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It is no secret that motherhood is challenging and one of those challenges is lack of sleep and feeling tired. Let me say first, being tired every so often is normal, especially in those very early days postpartum 2-4 weeks. However if you are feeling more tired than not, it is time to take a step back and look at why. We often tout about being “busy” and being “exhausted” in motherhood as if it is a badge of honor and just the way things are or should be. I know I have been there before! But is that really how we want to feel on our motherhood journey?
If you are feeling exhausted these are some of the reasons why that might be so. Know that there is a way to move past feeling exhausted and to have more energy. It is important to evaluate where you are at and see what things you can change. Keep in mind that some of the reasons are medical so make sure you are not gaslighting yourself with thinking that “fatigue and exhaustion” go hand in hand with mom life.
1. Lack of sleep is exhausting
It is recommended that adults get between 7-9 hours of sleep each night. As a new mom that may feel impossibly far away. Does that mean your only solution is sleep training or you are doomed to live in exhaustion purgatory?
Simply put, no!
Although consolidated sleep is ideal there are studies that show the benefit of napping during the day, some of those benefits include better memory. Studies that show that segmented sleep is not as effective as consolidated sleep had those attempting to split sleep up throughout the day in an overall attempt to get less total sleep in 24 hours. Keep in mind these studies were not performed on postpartum women.
So go ahead and eye roll if you must but I am going to say it anyway. Sleep when baby sleeps, yes as you are able to during your postpartum recovery, it will serve you well to try and rest throughout the day as baby naps. This recommendation is often met with so much animosity, and I get it, it seems our “to do list” is never ending but if you are feeling exhausted it is time to see what can be adjusted and I will address some of this as we move down the list.
If it feels like you are too far off from getting a good night’s sleep and you find it difficult to sleep when baby sleeps know that postpartum fatigue is not fixed with rest and or sleep alone. A 2019 study demonstrates that postpartum fatigue is multifactorial and isn’t easily fixed with sleep alone. This means there are many things at play here and thus many factors that need to be addressed. To me this is a sigh of relief because while I might not have control over the amount of sleep I get postpartum I can gain control in other areas.
Also keep in mind THIS IS TEMPORARY!
2. Expectations Can Perpetuate Your Exhaustion
When we are expecting to get close to a full night’s sleep and you are far from it nothing can be more frustrating. This can lead to emotional exhaustion. When you are angry or frustrated your body is in a stress state and stress wears on the body.
The truth is that infants sleep is very different than adults sleep; and this is for biological reasons. When we start to wrap our heads around what is biologically normal (and no it is not a 12 hour night) it can be very freeing. We can feel a little sense of peace. We feel like less of a failure, more compassionate towards our little ones and more likely to change and adjust what we actually can.
Of course there may be reasons your baby is not sleeping such as sleep apnea which occurs in less than 5% of full term babies but is more common when premature. Address sleep concerns with your pediatrician but if workup comes back with the all clear chances are they are just “sleeping like a baby” and it is your expectations that might need to be adjusted.
Babies sleep varies from 9.5 hours to almost 16 hours a day. This sleep is split up throughout the day, not the amount of night time sleep. It is also important to note that babies sleep is not linear and is constantly changing due to milestone development, teething, illness ect.
Babies wake often throughout the night for several reasons: they are seeking contact with their caregiver (we are carrying mammals), breast milk digest quickly, frequent wakes are protective. While you maybe thinking great if breast milk digest quickly I’ll just switch to formula but it’s important to know if that is your reason for switching, there is no evidence that suggest formula use improves maternal sleep. There is however some evidence from James McKenna at University of Notre Dame that parents and babies that co-sleep sleep longer overall even though they are both still waking throughout the night. Grab his book Safe Infant Sleep to find out more. The Gentle Sleep Book is another good resource on what normal baby sleep looks like if you need help resetting expectations.
3. You need to take time to recover from childbirth
Whether you had a vaginal or cesarean delivery your body needs time to heal. When our bodies are healing they use more energy and can feel more tired. If you had a cesarean birth it is a major surgery with multiple layers of sutures and thus multiple layers of healing that needs to occur. If you had a vaginal delivery labor and pushing is very taxing on the whole body, I was surprised how sore my arms where after I had my daughter. Now if you were like me with my first and got to push but still ended up with a cesarean, then you are recovering from both.
Regardless of delivery method, you need time to heal your pelvic floor but there will also be mental and emotional healing and adjusting as well. You are thrown into a brand new identity and that can take some adjusting. If you are looking for a well rounded and whole person program for healing check out The Postpartum Revolution (TM)
4. Speaking of re-identifying yourself; you are adjusting to a brand new role.
Congratulations you were promoted to a brand new role! You are in overdrive learning something new every minute of every day. Learning how to read and communicate with this brand new baby, learning their various different crys, how they like to be held, how to keep them comfortable, how to feed them and a million and 1 other new things. Think about when you are starting a new job and going over all the new procedures, how tired you are at the end of those first few orientation days.
The more you are using your brain and learning the more glucose your brain is using, taking it from the bloodstream and other parts of your body and well making you feel extremely exhausted.
Now this is something you can’t change but rather be aware of. Give yourself grace in those very early days and make sure you are eating enough.
5. Your Brain is Hypervigilant
Your brain changes postpartum and those changes may contribute to some of your exhaustion. Your amygdala increases in size postpartum. You become more aware and alert of the potential needs of your baby as well as potential threats. This heightened state can lead to a state of anxiety. As we become anxious our sympathetic nervous system prepares for fight or flight and our body is flooded with hormones and neurotransmitters. This process can be draining. Mother’s brains are more responsive postpartum in particular to their babies hunger cries. Being in a constant state of high alert can make you feel more fatigued.
Learning skills to calm your nervous system and keep you present can help. Skills to practice are deep breathing and meditation.
6. Self doubt and mind clutter can be exhausting
In a culture where it seems like a mother can never do the right thing (enter the mommy wars on the decision to work or stay home) and a “good mother” seems down right unachievable it is no wonder you have self doubt and mind clutter. You are trained to constantly second guess yourself. Note, you do not need to stay here.
When you don’t trust yourself you can spend too much time trying to prove yourself right (or wrong.) You run through multiple scenarios in your head and then second guess every decision. These racing restless thoughts or what is often referred to as the Monkey mind can make it difficult to concentrate and can contribute to fatigue.
Practicing yoga and focusing on reconnecting mind and body can be very helpful for taming the monkey mind, staying more present and thus more focused. The Postpartum Revolution guides you through these skills and helps you ditch the self doubt.
7. Postpartum Depression
Fatigue is one of the most common symptoms of depression and postpartum depression is no different. A study in the Dialogues of Clinical Neuroscience indicates that 75% of people with depression have insomnia. People with depression often have difficulty falling or staying asleep so while you might have the chance for a 3 hour stretch between baby wakes your inability to fall asleep maybe decreasing the stretches you could be getting.
Know that you are not alone. Between 1 in 10 and 1 in 7 new mothers experience PPD and this is thought to be under reported.
While there are several studies that demonstrate how gratitude and positive reframing can help with depression, they do not take the place of conversations with your physician. If you think you may have depression please discuss with your provider.
If you are really struggling call the National Maternal Mental Health hotline if you are in the US 1-833-943-5746 (1-833-9-HELP4MOMS)
8. Postpartum Hormones
It is no secret that your hormones are ALL OVER THE PLACE postpartum! Usually people think of just the female sex hormones estrogen and progesterone as being affected but our testosterone and cortisol can all shift leading to fatigue.
Thyroid hormones are affected as well. 5-10% of postpartum women will have an inflamed thyroid causing their hormone levels to be off. Both hyper and hypothyroid (high and low levels) can have symptoms of fatigue. Generally higher levels are found in the first 3 months postpartum with symptoms of fatigue, anxiety, irritability and are often overlooked as just typical postpartum. Lower levels are usually seen later postpartum 4-12 months.
Have your hormone levels checked as treatment would be needed. Most people with postpartum thyroiditis (4 out of 5) will have their condition reversed and be able to come off medications (with the guidance of their physician.) Check out the American Thyroid Association for more info.
9. Breastfeeding is exhausting
Speaking of hormones when you breastfeed your body produces more oxytocin and prolactin which can make you feel relaxed, drowsy and well just plain tired. This isn’t the only reason breastfeeding is exhausting.
Breastfeeding increases your energy needs. My pregnancy hunger and cravings were nothing compared to my breastfeeding hanger. Typically a women needs about 500 more calories a day to breastfeed and an additional litter to litter and a half. If you are not meeting this need you are going to not only be depleted but feel depleted as well.
Anxiety about insufficient milk and breastfeeding challenges may also contribute to fatigue (mind clutter and self doubt.) It is important to get help from a lactation consultant if you have concerns. La Leche is a great resource and most hospitals have lactation support at this time. Some of which is even covered by insurance.
10. You are attempting to Bounce Back
Sorry to disappoint you mama but there is no bounce back. On average it takes 6-12 months to return to pre-baby weight and it could take just as long to start feeling like yourself again.
As previously mentioned your body requires more calories to heal, learn new things and breastfeed so trying to cut calories early on can lead you to be depleted and exhausted. Also your body needs to heal and you need to adjust to your lack of sleep schedule so this is not the time to jump into a new high intensity workout in attempt to lose weight.
I am not saying never get back to exercises you loved but the 6 week all clear is not the green light to a full go with your workout routine. You need time to heal, recover and rebuild and then by all means mama as you are ready get back to what you were doing. IF you started too much too soon this could be a reason you are tired all the time.
Also if you are trying to do “all the things” delicious meals, perfectly clean home, cutely dressed baby, sneaking in some work while on your maternity leave, learning to breastfeed and get your baby to nap. I mean the list could go on and on. Take a pause. Trying to do too much too soon in any and all areas of life postpartum could lead overwhelm and burnout. And burnout is just a state of exhaustion (mental, emotional and physical.)
SO be bold mama say no to bounce back culture. Be brave enough to see what you really need and learn to delegate what and where you can. I know asking for help is hard but it will serve you well postpartum.
11. Decision fatigue is real
As a mom (particularly as a new mom) you are making decisions ALL DAY LONG. Decisions for yourself, your baby and likely your household. Adults make thousands of decisions a day and as your responsibilities increase (hello motherhood) so do the amount of decisions you make.
Remember about speaking up and asking for help? Ask your partner to take on some of the load, split who decides what’s for dinner or have them go to the grocery store for a bit. Simplify where you can, set up a meal rotation or simplify choices of what baby wears.
12. Exhaustion can be caused from anemia
Postpartum anemia is usually anemia due to iron deficiency and can be caused from excessive blood loss during delivery or low iron levels while pregnant. When you are anemic your are insufficient at oxygen distribution throughout the body which can make you feel really tired and affect your wellbeing. The prevalence of postpartum anemia is high 20-55% in the developed world and higher in the developing world.
Talk with your physician about having your levels checked, eat foods high in iron such as dark leafy greens, legumes, nuts, oats and fortified breads, cook on a cast iron skillet and continue with your prenatal vitamins. If your levels come back low your doctor may want you to supplement.
13. Postpartum sleep apnea
Obstructive sleep apnea can develop during pregnancy or early postpartum due to hormone changes and increased abdominal volume limiting muscles of breathing. Signs could be new snoring, difficulty staying asleep or heavy breathing when napping.
Change in sleep position maybe all you need. You can try adding extra pillows or use a wedge. Please note that if you are using extra pillows or a wedge you should not be bedsharing with your baby. For most new mamas sleep apnea will resolve on its own within a few weeks to a few months but always discuss with your healthcare provider.
14. You might be staying in too much
While yes rest is needed and important early on postpartum there is no need to be bed bound and it is ideal to get out of the house for fresh air early and often. Now I am not talking extravagant excursions early on but I am suggesting a 5-10 minute walk or some time seated in the garden or patio. Fresh air can improve your mood, and increase your energy.
Natural light helps your (and your babies) circadian rhythm which can help you feel alert during the day and sleep better at night. Expose yourself to as much natural light as you can during the day and dim lights and avoid blue light at night (especially the hour before bed.)
Fatigue can be a symptom of Vitamin D deficiency and spending a bit of time in the sun can help boost Vitamin D levels. Darker skin, older age and geographical regions may limit the amount of Vitamin D you are able to get from sunshine alone.
15. You may not be moving your body enough
I know, we recently talked about doing too much too soon but that doesn’t mean not doing anything at all. Prolonged rest and inactivity can actually promote fatigue. An object at rest stays at rest is very accurate here. Regular light exercise such as walking is shown to decrease fatigue.
A study published in the British Medical Journal states that bedrest is not a useful tool or suggestion as a treatment of chronic fatigue. And there are many more articles and studies that emphasise the importance of exercise to reduce symptoms of fatigue. Exercise directly acts on the central nervous system to increase energy and improves circulation and oxygen delivery which also directly increases energy and reduces fatigue.
Start with walking and gradually increase the time you are able to spend walking each day. Walking is a safe and effective exercise you can start immediately regardless of delivery method. Make sure before you start more intense exercises that you are cleared by your physician AND that you give your pelvic floor a little TLC first and focus on rehabilitating your pelvic floor and core before jumping back into higher level exercises. If running was your go-to before you are going to want to wait at least 12 weeks before resuming regardless of getting the all clear at 6 weeks. Grab my return to running cheat sheet here to see if you are ready.
16. Older moms are at an increased risk of having postpartum exhaustion
Probably not too surprising here but a British study concluded that maternal age was a risk factor to postpartum fatigue. Older moms were more likely to report increased fatigue at 10 days, 1 month and 3 months postpartum. No similar studies at the moment for complaints of fatigue or exhaustion past the 3 month mark.
Other risk factors seem to be having a higher education level, more partner support but less contact than one would like with their midwife and first time moms.
Now there is nothing that can be changed here but I believe it is important to note and be aware of. I feel this could speak to expectations around early postpartum not matching reality.
17. You are not prioritizing yourself
You might be shouting at me “obviously!” I know our babies tend to take over our world, especially early on, and I get it BUT you still need to take care of yourself. Not prioritizing yourself could look like lack of hygiene, skipping meals, eating junk, lack of boundaries. And this could be contributing to you feeling run down and down right exhausted.
Lack of boundaries can have you saying yes to visitors when you would rather be resting, it can have you taking on more of the workload in the home. Lack of boundaries can lead to resentment, increased stress and burnout.
When you neglect your basic needs a for go a shower for longer than you are comfortable with you can start to feel a bit icky and just run down. Nourishing yourself appropriately means eating when hungry, eating balanced meals with protein, carbs and fats in each meal and plenty of fruits and veggies. While the occasional treat is more than OK you don’t want to be eating a bag of Doritos for lunch every day.
How to feel less exhausted and more energized
We need to stop normalizing exhaustion and fatigue as just a part of mom life or normal postpartum. An older study in The Journal of Obstetrics, Gynecologic and Neonatal nursing demonstrated that long term fatigue at 18 months is associated with poor maternal mental health and delayed infant development but not infant health. Although the study had some limitations, this is not insignificant.
So what can be done? Take note of some of the suggestions and start implementing. Step one is to identify what could be causing your postpartum exhaustion. Rule out any medical reasons with your physician first then continue through the list. To get more information and if you want to stop feeling so exhausted and start feeling more energized (without sleep training) then check out my free training!
