EPISODE 44

Breastfeeding and how it relates to hair loss (or does it?!): decoupling a myth‪!‬

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Episode Transcript

February 12, 2021

Postpartum hair loss... is it related to breastfeeding?

This is Maureen Feral and Heather O’Neal and this is The Milk Minute. We’re midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships and mental health. Plus, we laugh a little, or a lot along the way.

So join us for another episode. Welcome to another episode of The Milk Minute Podcast everybody. Thanks for being here. We’re going to talk about balding today. Balding and breastfeeding, more commonly known as hair loss, but scientifically called telogen effluvium. Yes. Telogen effluvium is correct, actually.

And I was about to say the F’s and the L’s in that like backward, I was going to be like “teffogen elluvium. ”  Nope, it’s telogen effluvium. And, um, I know all about this because I, myself balded after I had my last baby and yeah, it was pretty intense. So today we’re going to start with a listener question, but then we’re going to talk about postpartum hair loss and how it relates to breastfeeding or does it? Or does it? Or does it, and then we are going to give an award in our alcove as per usual.

And you never know, it might be. You stick around. Let’s take a quick break to thank our sponsor Liquid IV. Liquid IV makes your water work harder for you. It’s a great option for parents that are trying to stay hydrated during lactation, without having a ton of sugar in a sports drink. They’re natural powdered drink mixes actually tastes good too and contain five essential vitamins. So what do you really have to lose? Right. I mean, my favorite’s the ginger, and, uh, your mom told me she loves the sleep blend. And I personally liked the lemon lime. So with our code MilkMinute, you can get 25% off of your order of Liquid IV plus free shipping and a free gift. Oh yeah, I got a free water bottle. I got a color changing cup. So give it a try Liquid IV. Go get some.

So Maureen, read this question for me. Okay. So this is a question from one of our patrons, Ashley, we really appreciate you. So she said about three years ago, I found out I was hypothyroid and by the time I sought treatment for my symptoms, I had significant hair loss. I was able to get everything back on track and even my hair was better. One thing I was super nervous about postpartum was that hair loss, and boy, was it bad. I know we can’t stop the loss postpartum, but what can I do or take to help with new hair growth that won’t affect breastfeeding? I’m super cautious about what I take while breastfeeding.

So many good questions in that one question. So first of all, hypothyroid that segment of the question we’re going to save for another day, because we could just talk about that endlessly. Those hormones definitely play a huge role in hair loss and what’s growing and what’s not growing within your body.

However, this, today this episode is going to be covering more of like what happens in pregnancy and then what happens postpartum. And is it breastfeeding that actually gets in the way of what’s going on, that causes hair loss? Just going to echo you every time, but is it? But is it? Um, so I mean, Ashley, you said, I know we can’t stop the loss postpartum.

Well, maybe, but there’s some things that we could do to maybe prevent it or maybe make it not as bad. And there are some medications out there that dermatologists are toying with and researching more and prescribing. And of course there’s no good research on any of it because we don’t do it for lactating parents.

But, uh, some dermatologists are doing it. You know, some of the postpartum hair loss is bad enough that they are actually prescribing for people. And so, you know, a couple more years, we should have some pretty good retrospective data on the medications. I hope so because we get this question so much and I’m always like, Oh, it’s normal, it’s fine. It’ll go away. But like, I feel like such a shitty person for making that the the only answer I have.

It is so emotionally difficult to go through postpartum hair loss. Because it tends to occur anywhere between 5 and 20 weeks postpartum. And mine actually hit, I thought I was in the clear, like I had finally stopped peeing my own pants because of my pelvic floor dysfunction.

And I was like, all right, you know, my breastfeeding’s under control. My pelvic floor is starting to heal. And I think I’m actually in the clear. I’m going to start, you know, getting back to being sexy again, I’m going to work out and then bam, literally effluvium, telogen, effluvium fucked my world up. And like half my hair fell out and I have really curly hair.

So it looked like I looked basically like Gollum from Lord of the Rings. A hedgehog would be cuter. You know, they are very cute. It was just very stringy and we’ll get into it. And it’s so hard because so many people who identify as women really center a lot of their identity around how good their hair looks; how feminine their hair looks.

 I am so guilty of that. And I have always been guilty of that because, you know, let me just air my dirty laundry here for a quick second. I love it and love when we publicly air our dirty laundry. So I have always had really long, thick, curly hair that gets a lot of comments. So as a child,  from the time I can remember, when I meet new people or when I’m in a room, it’s like a talking piece.

You know, people use my hair as an icebreaker. Oh my gosh, look how pretty your hair is. You know, my gosh. So for my entire life, my hair has been a huge part of my identity. And so when I was going through postpartum hair loss, I was literally listening to that song by India, Arie, “I Am Not My Hair,” crying in the mirror just trying to find some other shred of me that I liked. Oh God, it’s bad. Also, it alerted me to the fact that I needed to identify other things about myself that defined me that weren’t so fucking superficial. Maybe my postpartum is not under control if hair loss is causing a mental health spiral.

Yeah. So here’s your sign, FYI, everybody. That’s your public service announcement for the day. Okay. So the first thing that you need to know about hair is that the quality of your hair actually comes from the quality of what’s happening on your scalp. So, I mean, big shocker. It’s like growing from the extracellular matrix, that is your scalp. Okay. Well, I guess that makes sense when you phrase it like that. And it’s, so imagine this little hair follicle, we’ll call him Bob. Bob has to use his little root and reach down within that extracellular matrix of your scalp and pull out all of the things that Bob needs to grow long and strong.

And he’s dying to get his friction on. He’s like as soon as he gets nice and healthy, you’re just going to tear him apart with hairdryers. And he’s going to have split ends. So sorry, Bob. Sorry, Bob. So here’s the thing about Bob. So he’s sitting on your head and he’s a new, let’s call him a new little bulb. And he is cute. Are they cute? Hair follicles? Yes. They’re very cute. I mean, they look like little skin raindrops. Oh. Under the microscope. That is really cute. I bet they’re not really that cute though. Probably not. Okay. But there is a messenger on your scalp called proteoglycan. So, this is actually also found in your cervix and the lining of your uterus.

Yes. So during pregnancy, your body is really extra as, you know, your extra, everything, extra farts, extra fat, extra sweat, extra vomit, extra hormones, extra everything. And so the proteoglycans are no different. They are extra as well, and they’re really amped up. And so they’re telling your uterus to grow and expand so it can have a baby.

And it’s also telling your scalp to grow and expand just because your scalp has those receptors on it as well. Yeah. This is literally why I have long hair right now, because I cannot keep up with cutting it enough so it’s not like in the in between. Like, so anyone who has short hair usually knows the in-between stage where it’s like, not chin length and it’s not cute and short anymore. I’m in it now. But like, it’s like when it’s like at the top of your ears though, and you’re like, this looks like I’m a shaggy 12-year-old boy. Or are you like that nice, Dorothy Hamill look? Like the ice skater from the eighties? That does not happen to me.

And also like the back of your hair grows faster than the front of your hair. Hmm. Um, so that’s a like fun thing, you really notice when you’re growing out short hair. So just starting the pregnancy I was like, I’m growing it out to chin length because then if I like, don’t get a haircut for two months, it’s not going to look actually hideous.

Yeah. I think that’s a great plan. You know, kind of planning your hair, especially if you know that you’re the kind of person that loses hair, postpartum. Plan it. You know, let’s just. Talk to your hairdresser, if you have one. Hell yes. They know how to deal with this. They do. They’re like, Oh yeah, balding spots? We know that.

Yeah. So this is why you have bomb ass hair when you’re pregnant, because these proteoglycans are telling your uterus, sir cervix and hair, scalp to grow. So then all of a sudden, we have the baby. Okay? So when your uterus and cervix get the message that they no longer need to be growing and they need to go back to normal, there’s this huge drop in these proteoglycan messengers, which are also found on the scalp. So all this time that these little hair bulbs have been receiving this message, they’ve all been receiving it at the same time, even though they’re all on different life cycles, right. We’re going to have a scheduling problem, huh? Yes. So, you know, like our hair is not like leaves on the tree. They don’t fall out all at once. Like every hair, Bob, and then we’ll have a friend, Carol. So there’s two, they’re different, you know, Bob might be only a month old and Carol might be five months old and she’s like, she’s ready to go. She’s done. They’re in different phases of their lives.

So. You know, that’s why it would be weird, right? If they were all on the same schedule and all your hair fell out at once like a tree. Just like every six months you’d be bald and then need to regrow your hair? You literally go through seasons, like the, like the forest. And you’re like, Oh, this is my balding season. Like, Oh, okay. How weird would spring be when you just have like peach fuzz all the time? This would be like a whole new fashion area though, of like, when it’s fashionable to have your balding thing, you know? I only bald in the summer.

It’s like what? You’re so wild. So anyways, so the thing with pregnancy is it kind of delays that death. So like, whereas Carol, bulb Carol, might be on her way out because of those proteoglycan messengers that are telling her no, we’re still growing, Carol. And Carol she’s like, shit, I’m going to be 112. I thought I was going to fall out, but I guess I’ll wait. And so then Bob is still growing, you know, and then all of a sudden, these proteoglycan messengers get cut off and all the hair starts to fall out at the same time. And actually they fall out, they “shed.” We’ll call it the shedding phase, very, a lot more around the frame of the face.

So, of course like you’ll see it around your ears, up in your receding hairline. I was a classic receding hairline frame of the face balder. So headbands are great. Is it made worse if you’re someone who wears your hair back in a ponytail a lot? Because you also have the breakage there too? Probably, but like, this is more at the root, right.

You know, this is more like, you can tell that there’s a pattern to it. Um, if you start to see that your hair is falling out in patches all over your head, that could be a thyroid thing. So that could be a totally different situation. But if you’re seeing it mostly around the frame of the face, then it’s normal.

I mean, even, I actually have some scary pictures from my postpartum hair loss. I know you all do too, where I was like, so obsessed with it. I was like, I know what I’ll do. I’m going to get all the hair from one shower and I’m going to count every single one of them. Make an animal picture out of it. We’re just going to turn it into a little mouse.

I was like, I need to count exactly, how many there are, and then find out how many is normal to see. Stop, did you actually count hair? If you’re literally counting the hairs that come out of your head, please like consider some evaluation around postpartum anxiety and depression. Yes. Do that because that is not normal.

That is extra. It is extra. So actually when I went to get my hair cut, I told my daughter’s daycare provider. Again, like I overshared, I was telling people that don’t need to know about my hygiene practices, that I was about to go get my haircut. And she was like, Oh, you can’t do that. And I said, why? I was four months postpartum and she goes, you can’t get your hair cut. It’ll all fall out. Oh my God. You’re like, wow. That was a myth. So apparently, apparently though, this is the old wives tale that kind of. Oh, so the old wives tale is, if you get your hair cut postpartum, it will all fall out. Right. And this is why, so twofold. First of all, if you go to get your haircut, because it’s in your way, you know, and then all your hair starts falling out, that’s a problem. Because now you have a new haircut and half the amount of hair after the haircut already happened, but that’s where that old wives’ tale came from. But then the other thing is if you go to get your hair cut after it’s already started to fall out, People are like, Oh, you’re going to get the old mom haircut.

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And it’s like, no, literally it looks like a stringy mess back there. Right. Also, there’s a total reason why this haircut is very popular postpartum. Your baby can’t pull it and it hides hair loss. Exactly. Yeah. But my tip actually is I probably wouldn’t have got it cut like I did. I took off like, 12 inches or something.

And that made it really hard to put back. And it was also very hard to cover up the bald spots. So I probably would have kept it long and just wore a headband for like six months and then trimmed a little bit at a time if I could go back and do it again. Because then I just ended up with a new haircut that wasn’t me and it just added to my identity crisis.

Oh gosh. And then every time you looked in the mirror, you’re like, who am I? Yeah. Who is this person with no hair? Right. So the point of this is that this has absolutely nothing to do with breastfeeding, right? None of the chemicals or hormones or processes we mentioned have anything to do with the process of lactation.

If you listen to the podcast a lot, you’re like, probably a little bit familiar with some of the hormonal processes and all of that. Like the things that cause lactation and sustained lactation. This, this has nothing to do with it. And this is my biggest issue. Like my biggest pet peeve here with postpartum hair loss is when people talking about it. I literally, the other day read a comment from someone saying that their doctor told them if they stopped breastfeeding, it would stop their hair loss. Yep. What the fuck? Yeah. People are just, this is classic. People are so desperate and they go to their doctor for answers and often they don’t have the answers. But instead they kind of latch onto one thing that is very easy to control, which is breastfeeding. Yeah. Well, and imagine it, somebody says it’s because you’re breastfeeding. If you are exclusively breastfeeding and infant, at that point, it usually takes a couple of weeks to wean down. Hair loss usually only lasts a couple of weeks, guys, like the really intense hair loss, right.

So you’ve had a week or two of really intense hair loss enough that you’re willing to try anything. You start to wean. By the time you’re done weaning, you’re pretty much done losing hair. So that’s a really easy way to correlate that in your mind and say, Oh, they’re right. It was breastfeeding. Right. My hair’s growing back.

No, exactly. But then you’re left with even more postpartum emotional issues to deal with. Yeah. I just want to reiterate again. Postpartum hair loss, as far as we know, backed by scientific evidence, is not influenced by lactation. I have yet to see any studies that even correlate lactation and increasing hair loss.

Right. So if you had hair loss with your first baby and are considering formula to prevent that, it ain’t going to happen. Nope. It’s probably going to be a similar story. You’re probably more prone to it. Um, but there might be a couple of things that we can do. So, like I said, at the very beginning, the first thing to know is that the quality of the hair comes from the quality of the scalp.

And the quality of the scalp comes from the quality of the stuff that you’re ingesting. We are what we eat. So for example, if you were a person with anemia, chronic anemia, and you don’t have enough iron in your body. Um, that’s pretty important for building new cells and just being a healthier person overall.

So taking iron supplements, if you are low in that, making sure that you will have the vitamin D that you need. Yeah and if you’re taking iron supplements, taking vitamin C helps you absorb them. Yes. So we did do a little bit of research. Thinking like, Oh gosh, we have to give some people like light at the end of the tunnel.

Right. And there is some research about the effectiveness of vitamins and minerals you can add to help hair regrowth. Right? And usually we see vitamin D and collagen and whatever. Um, those haven’t been proved, but they’re also not harmful. Right. Go for it. Yeah. But, and they have been proven to help with other postpartum issues, you know, so going ahead and upping your vitamins and making sure that you are getting the adequate dosage of every single vitamin is going to put you in a better position to regrow cells, which is regrowing hair. Yeah. And we do have some evidence that supplementing with vitamin D, iron and vitamin C actually does help.

Yep. And you know, if you’re somebody who’s also dealing with low milk supply, in, if you’re deficient in iron, that’s going to cause low milk supply. Right. You know, a lot of the time we have people there they’re having all of these crazy symptoms, you know, lots of hair loss, they’re having issues making milk, they’re tired, blah, blah, blah, blah.

One of my first things is like, “Hey, when, when did you last have blood work done? Was it in your pregnancy?” Probably. Yeah. Things have changed. Right? So it’s a good idea around like six to eight weeks postpartum. If you’re having that follow-up visit with your OB to just get some basic blood work done. Check your iron level, check your vitamin D.

Yeah, go ahead and get your thyroid. See what happens. Sometimes pregnancy can really knock your thyroid out of whack and, you know, hopefully during that postpartum period, it’s repairing itself, but sometimes you just don’t have enough to repair it. You know, you don’t have enough, whatever it is to fix what you have going on.

Yeah. And especially if you had some kind of preexisting issue pre pregnancy or during pregnancy, sometimes those resolve, sometimes they get worse. Postpartum is the fucking Wild West of hormones. And, you know, we, we just have to double check those things. Right. And the drug that I mentioned in the beginning, it’s called Nourkrin N O U R K R I N, with Marilex, M A R I L E X, Nourkrin with Marilex and it’s made by Pharma Medico.

So that is something that dermatologists are sometimes prescribing to people that are experiencing telogen effluvium, which is just hair loss from you know, postpartum. Yep. And you know, some people are showing some positive hair growth, but again, it could just be time. You know, time is just showing that your hair is fixing itself. Yeah, it’s, it’s definitely a hard thing to study because the amount of hair loss and the duration of hair loss is going to be different for every person. Right. And on that note of things that are not confirmed, but maybe worth a try, would be folic acid and B 12. Some studies say they help with hair regrowth, some don’t prove it.

But, you know, most people need those in the postpartum anyway. So yeah. So basically take care of yourself, make sure you have all of the vitamins and minerals that you need to be healthy as a person and to grow as many good cells as you possibly can. Your body will make cells, but sometimes they will make shitty cells.

You know what I mean? Your body’s like, Hey, if you’re gonna drink a monster and like eat Sheetz drive through, you know, which like, I mean, we, we all end up there some days, some days. Um, but like, you know, the cells they make that day, like are not going to be the cells they make on the day that you like make yourself a farm-fresh omelet with fresh spinach and you drink.

Yeah, that’s what I had for breakfast. My husband made it for me. It was very nice. But you know, like, just, just as always, like you said before, Heather, we are what we eat. We are what we eat. And just to reiterate, I’ve been there. I feel you. It’s one of the hardest things that you can go through postpartum because we feel like you’re out of the woods and then it just kind of hits you like a ton of bricks.

And you’re already having a little bit of an identity crisis, maybe in the postpartum period because you’re making that shift from being a person to being a parent. And it is just really, really difficult to move forward in that new role when you’re not feeling your best. And I just want to let you know that it is temporary.

And you’re allowed to be upset about it. And if you find yourself like I was doing weird shit, like counting all the hairs in your shower, or looking up experimental drugs to try to put on your head or pasting your scalp with mayonnaise or whatever the hell you think you’re gonna do. Did you seriously put mayonnaise on your scalp? I will neither confirm nor deny that, but. I love you Heather. Call you your midwife and be like, this is what I’m experiencing and there’s not one headband in the whole world that’s going to help me feel better about it. So reach out, let us know. Also I had some pretty unrealistic expectations about what I would look like postpartum because I was really conscious about taking care of myself during pregnancy.

And I really, I don’t even get on Instagram that much, to be honest, but I did have an unrealistic image of being this fit, sexy as hell, postpartum mom, who’s breastfeeding on these beautiful boobs and just like rocking it because I was older now. I was like, Oh no, I’m 32 now. And I, I know how to do this.

I’m not some stupid 25-year-old anymore. Like I’m going to crush this mom thing. I’m going to nail it. And then I’m like, all my hair fell out and I was so depressed. I actually like gained weight, not because I was breastfeeding. I gained weight because I was not moving and I was stress eating. And so then I was like, great, I’m bald and fat!.

Yeah. It’s okay. Well now in this pregnancy, I feel like I’ve, I have realistic expectations. I’m like, okay, cool. It’s great. Um, I already have the pancake boobs, like gained a ton of weight postpartum last time. Like I think I can only go up from here. Yeah. I mean, and that’s the thing. That’s the beautiful thing about our bodies is you pretty much get a brand-new body every seven years.

Like every cell in your body gets replaced every seven years. Very comforting. There’s actually an Eastern medicine book that I read a long time ago, which is fantastic, which you should borrow. It’s called Seven Times a Woman. Okay. And it talks about those different phases in your life of literally becoming a new person every seven years.

And this, by the way is not our best phase. Like there’s, there’s perks and there’s, you know, different things that you can work with to improve it during those times in your life, but it’s not necessarily like, Oh, I’m in the best phase. It’s like, no, this is, these are the challenges that you’re going to be working with in this phase.

And we have a lot of challenges, a lot of challenges during these childbearing years. Not to mention these are actually, were we technically, according to our biology, are moving towards the end of our childbearing years. Yeah. I mean, the, the reality is while a lot of people do have children in their thirties and maybe even forties now, biologically for most of human history, we’ve had babies in our teens and maybe twenties. If we’re still alive.

Right. If we’re still alive. Yeah. And I, you know, like I try to remind myself of that when it’s five o’clock and I’m like, cool, everybody I’m going to bed. Yeah. Because I’m exhausted. I’m 31 and this is my second pregnancy and it’s okay for it to feel different than my pregnancy at 26. Yep. A hundred percent.

Yeah. Just be where you are, you know, you can’t expect the impossible from your body. And if you’re sad about it, just be sad. If it’s uncontrollably sad, call your midwife or your provider and be like, I’m uncontrollably sad about my unrealistic expectations of my body. Yeah. Or go to the, um, postpartum support international website.

Yep. We’ll put that in the show notes again. Yeah. Okay. So before we go, we of course have to give an award to one of our awesome listeners. But first, Hey guys, it’s Maureen here, and I wanted to let you know about my Etsy shop. I am an artist and a designer, and I have a shop where I make educational breastfeeding posters, shirts for birth workers, like for your favorite nurse or midwife, shirts for people who are lactating, mugs, stickers, all kinds of stuff.

Some of my birth paintings are on there. It’s an eclectic collection and it’s really beautiful. So if you want to find that you’re going to go to etsy.com/shop/thewanderingwom6, except instead of a B it’s a six. So that’s The Wandering Womb with a six instead of a B.

This week’s award goes to Rachel. Rachel tells us that she’s been nursing her son for 14 months, which is an amazing win! Her goal was to just go as long as it all worked out. And when her son turned a year old, she started to worry he was going to self-wean, but that didn’t happen. He still nurses three times a day.

She loves every minute of it. She has friends who are pregnant and planning on breastfeeding and she loves that she can provide them support and knowledge. Oh, so Rachel, all of it, we fucking love that. Yeah. That pretty much makes me feel like we are doing this for the right reasons. I’m going to give you the Lactation Connoisseur Award.

Oh, how fancy is that? Because you’ve just like upped your level. Yeah. Bonjour Rachel, tu es un Breastfeeding Connoisseur.

Oh dear. Yes. You surpassed your goal and now you’re going on to motivate other people. So thank you, Rachel, for doing that. Yeah. And that also just goes to show you that goals are suggestions. They can be moved in either direction, up or down the line of expectation. Fuck. Yeah. Yeah. All right, guys. Thank you so much for listening to another episode.

Don’t forget to share your breastfeeding wins or questions with us. Send those to [email protected] Also don’t forget to hit subscribe so you never miss an episode. Bye. Bye. Thanks for listening to The Milk Minute. If you haven’t already please like, subscribe, and review our podcast wherever you listen.

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