Perimenopause: Can it affect lactation?

I am 45 years old and pregnant with my third baby. I plan to breastfeed again, but I'm concerned because prior to my pregnancy I was beginning to show signs of perimenopausal symptoms, like night sweats. If I go through menopause during this time, will it affect my milk supply?

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Kathy Kuhn

Kathy Kuhn is a registered nurse who has been working with breastfeeding families since 1981. She has been an International Board Certified... Read more

There is no research that I am aware of addressing the issue of menopause and breastfeeding. There are however, numerous reports of women successfully breastfeeding or relactating after menopause from as early as the Old Testament. (Ruth 4:16) to the twenty-first century. (Baumslag, & Michaels 1995) Generally one would assume that if a woman has been able to conceive she should be able to breastfeed.

Just as your body is able to provide all the appropriate hormones to sustain a pregnancy at this time I would expect your body would also be able to provide the hormones associated with breastfeeding. In fact, perimenopause and lactation have some hormonal similarities, such as lower estrogen levels and a lessening or elimination of ovulation.

It is the reduction of estrogen that typically causes the symptoms associated with perimenopause. This is why estrogen replacement therapy is frequently recommended. Since we know that the presence of estrogen is thought to suppress milk production, it seems reasonable to conclude that any drop in estrogen associated with perimenopause should not negatively impact milk supply. Lower estrogen levels are normal in breastfeeding women.

If it is recommended that you start estrogen replacement therapy, you should remind your doctor that you are breastfeeding. The American Academy of Pediatrics has approved the use of estrogens, typically for use as birth control pills, in breastfeeding mothers, but their use in the early postpartum period is associated with a reduction in the milk supply, so you may want to consider other options if your perimenopausal symptoms return.

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