Hello Lactnetters,

I am working with a third time 
nursing mother mother
 who definitely is experiencing 
something beyond the range 
of normal postpartum alopecia.

This mom experienced an episode 
of alopecia at 16,
in which she lost a patch of hair 
about the size of a quarter.

 She was treated with cortisone injections. 
The hair regrew but a significant 
portion of it was white.

At 23 she lost another patch of hair 
about twice the size in the same place.
This time she did not seek treatment
 and the hair came back within a few months.

At age 27, 
4-6 months after her first child was born
 she lost hair from the same spot only bigger.

She went to see a dermatologist 
who suggested cortisone injections.
She opted not to take the cortisone injections
because she was told it would require her to wean 
her baby.

The hair grew back 4 months later.

At age 29 she had her second child. 
When he was about 6 months old 
her dermatologist told her to wean,
but she nursed him until he was 10 months old.

She lost most all of her hair and had to wear a wig.
The hair that did come back came back white, 
and not all of it came back.

She is 31 now and nursing her 2 month old.
In addition to the diffuse postpartum alopecia 
the area of her scalp where her hair never regrew
 after baby number 2 
is enlarging considerably 
and she is afraid she is going 
to have to wear a wig again.

It seems to me that her dermatologist is treating 
her as if all she has is normal postpartum alopecia. 
And even that he seems not to understand very well,
because he has advised weaning as a treatment.

I am having trouble understanding this advice 
because while estrogen might help hairs regrow
it will not stop hairs put into the telogen phase by pregnancy from falling out...
at least that's my understanding...or I am I missing something?

And weaning doesn't address the alopecia that is not diffuse but localized,
or am I mistaken?

Because her hairloss was so global last time,
and could be this time,
I was wondering if she is still a candidate for steriod injections?

If the mom has estrogen levels considerably
lower than the average nursing mother
could she take low dose estrogen replacement
to help the hair regrow?

Shouldn't she be offered the same sorts of tests
a woman who wasn't breastfeeding would be offered?

No one has tested her thyroid,
or mentioned zinc deficiency
or an autoimmune disorder
which may go into remission when she's
pregnant, only to come back not because
she's breastfeeding but because 
she's not pregnant anymore....

This mom is so brave.
Losing all her hair last time
was so traumatic for her,
and because she was told the hairloss
was caused by breastfeeding she had decided
not to breastfeed this time.
But she couldn't bear not nursing her daughter
once she was born.

Any ideas for treatments that would help this mom
continue to breastfeed and keep more of her hair?

Jen O'Quinn IBCLC

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