What to do about Postpartum Hair Loss
The dreaded postpartum shed. AKA when your hair falls out in chunks after having a baby and everyone tells you it’s fine.
Let's talk about something that a ton of moms experience in the first year postpartum.
Postpartum hair loss.
You've probably heard that like so many things that happen after baby - it's because of hormones! And it's normal!
And while that’s (kind of) true - it’s still really critical to get the building blocks of hair growth so that the shedding is minimal and regrowth happens quickly! It’s also important to keep an eye out for red flags of deeper issues - depending on the duration, severity, and connection to other symptoms, postpartum hair loss can also be a warning sign of something bigger going on.
What’s happening?
Hair growth goes in phases - the growth phase and the loss phase. Both estrogen and progesterone influence this rhythm, and during pregnancy the high amounts of both of those hormones keep your hair in growth phase and the loss phase is reduced. This means that the normal hair loss rate is significantly slowed during pregnancy. After giving birth (and also losing out on those lusciously high levels of hormones) - your hair will start to play catch up with the extras you held onto during pregnancy.
What’s normal?
Hair loss that starts around 4 to 6 months postpartum
The loss peaks after about 2 months of shedding, then slows down to pre-pregnancy rates (loss of about 100 hairs per day is typical/ normal. Please don't count them).
Hair shedding mostly toward the front of the head.
Feeling like LOADS of hair is coming out, especially in the shower or after brushing.
Regrowth of tiny baby hairs and sudden appearance of bangs you don’t remember cutting. Some people are more annoyed with the regrowth than the shedding!
What’s NOT normal?
Prolonged severe hair loss that does not peak and then slow after the first 3 months.
Losing hair elsewhere on your body - like eyebrows.
Hair coming out in super big chunks from a particular area (it should be more diffuse throughout scalp).
Visible bald spots.
Lots of breakage and splitting happening at the same time.
So like most things, some is fine - more is not.
Let’s look at some reasons why you might be experiencing an abnormal amount of shedding, and some red flags to head to the doctor.
Thyroid issues
Postpartum thyroid issues happen in over 10% of new moms, and can definitely exacerbate the postpartum shed. If the hair loss comes along with intense fatigue, constipation, dry skin, feeling cold all the time, and heavy periods - go get that thyroid checked out. Another telling sign of a thyroid problem is that the hair loss is not just confined to your scalp, but you are losing eyebrow hair on the outer third of your brow.
Iron deficiency
This is the most common cause of hair loss that I see. Iron deficiency and anemia can lead to significant hair loss. So if that hair loss is continuing past 1 year postpartum and coming with other symptoms like fatigue, depression, pale skin, dizziness, difficulty concentrating - let’s get an iron panel. Really important to note that typically only a CBC is offered to rule out iron issues, but I’ve seen a normal CBC many many times with symptomatic iron issues. Always ask for a full iron panel with ferritin, which can be extremely low before a CBC starts to dip. Aim for a ferritin of at least 50.
C-word
Rapid hair loss following a viral infection like the big C is increasingly common, and this happened to me last year. I’m not sure that a cause has been determined - but my guess is inflammation and physiological stress from immune system activation. Post viral hair loss is actually quite common, but anecdotally we’re seeing reports of C19 hitting the hair follicles particularly hard. Aside from avoiding getting sick, there’s not much to do in the way of prevention here - but just like postpartum hair loss we want to make sure the building blocks of hair are available for regrowth.
Stress
I know. Annoying. Stress, both mental-emotional stress and physiological stress can cause something called telogen effluvian. High levels of the stress hormone interrupt the growth phase and change the normal rhythm of hair growth: hair loss. Typically we don’t start to see excessive shedding until about 3 months after a big stressful event.
what to do
First step is to make sure you're getting the building blocks of hair growth. Protein - around 100g per day is a good ballpark - is absolutely critical to hair growth. Many cases of inadequate regrowth in my practice is massively improved by upping the protein intake. Supplementing with collagen can help as well - though collagen doesn’t have a full profile of amino acids compared to other sources, so this shouldn’t make up more than about 10% of total protein intake. For hair quality, including strength and resistance to breakage, eating enough healthy fats like fish, avocado, nuts and flax. Consider supplementing with a fish oil as well!
Get checked. When in doubt, test don’t guess. Start with a full thyroid panel and full iron panel. Consider functional testing like cortisol and comprehensive nutrient panels - these are offered inside Mother Recover.
Get enough zinc - another deficiency linked to hair loss and depleted by the birth control pill, pregnancy and breastfeeding. Zinc deficiency is so common in new moms, and if there are any gut health issues that can make it worse. Zinc is found mostly in animal products like meat
B12 is needed for hair growth as well, and is only found in animal products like egg yolks and meat. A lot of people have issues absorbing this nutrient, so supplementation is sometimes necessary.
Biotin might not be your issue. Although this B vitamin biotin is often toted as a great nutrient for hair, clinically we only see this if there is a pre-existing deficiency which for this vitamin is less common. It can't hurt to eat more biotin sources like eggs, nuts, seeds and avocados though! You'll also get a hefty dose of many of the above nutrients.
Lots of things to consider beyond the "just wait it out!" advice you may have heard already. And you can probably understand why replenishing lost nutrients is one of the flagship courses inside the Mother Recover program!
Tell me, are you experiencing this now? Or how was your experience if you've made it through to the other side?
