Lactation and Your Pelvic Floor
Lactation and Breastfeeding Series (3-Part Series)
Part One: Lactation and Your Pelvic Floor
Breastfeeding can be both beautiful and hard. It’s a time of love and connection, but also of discomfort and exhaustion. Feeling a mix of emotions is completely normal. That’s why we’re sharing this three-part Lactation and Breastfeeding Series. This series is designed to help you better understand what’s happening in your postpartum body and offer support and guidance so you can feel more comfortable and confident during this season of life.
In this blog (Part One), we’ll explore how lactation impacts the pelvic floor (yes, it changes during this time, too!). In Part Two, we’ll focus on posture and breastfeeding positions. In Part Three, we’ll talk about recognizing and managing clogged ducts.
Part One: Lactation and Pelvic Floor: Explore how lactation impacts the pelvic floor.
Part Two: Posture and Breastfeeding: Posture and breastfeeding positions that help relieve pain.
Part Three: Clogged Duct Management: Recognize and manage clogged ducts.
Lactation and Your Pelvic Floor
As pelvic physical therapists, we support many aspects of your postpartum recovery, even during breastfeeding. While we aren’t here to teach you how to breastfeed, we do provide a lot of support throughout the nursing process. For example, we can help relieve upper back, shoulder, and neck discomfort from nursing or pumping, as well as help you manage the changes in your pelvic floor (yes, the pelvic floor changes during lactation!).
Because we see so many newly postpartum clients navigating breastfeeding, we want to make sure we always have the most up-to-date information to better support you. That’s why we recently attended a Lactation Essentials class hosted by the lovely Molly Peterson, owner of Wisco Lactation. This training helps us guide you on troubleshooting nursing positions, addressing posture changes, managing clogged ducts, and knowing when to refer you to a lactation consultant.
Before we continue, please know this: We, at Pelvic Health and Wellness, support you no matter how you choose to feed your baby. There are so many reasons you may choose to breastfeed, pump, supplement with formula, or do a combination of all three. Everyone is different, and we are never here to shame or judge what you decide is right for you and your little one.
How Does Lactation Affect the Pelvic Floor?
In a recent blog, we discussed Genitourinary Syndrome of Menopause, detailing how hormone changes (declining estrogen) during and after menopause can have a drying, atrophic effect on the pelvic floor tissues. Did you know that the exact same thing happens during lactation? We call it the Genitourinary Syndrome of … Lactation!
The common factor between menopause and lactation is low estrogen. While estrogen keeps vulvovaginal tissues moisturized, elastic, and resilient, the hormone prolactin—which is the primary producer of milk—actually suppresses estrogen. So as long as prolactin is high and milk production is active, estrogen remains lower.
Common Pelvic Floor Symptoms During Lactation
During lactation, you may experience several pelvic floor symptoms, such as:
Lack of a period
Vaginal dryness
Thinner vaginal tissues
Vaginal hypersensitivity or discomfort (notably but not limited to burning, itching, stinging sensations)
Lower libido
Essentially, these are many of the same symptoms seen during menopause. However, during lactation, these symptoms are temporary. Estrogen levels will rise again when breastfeeding frequency decreases (like when your baby starts solids) or after you’ve weaned completely. An indication that estrogen levels have risen is the return of ovulation and your period.
Managing Pelvic Floor Symptoms During Lactation
As noted, changes to your pelvic tissues caused by lactation are temporary and will improve or resolve after you’ve weaned. But while you’re still breastfeeding, these symptoms can be uncomfortable. That’s where we can help.
During a postpartum pelvic floor assessment, our team can recommend ways to manage and improve your symptoms. There are many over-the-counter vulvar moisturizers that may help add moisture to your pelvic floor and different types of personal lubricants (oil-based preferred for this issue) to decrease friction during intercourse. We can also recommend getting a prescription from your OB-GYN for a topical vaginal estrogen cream to increase the estrogen specifically at the vulvar tissue to relieve symptoms.
Positions for pelvic floor relaxation and diaphragmatic breathing can also be helpful during this time, as the pelvic floor muscles tend to tense and guard against pain, especially after childbirth. Some examples of restful positions are child’s pose or happy baby. We also want to promote blood flow to the pelvic floor muscles to help with healing and comfort. We can promote this using gentle manual stretching in session with a gloved finger, and we can teach you how to use a pelvic wand or tool with vibration (vibration = blood flow and relaxed tissues) for a home exercise program.
To recap, there are a variety of ways to manage and improve the symptoms of Genitourinary Syndrome of Lactation:
Over-the-counter vulvar moisturizers to add moisture to the pelvic tissues
Lubricants (oil-based preferred) to reduce friction during intercourse
Topical vaginal estrogen cream to restore moisture and relieve discomfort
Positions for pelvic floor relaxation and diaphragm breathing, such as child’s pose or happy baby, to reduce tension
Gentle manual stretching in session to promote healing and comfort
Pelvic tools with vibration for home use to increase blood flow and relax tissues
Next Steps
We’re here to help make your postpartum experience and recovery as comfortable as possible from head to toe and everything in between. Stay tuned for Part Two of our Lactation and Breastfeeding series, Posture and Breastfeeding. In this blog, we’ll cover how breastfeeding affects your posture and provide strategies to help relieve upper back and neck pain.
About Pelvic Health & Wellness
Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our physical therapists specialize in treating pelvic health concerns such as pelvic floor dysfunction, bowel and gut health, pelvic pain, pelvic organ prolapse, constipation, incontinence, fertility, and various pregnancy and postpartum-related conditions.
We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. We are here to support and encourage you on your journey back to health so you can return to doing what you love! If you are ready to take the first step in reclaiming your pelvic health and wellness, don't hesitate to get in touch with us today.
