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postpartum fatigue

Kate Purvis

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Postpartum Fatigue

Postpartum Fatigue

*This blog is for educational purposes only. None of the information below is medical advice. Consult with your doctor if you have any concerns and before taking any supplement, herb, or homeopathic remedy.

Being tired as a mom is an absolute given. Between changes to routine, interrupted sleep, and caring for a baby (and any siblings), postpartum fatigue is expected. But, there are things that you can do to optimize what little energy you do have. You don’t have to do all of these things, but add one or two and see if you feel a tiny bit better as you’re changing your millionth diaper.

The very first thing to do to manage postpartum fatigue is take care of any medical concerns. While there are many medical concerns leading to excess postpartum fatigue, two of the more common concerns are anemia and postpartum thyroiditis.

Unfortunately, screening for anemia is not routine delivery, but it probably should be because it is fairly common. Studies have found postpartum anemia to be around 22-29%, but as high as 60% in certain populations such as those who had an instrumental delivery (forceps, vacuum) [1]. Usually taking your prenatal vitamins with iron is enough to restore your iron within a few weeks of delivery, but many women skip their prenatals after giving birth, or their prenatals do not have enough iron to replenish stores. Symptoms of anemia include fatigue, exercise intolerance and mood changes [2]. Huh, know any moms with those symptoms? Because those symptoms can be “normal” or have other causes, it might be worth asking your doctor to run a CBC and iron panel.

Postpartum thyroiditis is also a concern and may contribute to excess fatigue postpartum. Again, doctors don’t routinely screen for thyroid dysfunction postpartum. Postpartum thyroiditis can present in a few different ways. It can present as too much thyroid hormone (hyperthyroidism), too little thyroid hormone (hypothyroidism) or a period of hyperthyroidism followed by a period of hypothyroidism. The prevalence of postpartum thyroiditis ranges from 1-17% and is higher in women with type 1 diabetes, a previous history of postpartum thyroiditis, and women with positive anti-TPO antibodies during pregnancy.

Most women return to normal thyroid status within 1 year postpartum, but many never recover from the hypothyroid phase. Furthermore, about 20-40% of women who do recover develop permanent hypothyroidism within 3-12 years. There are numerous symptoms of thyroiditis and you may not have all of them! The symptoms of the hyperthyroid phase (too much thyroid hormone) are fatigue, weight loss, palpitations, heat intolerance, anxiety, irritability, heart palpitations and tremor. Hypothyroid (too little thyroid hormone) symptoms include fatigue, cold intolerance, constipation, sluggishness, and dry skin. Another symptom of thyroid function that you often don’t see discussed is issues with milk supply (both over and under supply) Many doctors are unaware of how thyroid function affects milk supply. So, if you are tired and have issues with milk supply, ask your doctor to run a thyroid panel including antibodies. If you have positive anti-TPO antibodies, selenium supplementation may help stop the progression to postpartum thyroiditis. [3-6]

Okay, now that we have a couple of the more common medical concerns out of the way. Let’s address some ways that you can boost your energy level postpartum and beyond!

Nutrition:
Make sure to eat nutrient dense foods regularly. Big swings in blood sugar can affect your energy, cognitive function, and mood. Both blood sugar spikes and lows can contribute to fatigue. [7] Making sure that you’re including healthy fats, protein, and fiber in each meal will help with consistent energy throughout the day. That is tough to do as a mom especially in that postpartum period. Having prepped snacks and meals can help. I also recommend having a snack basket with easy to grab snacks such as pre-cut fruit and vegetables, nut butter, nuts, seeds and meat sticks. That can help when the hunger strikes while feeding or during night wakes. If you are breastfeeding or pumping, you may find that you have increased hunger.

Hydration:
Even just slightly suboptimal hydration will affect your energy. Don’t just chug the water, though. Overhydration can cause electrolyte imbalances which can decrease subjective energy levels and even decrease milk supply if you’re nursing/pumping [8,9]. The addition of electrolytes to your water will help maintain hydration status and contribute to a number of bodily functions that lead to a subjective feeling of having more energy such as regulating energy metabolism and muscle contraction [10]. They can also lead to more restful sleep (when you are able to actually sleep).

Exposure to sunlight:
One of my favorite tricks for tired moms (and their babies) is exposure to morning sunlight. Within the first 30-60 minutes of waking, try to get outside. The exposure to morning light will help your energy levels throughout the day [11]. As a bonus, exposure to morning sunlight will promote the development of your baby’s circadian rhythm which can lead to more restful sleep for both of you [12].

Movement:
I know, I know, exercise has fallen far down on the priority list. You don’t have to do an hour long workout (especially if you are newly postpartum), but going out for a walk or doing a short postpartum yoga flow can help your energy. Just making a priority to intentionally move even as little as 10 minutes a day to start can help energy levels [13]. From there, you can increase the amount of exercise slowly or do short bursts of movement throughout the day. Not only will this help with energy levels, but it will help regulate blood sugar and cognitive function (mom brain, anyone?)[14]

Hydrotherapy:
Everyone seems to be doing cold bathing these days for a reason! I know this sounds miserable especially when you’re tired but using cold water therapy can help with subjective energy levels. The trick to doing this postpartum, is taking it slow and not using extreme temperatures. To start, end your shower on 30 seconds of cool and see how this helps your energy levels and potentially your mood throughout the day [15,16]. You can increase the length of time and decrease the temperature used from there.

Meditate:
Meditation has been found to enhance cognitive abilities, subjective energy levels, and mood[17]. Does starting a meditation practice sound too daunting? Taking a few intentional slow deep breaths throughout the day can also give you a boost of energy. Deep breaths allow fresh oxygen and nutrients to be distributed to your cells improving subjective energy levels. It can be helpful to set a reminder to take a few deep breaths. Maybe every time you feed your baby, you do a quick breathing exercise. If you are pumping or breastfeeding, that may even support your milk supply.

Supplements and herbs (check with your doctor before starting any supplements or herbs):

There are some supplements that can help with energy levels. I mention some supplements that might help below but check with your naturopath for supplements related to your individual situation.

As mentioned above, continue to take your prenatal vitamin after delivery. That can help restore iron levels and fill in any nutritional gaps. Omega-3 deficiencies have been linked to inflammatory states and increased fatigue [18]. If you are unable to get appropriate omega-3 fatty acids through your diet, the addition of a fish oil supplement may help. Vitamin D deficiency is common and commonly linked to increased perceived fatigue [19]. Taking a vitamin D3 supplement may help, but check with your doctor and have labs run because too much vitamin D can be harmful. You might be more at risk for vitamin D deficiency if you are breastfeeding [20]. Probiotics might also be helpful. Probiotics can decrease systemic inflammation, decrease oxidative stress, and improve nutritional status all of which may improve energy levels [21]. If you are breastfeeding, choose a probiotic with L. salivarius as it may prevent mastitis [22].

I like using adaptogens to support postpartum women. Adaptogens are herbs that support your body maintain balance. Adaptogens are generally gently and help support you during times of stress. Thus, they can be very beneficial to support postpartum energy levels. It will typically take time to feel increased energy when taking an adaptogen. There are many adaptogens that might be helpful for postpartumfatigue, and I have mentioned a few of my favorites to use with tired moms.

Shatavari (Asparagus racemosus) is an adaptogen that promotes physical and mental health. It can help with energy levels. It also protects against a variety of stressors and has anti-depressant activity. It is a nutritive tonic which is very much needed during a time where many women feel depleted [23]. Ashwaghanda (Withania somnifera) is another adaptogen commonly used during the postpartum time. It is great for nervous exhaustion and brain fog especially during times of chronic stress [24]. Traditionally, it has also been used as a galactagogue. Eleuthero (Eleuthrerococcus senticosus) is an adaptogen used to help with fatigue during times of chronic stress. It also helps our body adapt to stressful situations. There have also been reports of Eleuthro improving mood [25]. Some people can find Eleuthro stimulating, so it should be taken in the morning and early afternoon.

My favorite way to support energy levels in mothers is with homeopathy. Homeopathy stimulates the body to heal and supports the whole person. So it will help not just with fatigue, but with the entire person. Because homeopathy is based on an individual’s symptoms, contact a practitioner to find the best remedy for you. While there are hundreds of homeopathic remedies, two of the most commonly used remedies postpartum are Sepia and Pulsatilla. Women that react well to Sepia may have a sinking or faint feeling accompanying their fatigue. If they have a prolapse following delivery, they may have a pressure or bearing down sensation. Their fatigue may be better from intense exercise. They may be sad and weepy, but not want to be comforted and might resent their partner. Women who react well to Pulsatilla may also be sad and weepy, but they want people around them, and they want to be comforted. Their fatigue is generally worse in the heat, and they feel much better with slow, gentle movement especially in open air.

While postpartum fatigue may feel inevitable as a mom, there are ways to support your energy levels. If I can support you on your journey, please reach out or schedule a consult at wholehealthbaby.com.

All supplements, herbs, and homeopathy mentioned here are available at a discount in my Fullscript dispensary if you are in the US or Canada.
https://us.fullscript.com/protocols/wholehealthbaby-postpartum-fatigue

Sources:

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Whole Health Baby offers a variety of postpartum health tools to assist you. If you are based in the United States virtual appointments are available. If you live in the Quinta do Lago or Loulé area and would like to learn more about the innovative programs Dr. Kate Purvis, ND, has to offer, please email info@wholehealthbaby.com