My Patient is Breastfeeding, How Do I Support Her Hormone Health?

Dr. Liz Bartman

Many minerals are not only safe but also needed when women are breastfeeding. However, although many herbs are thought to be safe, there are simply not enough studies done to confirm that they will not cross into breast milk and cause negative health outcomes to the infant. The other concern is that some herbs may dry up milk supply, which may not be desired by the breastfeeding mother. 

For this reason, most of our products are not considered safe for a breastfeeding woman. 

Yet women may still be struggling with hormone imbalance, so what is the next step?

Remember that hormone suppression during breastfeeding is natural and necessary to ensure that resources are being directed into the breastmilk for the growth, development and optimal health of the developing baby. It is not an imbalance that needs to be corrected, as it is happening for an appropriate physiologic reason. 

Instead of trying to fight against nature, it is encouraged that you instead focus on optimizing the stage of life that she is in. Support during her breastfeeding phase of life will help her hormones have a better chance of bouncing back following her infants wean phase. 

Ensure she is replacing all the minerals she requires to support her health, while also supporting the health of her baby. 

Recommended products during this time include: 

• A whole food, organic, high quality postnatal blend with iron 
• A good fish oil, with certification that it is free of heavy metals and toxins. A higher DHA ratio is desired at this stage, as it will pass into her breast milk to support the neurological development of her baby.  
• Vitamin D should be checked and replaced if needed. 
• Finally, food as medicine is best. 
• Eat a variety of colors of fruits and vegetables. Focus on lower glycemic index foods, lean proteins and healthy fats. 
• Staying well hydrated, and reducing caffeine can help support milk supply, sleep and mood while breastfeeding. 
• Tea blends can be very beneficial. Always choose a USDA-certified organic tea, from a brand that is free of PFAS in their tea bags. Safe herbs in tea form include:
  • Red Raspberry tea: a great option for gentle hormone balance. Rich in minerals including iron and magnesium. A natural diuretic, which can help with puffiness and swelling if needed. 
  • Chamomile tea: can help improve milk supply and will pass a little bit into the milk supply. It is very safe for babies in this form. It can help milk taste naturally more “sweet,” which may help the infant latch to the breast. Chamomile is also naturally relaxing and soothing, for mother and baby. It can support natural sleep cycles for both mother and baby. It may also help improve digestive health. 
  • Fenugreek tea: a great option to support blood sugar regulation, hormone balance and breast milk supply. 
  • Spearmint tea: helps hormone balance, while supporting digestive health and milk supply. 
  • Adding molasses as a natural sweetener to teas can also be considered. It is rich in iron and the natural, low-glycemic sugars help improve milk supply and support natural energy production. 

Lab considerations: 

Check her thyroid health and her iron levels, as both can become altered during pregnancy and may need support at this phase in her life. 

Check in on vitamin D, 25-OH levels, and optimize levels if low. 

Progesterone is often low during lactation, because prolactin is elevated and suppress follicular development. Without follicular activity, a corpus luteum will not form, and progesterone will be low. Estrogen can also be quite low at this time. 

When progesterone is suppressed over long periods of time, the impact on both bone and neurological health can be significant. For some women, replacing progesterone can be a game changer for their mood, sleep and overall health. The risk is that progesterone could alter the prolactin balance, and cause milk supply to dwindle. The good news is that in physiologic doses, progesterone rarely affects milk flow, and if it does, the flow returns to normal within a day or two of discontinuing the hormone. The risk appears lowest when the progesterone is administered topically. A greater impact to reducing milk supply was seen when oral progesterone bHRT was used, although this was also minimal. 

Vaginal dryness can be significant while breastfeeding. Vaginal health is critical to support, and can be accomplished with natural lubricants, including vitamin E oil. If that does not work, a 2mg dose of vaginal Estriol (E3) applied 2-3x per week can be considered to offer additional, safe, support of the vaginal tissue. Estradiol (E2) is more likely to cause her milk supply to dwindle. 

Avoid testosterone and DHEA, as these can pass into breastmilk and have deleterious effects on the development of the baby. 

Breastfeeding and bone health: 

There are some concerns that women who breastfeed for longer durations of time (3+years), may have bone loss. In 2023, the NIH and their affiliate group, National Institute of Arthritis and Musculoskeletal and skin disease, released a report that demonstrated that there is a temporary decrease in bone density seen in during 3^rd trimester of pregnancy and while breastfeeding, but that it was typically restored during/after the weaning period. They concluded that following the review of recent a large studies, pregnancy and breastfeeding are not associated with increased risk of osteoporosis or fractures later in life.

Ensuring adequate calcium, vitamin D and trace mineral intake can help ensure that her bones are protected during this time. Engaging in weight resistance training and core strength exercises can also help improve the matrix and cortex strength of bone.