The process of weaning involves hormonal, psychological, social, and physical changes.

By Cassie Shortsleeve
June 08, 2020
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Last month, one random morning while breastfeeding my 11-month-old daughter Sunday, she bit down (and laughed) then tried to latch back on. It was an unexpected snag in an otherwise smooth breastfeeding journey, but after some bleeding (ugh), a prescription antibiotic ointment, and shedding some tears, I decided it was also the end.

Not only did I beat myself up—I didn't make it to the (albeit self-imposed) one-year marker that I had set—but within days, those teary, dark moments that had been with me in the early postpartum period crept back up. I could almost feel my hormones changing.

If you just had a baby (or have new mom friends), you're likely aware of some of the mood changes that can accompany new parenthood, namely the "baby blues" (which impact some 80 percent of women in the weeks following delivery) and perinatal mood and anxiety disorders (PMADs), which impact some 1 in 7, according to Postpartum Support International. But mood issues related to weaning—or transitioning your baby from breastfeeding to formula or food—are less talked about.

In part, that's because they're less common than PMADs, such as postpartum depression. And not everyone experiences them. "All transitions in parenthood can be bittersweet and there is a wide array of experiences associated with weaning," explains Samantha Meltzer-Brody, M.D., M.P.H., director of the UNC Center for Women's Mood Disorders and a principal investigator in the Mom Genes Fight PPD research study on postpartum depression. "Some women find breastfeeding very satisfying and do experience emotional difficulty at the time of weaning," she says. "Other women do not experience emotional difficulty or they find weaning to be a relief." (See also: Serena Williams Opens Up About Her Difficult Decision to Stop Breastfeeding)

But mood changes related to weaning (and *everything* breastfeeding, TBH) make sense. After all, there are hormonal, social, physical, and psychological changes that take place when you stop nursing. If symptoms crop up, they can also be surprising, confusing, and occur at a time when you may have *just* thought that you were out of the woods with any postpartum woes.

Here, what's going on in your body and how to ease the transition for you.

The Physiological Effects of Breastfeeding

"There are basically three stages of hormonal and physiological changes that allow women to produce breastmilk," explains Lauren M. Osborne, M.D., assistant director of the Women's Mood Disorders Center at The Johns Hopkins University School of Medicine. (Related: Exactly How Your Hormone Levels Change During Pregnancy)

The first stage happens in the second half of pregnancy when the mammary glands in your breasts (which are responsible for lactation) begin to produce small amounts of milk. While you're pregnant, super high levels of a hormone called progesterone produced by the placenta inhibit the secretion of said milk. After delivery, when the placenta is removed, progesterone levels plummet and levels of three other hormones—prolactin, cortisol, and insulin—rise, stimulating milk secretion, she says. Then, as your baby eats, the stimulation on your nipples triggers the release of the hormones prolactin and oxytocin, explains Dr. Osborne.

"Prolactin brings a feeling of relaxation and calmness to mom and baby and oxytocin—known as 'the love hormone'—helps with attachment and connection," adds Robyn Alagona Cutler, a licensed marriage, and family therapist who specializes in perinatal mental health.

Of course, the feel-good effects of breastfeeding are not just physical. Nursing is an extremely emotional act in which attachment, connection, and bonding can be cultivated, says Alagona Cutler. It's an intimate act where you're likely snuggled up, skin-to-skin, making eye contact. (Related: The Perks and Health Benefits of Breastfeeding)

So What Happens When You Wean?

In short: Lots. Let's start with the non-hormonal. "Like all transitions in parenting, many people feel the bitter-sweet push and pull of the ending," says Alagona Cutler. There is a whole slew of reasons why you might stop breastfeeding: It just isn't working anymore, you're going back to work, pumping is getting tiring (as was the case for Hilary Duff), you simply feel as though it's time, the list goes on.

And although hormones certainly play a role in emotions (more on that soon), at the time of weaning, many parents experience a whole array of emotions (sadness! relief! guilt!) for many other reasons, too. For example, you might be sad that a "stage" of your baby's life has passed, you might miss the intimate one-on-one time, or you might beat yourself up for not hitting a self-imposed "goal time" for breastfeeding (guilty👋🏻). "Mothers need to know that those feelings are real and valid and they need to be acknowledged and have a place to be heard and supported," says Alagona Cutler. (Related: Alison Désir On the Expectations of Pregnancy and New Motherhood Vs. Reality)

Now for the hormones: First, breastfeeding tends to suppress your menstrual cycle, which comes with fluctuations of estrogen and progesterone, explains Dr. Osborne. When you breastfeed, levels of both estrogen and progesterone stay very low, and, in turn, you don't experience the same ups and downs of hormones that happen naturally when you're getting your period. But when you begin to wean "you start to have fluctuations of estrogen and progesterone again, and for some women who are vulnerable to those fluctuations, the time of weaning can be a time that they experience those mood fluctuations," she explains. (FWIW, pros are not positive what makes someone more vulnerable than others. It could be genetic or could be that you're just really in tune with your body.)

Levels of oxytocin (that feel-good hormone) and prolactin also sink as estrogen and progesterone to begin to rise. And a drop in oxytocin could negatively affect the way women respond to stress, says Alison Stuebe, M.D., an assistant professor for the division of maternal-fetal medicine at the UNC School of Medicine.

While there's not a whole lot of research in this area—more is clearly needed—Dr. Osborne believes that mood fluctuations linked to weaning likely have less to do with that drop in oxytocin and more to do with a return in those fluctuations of estrogen and progesterone. In part, that's because she says there's a lot of data around a metabolite or byproduct of progesterone called allopregnanolone, which is known for its calming, anti-anxiety effect. If allopregnanolone is low while you're breastfeeding then starts to come back when you wean, there might not be as many receptors for it to bind to (since your body hasn't needed them). Low levels paired with this dysregulation of receptors could be "double whammy" for mood, says Dr. Osborne.

How to Ease the Weaning Adjustment

The good news is that most mood symptoms related to weaning usually resolve after a couple of weeks, says Alagona Cutler. However, some women do experience more persistent mood or anxiety issues and need support (therapy, medication) to navigate them. And while there's no concrete scientific advice on the best ways to wean, abrupt changes can trigger sudden hormonal shifts, says Dr. Osborne. So—if you're able—try to wean as gradually as possible.

Know that you're vulnerable to hormonally-mediated mood symptoms? Your best bet is to make sure that you have a perinatal psychologist, psychiatrist, or therapist lined up who you can turn to and a solid amount of social support to help you through the transition.

And remember: Any reason is a good one to seek help and support if you need it—especially in new parenthood.

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