Spotting While Breastfeeding - Normal or Not?

Tracy Behr -

Table of Contents


Is Spotting While Breastfeeding Normal?

Yes. Seeing bright red spotting or (light) brown spotting is common during breastfeeding. We can safely say that there is no “normal" regarding menstruation while breastfeeding.

Certain things can cause spotting while breastfeeding, namely:

Lochia Discharge & Hormones

Spotting and discharge are common concerns when the initial postpartum bleeding starts to subside; this discharge is called lochia.

What is Lochia? Lochia is not the same as a regular period; it's a mixture of blood, mucus, and uterine tissue that is expelled from the body. Lochia typically begins with bright red bleeding in the first few days postpartum, resembling a heavy period. This discharge is not a menstrual period. Over time, lochia changes in color and consistency, transitioning to a lighter, brownish flow and eventually to a yellowish-white discharge. Women should be aware that lochia is a normal part of the postpartum period and may last for about 4 to 6 weeks.

During the first couple of weeks, spotting and nausea are frequently complained about, and this is often due to the hormone Oxytocin, which is responsible for the flow of milk (let down). When this hormone is released into your system, it can cause headaches, thirst, nausea, and uterine cramping. Oxytocin causes the uterus to contract, helping it to return to its original size; this contraction, in turn, could also cause spotting during the first few weeks after childbirth.

Your Period

Spotting and having irregular periods are pretty normal while breastfeeding. Although, most mothers will be free from menstruation for the first six months to a year after giving birth. When your baby breastfeeds on demand, the release of hormones will inhibit the return of fertility. Therefore, you will have no period; this phenomenon is called lactational amenorrhea. But, not all women have the same hormone levels.

What is Lactational Amenorrhea? The effectiveness of breastfeeding as a contraceptive method is known as the lactational amenorrhea method (LAM). LAM is considered reliable if certain criteria are met. Three main criteria for LAM's effectiveness include: (1) the baby is under six months old, (2) the mother is amenorrheic (not experiencing a period), and (3) exclusive breastfeeding on demand, meaning no long stretches of time without nursing during both day and night. LAM is considered highly effective when these criteria are met, with success rates ranging from 98% to 99%. However, it's essential to be aware of the specific conditions that make this method reliable.

Periods while breastfeeding could be longer or shorter than you are accustomed to. Also, skipping a few periods in between is a common occurrence. During those skipped months, you may still experience irritability and nipple tenderness.

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When Should My Period Return While Breastfeeding?

It varies from person to person, depending on your breastfeeding frequency and your personal hormone levels.

Just over 40 percent of exclusively breastfeeding mothers have their periods return within one year. Of that 40 percent, about 10 percent get their periods within six months after childbirth.

Those mothers who decide to formula feed will have their periods returning as soon as two months postpartum.

Hormones play a significant role in breastfeeding and its impact on the menstrual cycle. Two key hormones involved are prolactin and oxytocin. Prolactin is responsible for milk production and is found at higher levels during breastfeeding. It also contributes to the suppression of menstruation. The more frequently a baby breastfeeds, the higher the prolactin levels, which further inhibits the return of fertility and menstrual cycles. Oxytocin is another hormone released during breastfeeding. It stimulates the milk let-down reflex and plays a role in preventing ovulation by sending signals to the brain to suppress the hormone responsible for ovulation.

Menstruation Is More Likely to Occur When:

  • Your baby sleeps through the night without having a feed.
  • Your baby starts eating solid foods.
  • Your baby is given other liquids or supplements.
  • You begin to replace breastfeeding with pumping.
  • You put your baby on a feeding schedule instead of breastfeeding on demand.
  • Your baby is allowed to suck on a pacifier instead of comfort feed from you.
  • You start medication, the combination, or the mini-pill.
Baby sleeping


If you feel that your milk supply is lower than before, you can:

Some women worry that the return of their menstrual cycle will result in a decrease in their milk supply. While hormonal changes associated with menstruation can indeed impact milk supply, this doesn't mean the end of breastfeeding. It's common for women to experience a dip in milk supply during specific phases of their menstrual cycle, typically from mid-cycle until around the time of their period. Experts recommend taking a daily calcium and magnesium supplement during this phase to minimize the drop in supply. Such supplements can help maintain milk production. Changes in milk supply may also coincide with other factors, such as babies transitioning to solid foods, and are not solely due to menstruation's return.

Can You Fall Pregnant While Breastfeeding?

With an irregular period, how does a mother ever know if she is fertile or not?

If your periods are irregular, it would be wise to take extra preventative precautions because, yes, you can fall pregnant while breastfeeding.

Breastfeeding mothers often complain about menstrual cramping (PMS symptoms) without actual periods for months before their menses return. These symptoms are the first signs that your body is getting ready for your period to return.

Ovulation before Menstruation - Ovulation can occur before the return of menstruation, potentially leading to pregnancy. There are different phases related to fertility after childbirth, including: Follicular activity without ovulation. Some women report PMS-like symptoms in the weeks or months leading up to the return of their period due to this activity. And ovulation without luteal competence: An egg is released, and fertilization may occur, but the uterine lining isn't prepared for implantation, leading to unsuccessful implantation. And lastly, full fertility: Breastfeeding no longer affects the chances of pregnancy. Women need to be aware of the potential for ovulation to return before their first period. This is especially important if they want to prevent pregnancy.

Natural Family Planning and Other Birth Control Methods

During the first few weeks, postpartum spotting is even more common if you go back on birth control pills or get the Depovera shot.

Breastfeeding can be used as a method of birth control only when the following criteria are met (1):

  • Your baby is younger than six months.
  • Your period has not yet returned.
  • Your baby is breastfeeding exclusively.
  • You are not using any pacifiers or supplements of any kind.
  • You are breastfeeding on demand.
  • You breastfeed during the night hours too.

As soon as your period returns, you should consider yourself fertile.

If you are doing all these things, you only have a 2% chance of falling pregnant while breastfeeding. This method is as effective as using a diaphragm or condom.

As soon as your period starts, it would help if you considered using other safe birth control options while breastfeeding. That's, of course, if you don't want to get pregnant again immediately.

Nonhormonal barrier methods are the best options when you would like to continue to breastfeed. These methods include diaphragms, condoms, and spermicides. An IUD device is also deemed safe while breastfeeding.

If you want to use hormonal birth control, you should avoid Progestin-only options, as these may reduce your milk supply.

Natural family planning is an option for those who don't mind keeping track of their cervical mucus, body temperature, and other factors.

Encouraging the Return of Menstruation

Some women may want their menstrual cycles to return for various reasons, such as tracking their fertility or planning for another pregnancy.

  • The herb vitex, or chasteberry, is one option for stimulating and supporting ovulation, which can help bring back the menstrual cycle postpartum. It may work as quickly as within 1 to 3 menstrual cycles.
  • Adequate nutrition is crucial for lactating women. Restricting calories may affect hormonal balance and menstrual cycles.

Common Menstruation Concerns

Is Irregular Bleeding While Breastfeeding Normal?

Yes. A mother's period can be irregular, with some spotting while breastfeeding due to a change in breastfeeding frequency and hormone fluctuations.

Sometimes a decrease in nursing frequency occurs when the baby is ill, teething, has a growth spurt, or if the baby is separated from the mother for a few hours.

Can a Period Disappear and Then Return?

Yes, a mother may get her period a few months after delivery and then have it stop again when she starts to breastfeed more often.

Is Heavy Bleeding While Breastfeeding Normal?

A heavy period might be due to hormonal fluctuations and your body's way of getting things back to normal again, BUT if you have any concerns, please don't hesitate to talk to your doctor or OB-GYN about it.

What If You Are Having Frequent Periods While Breastfeeding?

Is it normal to have two periods in a month after pregnancy?

There is usually a considerable period of time between postpartum bleeding and a woman's first period. Postpartum bleeding is normal and can last a few weeks after giving birth.

An irregular cycle is to be expected, with your period coming sooner or later or not coming at all. Still, if you are having random spotting of more than one period per cycle or constant spotting while breastfeeding, you need to see your doctor about it.

Is Cramping During a Period Worse When Breastfeeding?

Some mothers complain about the extra tenderness of the breasts and nipples during a period while breastfeeding, especially while the baby is feeding.

As mentioned above, spotting and nausea are frequently complained about during the first couple of weeks. This is often due to the hormone Oxytocin, which is responsible for the milk flow (let down). When this hormone is released into your system, it can cause headaches, thirst, nausea, and uterine cramping. Oxytocin causes the uterus to contract, helping it to return to its original size; this contraction, in turn, could also cause spotting during the first few weeks after childbirth.

These symptoms will usually subside once your period has normalized.

Will Menstruation Decrease My Milk Supply?

Breastfeeding doesn't have to end when your period returns. You may notice that your baby is fussier during "that time of the month." Your milk has not turned "sour" or lost its valuable properties. Your baby's fussiness is probably because milk production may drop a little due to hormone fluctuations. This also causes the sodium levels in your milk to rise, making the milk taste saltier than usual (some babies don't like the taste of salty milk).

Your supply will increase as soon as your hormone levels return to what they were before your period. Some babies drink more during a menstrual period to make up for the drop in milk production, but others will drink more after a period to make up for any calorie deficit.

Conclusion

There is a broad range of normal regarding your periods while breastfeeding. Every woman is different. If you are concerned, see your OB-GYN.

References and Resources

1. Using complete breastfeeding and lactational amenorrhoea as birth spacing methods


Header photo by Paul Hanaoka on Unsplash