Progesterone and breastfeeding

iVillage Member
Registered: 11-08-2003
Progesterone and breastfeeding
2
Sat, 11-08-2003 - 10:36pm
I'm hoping you can help. I have a progesterone deficiency and used natural progesterone cream to get pregnant and stay pregnant with my daughter born 1-10-02. We had horrible breastfeeding issues-blistering, cracking, breast infection, thrush--all lasting about 2 1/2 months. I had a low milk supply and had to supplement with formula, I couldn't get my milk supply to increase. We made it through thankfully and she weaned herself at 18mo old while in the middle of my current pregnancy. This time around I'm going to buy a medical grade pump and start using it right away after feedings to help supply. I read recently that larger women have higher estrogen and lower progesterone which can inhibit milk supply and that using natural progesterone right after birth can help milk supply and decrease baby blues as well. I know for sure I have low progesterone/high estrogen-we did use progesterone cream with this pregnancy as well to conceive and maintain pregnancy. Have you heard of this before and can you help??

Thanks--Sara :o)

Sierra 1-10-02

Baby Boy EDD 12-4-03

iVillage Member
Registered: 03-27-2003
Sun, 11-09-2003 - 8:51pm
Hi Sara,

Congratulations on your pregnancy!

The purpose of progesterone during conception and pregnancy is to sustain a fertilized ovum by supporting the uterine lining. Progesterone levels are naturally lower during lactation, but during a normally progressing pregnancy progesterone levels will steadily rise and inhibit the act of prolactin, the hormone responsible for milk production. This is why most pregnant, nursing mothers often see a drop in supply about midway through pregnancy. When progesterone - and estrogen - levels abruptly fall at birth (with the birth of the placenta), prolactin levels are rapidly elevated allowing the breast to begin producing a full milk supply.

Low progesterone does not inhibit lactation - low levels of progesterone are normal during lactation. In fact, some women find that extra progesterone (such as progesterone-only birth control pills or injections) decreases milk supply. This milk-inhibiting effect of progesterone is much more likely if mom starts the pill or gets a depo injection before around 6 weeks postpartum - this is likely connected with the fact that the sudden & dramatic drop in progesterone levels triggers mom's milk to "come in" (so adding extra progesterone to the mix decreases this drop). Does that make sense to you?

There is evidence that for moms with low progesterone, raising those levels *during pregnancy* can help with lactation, since low progesterone levels during pregnancy can compromise breast development: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10776184&dopt=Abstract

I would really avoid using a progesterone cream in the early weeks after birth (and be wary of it later on, too). If you use enough of it so it gets into the bloodstream (and it would have to do that to affect your progesterone levels, right?) then it would be enough to put your milk supply at risk. Do you know where you read that using progesterone cream early postpartum could help lactation? I'd be interested to see the studies.

Now, elevated levels of estrogen do have a milk inhibiting effect, but this is generally seen with moms taking combo birth control pills. I have seen info on the studies where larger women had a shorter breastfeeding duration, and I believe the estrogen link is simply one of the theories for the shorter duration (maybe Kathy has more on this). Also, the studies that I have seen did not go into any detail, but simply looked to see whether overweight moms were less likely to start breastfeeding or to stop BF earlier (one of the studies found that larger moms weaned about 2 weeks earlier). In the studies that I looked at, obesity was associated with (1) a lower initiation rate of breastfeeding, (2) a longer time before mom's milk came in, and (3) slightly shorted breastfeeding duration.

Here are some studies, if you'd like to take a look:

http://www.nutrition.org/cgi/content/full/131/11/3009S

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Display&dopt=pubmed_pubmed&from_uid=11694637

On the flip side, a large number of overweight women have very successful breastfeeding experiences. The studies don't say that being overweight is definitely going to affect lactation (at least one of the studies shower *longer* BF duration in overweight women), but that it is a risk factor and that extra breastfeeding support may be needed.

On your last breastfeeding experience, were you working with a board certified lactation consultant? Since you say you had blistering and cracking it sounds as if you were dealing with a bad latch, which on its own can affect milk supply significantly if baby is not transferring milk well.

Here's some info on getting breastfeeding off to a good start:

http://www.kellymom.com/bf/start/index.html

Good luck!




Edited 11/9/2003 9:22:04 PM ET by kellysb

 

iVillage Member
Registered: 11-08-2003
Wed, 11-12-2003 - 12:24pm
Thank you for all of the great info and links, it's nice to know someone out there is willing to help :o) I have low progesterone and high estrogen in general, when I'm not pregnant, and a definate progesterone deficiency at the beginning of pregnancy, I won't even get pregnant without using the cream. What I'm wondering is if the studies out there are done on women using synthetic progesterone (progestins) which is what all of the low dose progesterone birh control pills are made from. When I studied up on getting pregnant with progesterone deficiency, I found that synthetic progesterone was very bad stuff, and could even cause more problems with pregnancy, where natural progesterone was safe and worked to keep women from miscarriages. I used natural progesterone cream to get pregnant and stay pregnant through the first trimester (which lasted through May). I naturally had a lower milk supply during this time as daughter wasn't nursing very often. When I finally noticed a severe decline in milk, where I knew there really wasn't much coming out, was in July (which is when my Daughter started to self wean, it was also about midway thorugh my pregnancy. So I wonder what's really true out there. I read about the progesterone boosting milk supply from a book in a health food store (GNC). I can't for the life of me remember the name or author, but it was about menopause and natural progesterone therapy. I picked it up and looked through and there was a chapter for breastfeeding moms and how the natural progesterone could actually help milk supply, as well as boost overall well-being. It's all so confusing, as to what and who to believe. Today I'm going to try and find that book if I can, and also contact a lactation consultant who does breastfeeding support classes here in our area. She is a wonderful woman who is so very sweet and she may know something too. Please let me know if you find anything else too.

Thanks for the support~~

Sara :o)