Postpartum for Beginners After 6 Months: What to Expect and How to Thrive
Six months after birth, many new moms are moving out of the intense “fourth trimester” and into a new, steadier season. Your body has done something extraordinary. Now, you deserve clear, practical guidance to feel well, protect your mental health, and keep up your strength as your baby grows. This guide walks you through what’s typical at 6–12 months postpartum, what to watch for, and step-by-step tips you can start today.
Your body at 6–12 months: what’s normal, what’s not
Energy and healing: Most people feel more physically “themselves” by 6–12 months, though core strength and pelvic support can still be rebuilding. If you had a cesarean, the scar continues remodeling for up to a year and may feel tight or numb; gentle massage and progressive strengthening help. See your clinician if pain limits daily activity or exercise. (ACOG)
Bleeding and periods: Lochia (post-birth bleeding) is long gone by now. Menstruation often returns between 6–12 months—even if you breastfeed—especially after solids are introduced. Once your period resumes, fertility can return before the first period, so use contraception if you wish to avoid pregnancy. The lactational amenorrhea method is generally no longer reliable after 6 months or once menstruation returns. (ACOG)
Hair and skin: Postpartum hair shedding usually peaks by 4–6 months and then improves. Persistent shedding with fatigue, anxiety, weight changes, or palpitations may signal thyroid changes common in the first postpartum year—ask your clinician about testing. (American Thyroid Association)
Contraception and family planning
By six months, most methods are safe to use whether or not you are breastfeeding. Highly effective options include IUDs (copper or hormonal) and the implant. Pills, patch, ring, and shots are also options; some people prefer progestin-only methods while breastfeeding. If you are considering estrogen-containing methods (combined pills, patch, ring), discuss milk supply and any personal risk factors with your clinician. (ACOG; CDC US MEC)
Step-by-step to choose a method now: 1) Decide your goal: avoid pregnancy for years, for a few months, space pregnancies, or trying soon. 2) Consider what matters most: effectiveness, hormones vs. non-hormonal, on-demand vs. “set-and-forget,” bleeding changes. 3) Review options with your clinician using the CDC Medical Eligibility Criteria to match your health history. 4) Make a follow-up plan in 1–3 months to reassess comfort, cycles, and side effects. (CDC)
Pelvic floor and core: rebuild your foundation
Leaking urine with cough/sneeze, heaviness in the pelvis, or core “doming” can persist at 6 months but should be improving. Pelvic floor muscle training is proven to reduce postpartum leakage and improve support. A pelvic floor physical therapist can tailor a plan, especially if you notice pressure, bulge, pain, or persistent diastasis recti. (Cochrane Review)
How to do effective pelvic floor squeezes (Kegels): 1) Exhale gently and imagine stopping gas and urine at the same time—lift and squeeze around the vagina and anus. 2) Hold 5 seconds, then fully relax 5 seconds. Build to 8–12 holds. 3) Add 8–12 quick squeezes. 4) Do 3 sets daily. Progress by practicing during daily tasks (lifting, coughing). If you can’t feel the lift or have pain, see a pelvic floor PT. (NHS)
Returning to fitness: Aim for 150 minutes per week of moderate activity plus two days of strength work when cleared and comfortable. Start with low-impact cardio, walking hills, cycling, and progressive core and hip strength; add impact (running, HIIT) only when leakage, pain, and heaviness are resolved in daily life and during brisk walking/jog intervals. (ACOG)
Feeding your baby—and yourself—after 6 months
Breastfeeding beyond 6 months: Many families continue nursing while introducing solids. This is normal and beneficial; the American Academy of Pediatrics supports continued breastfeeding with complementary foods for 1–2 years and beyond as desired. Expect patterns to change as solids increase. If you develop a firm, tender area on the breast with fever or flu-like symptoms, act quickly with effective milk removal, NSAIDs, and cold packs; seek care if not improving within 24–48 hours. (AAP; ABM Mastitis Protocol)
Pumping at work or on the go: 1) Aim to pump roughly every 3–4 hours apart from direct feeds. 2) Store milk safely: room temp up to 4 hours, refrigerator up to 4 days, freezer ideally up to 6 months (12 months acceptable). Label dates. 3) Offer paced bottle feeds to align with baby’s appetite and protect supply. (CDC)
Weaning, if and when you’re ready: 1) Drop one feeding or pumping session every 3–7 days. 2) Hand express just enough for comfort if engorged; use cold packs and NSAIDs. 3) Watch for plugged ducts or mastitis; slow down if needed. 4) Expect emotions—hormonal shifts are common; seek support if mood symptoms persist. (ABM)
Your nutrition: While breastfeeding, most need an extra ~330–400 kcal/day and more fluids in response to thirst. Prioritize protein, whole grains, fruits/vegetables, and healthy fats. Key nutrients include iodine (290 mcg/day), choline (450–550 mg/day), iron (especially if your period is back), calcium (1,000 mg/day), and omega‑3s (DHA). Many continue a prenatal vitamin while breastfeeding; discuss any supplements with your clinician. Exclusively breastfed infants need 400 IU/day vitamin D. (Dietary Guidelines for Americans; NIH ODS: Iodine; NIH ODS: Choline; AAP)
Sex, intimacy, and pelvic comfort
Desire and comfort vary widely at 6–12 months. Vaginal dryness is common—especially with breastfeeding—so use generous, pH‑friendly lubrication and extended arousal/foreplay. Persistent pain with penetration or pelvic floor spasm merits evaluation; pelvic floor PT and, when appropriate, low-dose vaginal estrogen may be considered and are generally compatible with breastfeeding. Always confirm with your clinician. (ACOG; LactMed: Estradiol)
Mental health and sleep
Postpartum depression and anxiety can emerge anytime in the first year—not only right after birth. Red flags include sadness, irritability, loss of interest, intrusive worries, panic, sleep disruption beyond baby’s needs, or thoughts of self-harm. These conditions are common and treatable. Screening and treatment with therapy, peer support, and when needed medication are recommended; many medications are compatible with breastfeeding. If you ever have thoughts of harming yourself or your baby, seek urgent help. In the U.S., call or text 988; otherwise, contact your local emergency number. (ACOG)
Better sleep, realistically: 1) Keep baby’s first stretch aligned with your bedtime. 2) Share night duties when possible; split shifts with a partner. 3) Protect a 20–30 minute daytime rest when nights are rough. 4) Dim lights and screens an hour before bed; try a brief wind‑down routine (stretching, breathing). Even modest sleep gains help mood and milk supply.
Common aches and pains—and what to do
Back, hips, and ribs: Progress core and glute strength; vary carry positions; bring baby close to your body for lifting. If pain persists or radiates, seek PT.
Wrist/thumb pain (De Quervain’s): Keep wrists neutral when lifting baby, use forearms for support, consider a thumb spica brace, ice 10–15 minutes, and adjust feeding holds. Seek care if pain limits daily tasks.
Cesarean scar tightness: 5 minutes daily of gentle scar massage (circles, side-to-side skin rolling) once the scar is fully closed and comfortable, plus deep breathing and trunk mobility, can improve comfort. Ask for PT guidance if sensitive or stuck.
Health maintenance and check-ins
Vaccines: Stay current with seasonal influenza and COVID-19 boosters; if you were non‑immune during pregnancy, MMR and varicella are recommended postpartum. HPV vaccination is appropriate if you’re age‑eligible and not fully vaccinated. These are all compatible with breastfeeding. (CDC)
Thyroid and anemia: If you have fatigue, hair loss, mood changes, feeling too cold or hot, palpitations, or heavy periods, ask about checking thyroid function and iron stores—both can shift in the first postpartum year. (American Thyroid Association)
Dental and pelvic care: Schedule routine dental care and, if available, a pelvic floor PT assessment around this stage—especially if you have leakage, prolapse symptoms, or pain.
When to seek care now
Contact your clinician promptly if you notice any of the following: worsening depression or anxiety, intrusive thoughts, thoughts of self-harm; breast redness with fever that isn’t improving after 24–48 hours; new or worsening urinary or fecal incontinence; pelvic pressure or a bulge; persistent pain with sex; very heavy or prolonged periods; severe headaches, chest pain, calf swelling, or shortness of breath. Trust your instincts—if something feels off, you deserve evaluation. (ACOG; ABM)
A gentle weekly reset you can start today
Physical: Do 3 sessions of 20–30 minutes of moderate movement and 2 short strength sessions. Add daily pelvic floor practice and one focused core/glute circuit.
Mental: Plan two short “you-time” blocks (even 15 minutes)—a walk, call a friend, journaling, or a nap. If mood symptoms are present, schedule an appointment and connect with support like Postpartum Support International. (Postpartum Support International)
Logistics: Review feeding/pumping/weaning plans for the week, prepare simple nutrient-dense snacks, and set up your sleep routine cues. If using contraception, set reminders or schedule an insertion/renewal visit.
Most of all, be kind to yourself. Healing is not linear, and needing support is normal. Small, consistent steps—protecting your sleep where possible, nourishing your body, rebuilding your core and pelvic floor, and tending to your mental health—add up. You’ve done something remarkable; your ongoing care matters just as much.