thing, she is an expert - might be worth doing a shout out in General Health? I've not seen her on these boards before.

Honestly I think it very unlikely that breastfeeding is affecting this. I am NOT a doctor and have no experience, but breastfeeding is often blamed for a lot of odd things. And I have never ever heard that breastfeeding "causes a post menopausal vagina" - that sounds totally bizarre and random. Why would it? Biologically we are meant to breastfeed for 4-7 years, but fertility returns at about 1-2 years (don't rely on this as contraception obv!) - so in nature we would be reproducing. Hence, it makes no sense that breastfeeding would make a woman's vagina hostile and uncomfortable.

In fact, I'm looking now to see if I can find anything at all about breastfeeding causing low oestrogen because I've not found anything immediately, so suspect it might be bollocks.

What is HPB, by the way?

Agree with others you've done a fantastic job to BF for over a year - you have no need to feel guilty if now is the right time to stop.

Oh crap sorry that was somebody else's thread - see here! www.mumsnet.com/Talk/breast_and_bottle_feeding/a1500729-Low-oestrogen-while-breastfeeding

It's about 18 months old so you could try messaging the OP to see what happened in their case?

And no, of course, you shouldn't feel guilty about stopping - but if you don't want to stop then it would be worth researching to find if it's actually necessary to stop or not. If you are planning to stop in another 7 months or so anyway, then it might be that you can make a compromise :)

I saw a consultant gynaecologist at Kings to review my healing (my episiotomy became infected and the stitches fell out so it was left to heal on its own).

He asked if I was still bfing and when I said that I was he explained that I could expect a further improvement when I did decide to stop as my hormone levels would return to normal. Have your periods come back? If so I believe this indicates that your oestrogen levels have risen, even if not entirely to pre-pregnancy levels. My point is that if your periods have returned then you may not see a dramatic improvement on stopping bfing, but if they haven't then it might make a difference. Did you notice any improvement when you night-weaned?

If you are in the South East and you can get a referral then the team at Kings really are excellent. Good luck, and really well done on bfing for so long.

Really Bertie? I'm also most definitely not a doctor, so certainly my advice may well be bunkum, but I think there's a wide range in the way that our bodies respond to hormonal changes. Some of us get PMT, some don't. Some can't tolerate certain BCPs, some are fine with them. Some have a terrible menopause, some sail through.

You're probably right that the OP should explore other possibilities, but her experience is something that I and other women I know have also had, albeit a less severe version.

I'm not discounting the experience. I'm just not sure breastfeeding is the cause - many post-birth problems which are related to childbirth are blamed on breastfeeding, for example. It is very very common for issues to be blamed on breastfeeding when this isn't the case.

I don't think breastfeeding is some magical fairy dust that can never do wrong, but I do think that often HCPs underestimate its importance to mothers and seem to suggest stopping almost as a first resort (especially when some arbitrary time limit - based not on medical fact but their own personal opinion - has been reached) where, perhaps, this can be a hugely emotional decision to come to terms with. I think it should be worked with as a first resort and only if other methods are really not helping then stopping could be looked at as a solution.

From what I've found so far, low oestrogen levels are normal when breastfeeding and immediately following birth. The problem is that for some women they are too low which causes discomfort during both sex and everyday life.

If your periods have returned, then as Frumious says this indicates that oestrogen levels have risen - this happens in the normal course of breastfeeding and indicates that your fertility has returned. It doesn't always happen by 13 months, I didn't get my periods back until 18 months. Not sure what my eostrogen levels were like, though, but I didn't notice any symptoms (was single so not having sex anyway).

It sounds like it's worth trying the cream and/or pessary first (perhaps in conjunction with waiting for periods to return) but if this is not helping on its own then it probably would be worth thinking about stopping, or bringing the date forward a bit - 15/16 months instead of 18 months perhaps?

Thanks all for the encoaragement - you have certainly made me feel a bit more positive about choosing to stop sooner rather than later and thanks those who have shared experiences.

Neverquite i did wonder how that conversation wouldve come about haha but thanks, I was given some oestrogen cream a while back but couldnt get a straight answer on whether I could use it whilst bf so never did!

Bertie thanks for the thread link and I really appreciate you doing a bit of research for me, thank you! I have done a bit of googling myself but cant find anything concrete - although have found a couple of links saying the same as the gynae with regard to low oestrogen causing side effects in some women. From the actual HCPs I have seen, most have said they don't know, and two have said there is a link. To be fair neither of them told me to stop as the first port of call, but rather I think it is me looking for this to be the answer now that ive exhausted other options.

Frumious the first gynae I ever saw also said I should see improvement once I weaned, and yes, one of the things that makes me think it may be bf related is that I saw quite a big improvement at around ten months after my periods returned at nine months - I felt almost back to normal, but things have been up and down since then, sometimes better than others.

Hmm, but if your periods have returned then surely that means that BF isn't affecting your oestrogen levels any more? That's my understanding, anyway, that BF causes a dip in oestrogen which comes back up at 9-18 months when fertility and periods return. At this point BF is not affecting oestrogen any more, for example, if you are pregnant you produce a lot of oestrogen, yet you can still breastfeed during pregnancy (most women find their supply drops).

Unless I'm understanding it wrong, anyway. But I'm sure that once periods have returned breastfeeding doesn't have a huge hormonal pull anyway - oxytocin and prolactin being the only ones which are really relevant at this time.

Hi apologies I haven't read all the responses, but just wanted to say a big yes, bf ing can affect your vagina in the same way as the menopause, causing dryness pain and loss if elasticity. It's caused by low levels of oestrogen as a result of bf ing. I nearly shot through the roof at a smear test whilst Bf ing as it was so painful, I didn't want to stop feeding so was prescribed oestrogen pessaries please give them a go they might work wonders!

Thanks bertie it's so kind of you to do all this research on my behalf! I know what you mean and maybe I am just clutching at straws as my oestrogen levels must have increased a fair bit...although like I say, there was quite an improvement when my periods came back so I suppose I am hoping there is still improvement to come when I finish bf altogether. There just doesnt seem to be much research on this or knowledge amongst HCPs despite other women saying they have experienced the same...maybe it is just something a lot of women just live with?

Thanks for sharing 3girls - I take it you were given the ok to use the oestrogen pessaries when bf then? As I have some but havent used them as I got conflicting advice!

You've done fantastically bf for 13 months so don't feel guilty if you do decide to stop. My experience with bf and ds1 was that I had a lot of scar tissue from an episiotomy which was causing me problems during sex. I was referred to a gynaecologist who told me that bf can cause your body to not heal as well as it normally does (he explained why but I can't remember now, it is down to the extra hormones you are producing), but he still said I would need to have an op to have the scar tissue removed. The op was booked for in 3 months time. During that time ds1 stopped bf of his own accord and literally in about 6 weeks I no longer had any problems and didn't need to have the op after all.

My gynae said that they would never reccomend a woman to stop bf to see if any problems resolved themselves as not all do. But in his experience quite a lot woman's problems do resolve after they cease bf.

I'm been bf for just over 3 years now and only have problems with pain just before periods.

I'm not convinced bf is the issue but hormone levels could be checked.

If you're concerned about meds & bf the bfn (I think it's them) have a specialist pharmacist or check lactmed. I've no confidence in drs when it comes to bf as I've been told so much crap!

Yes I was told they are fine as the hormone is Absorbed locally and therefore less enters the bloodstream. It takes a little while to see results but imo it's definitely worth a try, they did the trick for me! People are all different though and bodies all respond differently to changing hormone levels, meds etc. Hope you get sorted, it's no fun.

I agree about the really painful smear when bf.