Q: Good day doctor and thanks for a job well done. Please I have a question ma’am. Should a woman be scared of a change in cycle after delivery? Basically I have been having my period twice in a month since I started seeing it again and it has been happening for 4 months now. This also comes with serious headache and leg pains which were not happening before pregnancy. And also Dr, which after pill is safe for a breastfeeding mother after sex? Thanks ma’am
A: Hello and Congratulations on your new baby!
Different women report different changes with their menstrual periods after child birth. Some report longer periods. Others report shorter periods; some others report less pain and others observe absolutely no change at all 😀
Cramps usually occur as the uterus tries to get rid of the foreign body, in this case, blood within it. These cramps cab spread to the lower back, legs, inner thighs and hips. Headaches during menstrual periods are referred to as menstrual or hormonal migraines and are due to a drop in the level of estrogen, a hormone. After having a baby, the estrogen levels drop significantly and could be a factor in your case. If this is so, you may have found relief during pregnancy as the level of estrogen rose. For a headache to be classified as hormonal, it would happen anytime between about 2 days before a menstrual period to about 3 days after the first day of menstrual period.
It’s best to check with your doctor for appropriate pain relief as a breastfeeding mother should definitely not be taking any medication without speaking to her doctor. That’s for sure! 😀 This is because drugs that you take will also end up in breast milk. Most times, the concentration of these drugs in breast milk is so small that it hardly causes any problems in the baby but in some instances, the drug could get very concentrated in breast milk, putting the baby at risk. So, all drug choices, be they pain relief, contraceptives or otherwise, must pass through your doctor.
A very common question I get asked is if breastfeeding mums can get pregnant. The answer is yes. If you’re exclusively breastfeeding, feeding your baby on demand (every 4 hours), you’re within 6 months of your baby’s birth and your menstrual period has not returned after the birth of your baby, you stand a better chance of not getting pregnant during this period. However, this is not a reliable method.
Birth control pills can help prevent pregnancy at this time. Pills that contain estrogen can lead to reduction in breast milk supply (and yes, combination pills contain estrogen). So, it’s a good idea to avoid such pills at this time. Pills that contain only progestin (like the minipill) is a better idea as it does not affect breast milk supply. It’s usually taken at the same time daily. It’s best to start this discussion before you have your baby or immediately after so that your doctor can advise as to when you should start taking the pills.
Barrier contraceptives like condoms, diaphragms etc can also serve the purpose of preventing pregnancy at this time.
There are, of course, other methods of birth control available eg Intra Uterine Device (IUD), implants, patches etc also exist and you may want to discuss these other options with your doctor as you conclude breastfeeding.
So, check with your doctor, especially on the issue of menstruating twice a month. Better safe than sorry.
I hope this helps.
Have a good night, y’all 😀