What do obesity and lactational amenorrhea have in common?

The seasonal role of prolactin in metabolism and fertility

Trying to bring back your fertility and have another baby? Is breastfeeding your big baby really what’s stopping this from happening?

Period not returning after two years of breastfeeding?

While the common advice for bringing your cycle back is to wean, I’d like to use this space we have together here to give you some reasons to reconsider this option.

Not only do I know many women who have conceived while breastfeeding and gone on to tandem nurse(for tandem nursing support, I started a conversation here), but there are biological processes at play here with prolactin outside of the breastfeeding relationship.

The circadian rhythm of metabolic prolactin is operating independently of your breastfeeding¹.

The body doesn’t need the excess prolactin to maintain your milk supply—it’s doing something else via the circadian rhythm and your metabolism to keep you and your family alive. This functionality is NOT directly tied to your breastfeeding relationship. This means you can lower your prolactin levels without stopping breastfeeding.

When I see this presentation:

1. Mama is breastfeeding a 2 year old

2. Mama is glowing with radiant skin

3. Mama is lean and her boobies look “skinny”

4. Her cycle hasn’t returned, but she has baby fever

5. Her toddler acts clingy and demanding in public, and wants to touch the boobies even when not nursing

6. Often (not always), this Mama also has low libido in spite of wanting a baby

7. Often (not always), this Mama also is very idealistic about her diet and very likely has been through a lot of trial and error to land on a “perfect system” and she may even have feelings of actual fear around even the idea of changes to diet

8. Often (not always), this Mama is facing some kind of additional stress at home—seems to often be either financial/business or security like an impending move

What I observe more than half of these in a fertility consultation, my instict usually says I am working NOT with a mother who needs to wean, but a mother who needs to nourish in a different gear than the (usually very good) gear she is currently pedaling in.

In this situation I just described, weaning for the sake of restoring fertility wouln’t get at the metabolic root of her issues.

What does high prolactin in breastfeeding really mean?

To the body, high prolactin is the body’s way of saying it is spring/summer now but I’m afraid we don’t have what we will need to make it through the upcoming winter. It’s saying, I’m afraid we are going to starve. In the animal kingdom, these seasonal prolactin cycles (dependent on circadian melatonin levels) are thought to regulate fertility and ensure babies are born in the correct season².

So, instead of weaning, here are the specific things I recommend to restore the body’s sense of safety and to lower the circadian threshold of prolactin to reboot fertility, all while maintaining the level of prolactin needed to maintain breastfeeding (if you choose to).

You can do this in addition to weaning if you feel it is naturally the time you want to wean anyways.

How to reduce prolactin while breastfeeding (or for a metabolic crisis, such as obesity):