Postpartum guide after 6 months: your next chapter
Six months after birth is a meaningful milestone. Many babies are starting solids, some parents are returning to work or settling into new routines, and your body and mind are still adapting. This guide walks you through what’s normal at this stage, how to care for your physical and mental health, and when to seek help—grounded in evidence and offered with encouragement.
Where you might be at 6 months
By six months, most people find that the most intense healing from birth has passed, yet recovery is still ongoing. Your periods may have returned, sexual health is evolving, sleep can still be fragmented, and breastfeeding or pumping patterns may be changing. It’s also a common time for new issues to surface—like wrist pain from holding your baby, lingering pelvic floor symptoms, or mood changes. Proactive check-ins with yourself and your healthcare team are worthwhile (ACOG, 2018).
Body recovery check-in
Periods, hormones, and fertility
If you’re not exclusively breastfeeding, your period may already have returned; if you are, it might still be absent. Ovulation can happen before the first period, so pregnancy is possible even without menstruation. The lactational amenorrhea method is not considered reliable after 6 months or once you’re supplementing or your period returns (ACOG, Postpartum Birth Control; CDC MEC, 2024).
Pelvic floor and core
Leaking urine with sneezing, a feeling of heaviness, or a visible abdominal “doming” are common but not inevitable. Pelvic floor muscle training can improve or prevent incontinence and support prolapse recovery (Cochrane Review, 2020). A gentle core program that emphasizes breath and deep abdominal activation is safe for most people even months after birth.
Try this 5-minute core and pelvic floor sequence: Step 1: Lie on your back with knees bent and one hand on your lower ribs, one on your lower belly. Inhale through your nose, letting ribs gently expand; exhale and imagine zipping up a low-rise zipper below your belly button while lightly lifting your pelvic floor (the sensation of stopping gas). Step 2: Hold that gentle contraction for 3–5 seconds, then fully release. Step 3: Repeat 8–10 times, breathing steadily. Step 4: Progress by adding heel slides or marching while maintaining the gentle contraction (stop if you notice bulging or pain). Aim for 1–2 sets per day. If you have pain, bulging, or persistent gaps, see a pelvic floor physical therapist.
Scar and musculoskeletal care
After a cesarean or perineal repair, gentle scar mobilization can improve comfort. Step 1: With clean hands, apply a small amount of plain, unscented oil. Step 2: Use 1–2 fingers to make small circles around and then across the scar, staying within pain tolerance for 2–3 minutes a few times per week. Step 3: If you feel pulling, numbness, or pain that limits movement, ask about physical therapy. Wrist/thumb pain (often “mother’s thumb,” De Quervain’s) is common; keep wrists neutral when lifting, use two hands, and consider a soft thumb spica brace. If pain persists, consult your clinician.
Thyroid and hair
Postpartum thyroiditis can appear any time in the first year, causing fatigue, anxiety, palpitations, weight changes, or hair loss. If your hair shedding is severe beyond 6–12 months or you have other symptoms, ask for thyroid testing (NIH NIDDK). Postpartum hair shedding usually starts around 3–4 months and improves by 12 months; gentle hair care and adequate iron and protein can help (American Academy of Dermatology).
Mental health and identity
Postpartum depression and anxiety can begin or persist beyond 6 months. Symptoms include persistent sadness, irritability, intrusive worries, loss of interest, sleep disturbance beyond what baby causes, or feelings of guilt and worthlessness. Help works—therapy, support groups, and when appropriate, medications compatible with breastfeeding (ACOG, 2018).
Do a 5-minute mental health check-in: Step 1: Rate your mood, anxiety, sleep, and pleasure in activities from 0–10. Step 2: Notice any intrusive thoughts or panic symptoms. Step 3: Ask yourself if these are getting better, worse, or staying the same. Step 4: Share your observations with a trusted person. Step 5: If your scores suggest moderate or severe distress, contact your clinician. The Edinburgh Postnatal Depression Scale and PHQ-9 are validated screening tools—ask your provider to administer them or access a reputable online version. If you have thoughts of harming yourself or your baby, seek emergency care or call your local crisis line immediately.
Feeding your baby and your body
Breastfeeding, pumping, and starting solids
At about 6 months, many babies start solids while human milk remains an important source of calories and nutrients (AAP, 2022). Changing feeding patterns can increase the risk of clogged ducts or mastitis. The 2022 Academy of Breastfeeding Medicine guideline recommends rest, adequate milk removal, anti-inflammatory measures, and avoiding deep, forceful breast massage (ABM Protocol #36, 2022).
If you feel a tender lump or have early mastitis symptoms: Step 1: Rest, hydrate, and continue feeding on demand or pumping to comfort without over-emptying. Step 2: Apply cool compresses after feeds for 10–15 minutes. Step 3: Use an anti-inflammatory (like ibuprofen if appropriate for you). Step 4: Gently hand-express only to relieve pressure; avoid aggressive massage or heat. Step 5: Seek care promptly if fever, chills, or worsening pain develop or if symptoms persist beyond 24–48 hours.
Weaning, partial weaning, and comfort
Wean gradually to protect your comfort and your supply decisions. Step 1: Drop one feeding or pumping session every 3–5 days. Step 2: Shorten remaining sessions by a few minutes if you feel full. Step 3: Use cold compresses and a supportive (not tight) bra; consider an anti-inflammatory for discomfort. Step 4: If you develop hard, painful areas, treat as a clog and slow your pace. Step 5: Monitor your mood—hormone shifts during weaning can temporarily affect emotions.
Nutrition, hydration, caffeine, and alcohol
Most breastfeeding people need an extra 330–400 calories per day, prioritizing protein, fiber, and micronutrients. Aim for calcium (1000 mg/day for most adults) and vitamin D (600 IU/day), plus iodine and DHA if breastfeeding; a prenatal or multivitamin can help fill gaps (NIH ODS). Up to about 300 mg of caffeine daily is generally compatible with breastfeeding; monitor your baby for sensitivity (CDC). If you drink alcohol, the safest option is not to drink, but if you choose to, limit to one standard drink and wait at least 2 hours before the next feed; routine pumping and discarding is not required (CDC).
Sex, contraception, and future family planning
Low libido, vaginal dryness, and discomfort can persist at six months due to low estrogen during breastfeeding and fatigue. Generous use of lubricant and a longer, gentler warm-up can help. If dryness or pain persists, discuss low-dose vaginal estrogen; it’s generally considered compatible with breastfeeding, especially after the early postpartum period, though individual counseling is recommended (LactMed; ACOG).
Contraception matters even if you’re breastfeeding. Options that are highly effective and breastfeeding-friendly include copper or hormonal IUDs and the etonogestrel implant. Progestin-only pills and injections are also options. Combined estrogen-containing methods can be used by many breastfeeding people after 6 weeks; after 6 months the impact on milk supply is usually minimal, but discuss your risks and goals (CDC U.S. MEC, 2024; ACOG). For emergency contraception, levonorgestrel pills are compatible with breastfeeding; ulipristal may require temporary interruption per product labeling. A copper IUD is the most effective emergency contraception and can be placed within 5 days (CDC SPR/MEC).
For spacing, most organizations recommend at least 18 months between deliveries to optimize maternal and infant outcomes, though plans should be individualized (ACOG, Interpregnancy Care).
Movement and rebuilding strength
If you feel ready, you can safely progress to moderate-intensity aerobic activity and strength training, adjusting for any symptoms (ACOG, 2020). A simple, symptom-aware plan looks like this: Week 1–2: Walk most days for 20–30 minutes at a pace that raises your breathing but allows conversation; do 2 short strength sessions focusing on bodyweight squats, bridges, rows, and gentle core breathing. Week 3–4: Add intervals (1 minute brisk, 1–2 minutes easy) and increase strength intensity with bands or light weights. Ongoing: Build to 150+ minutes/week of moderate activity plus two strength days. Stop and seek guidance if you experience pelvic heaviness, leaking, pain, or doming—those are cues to modify and consult pelvic floor PT.
Sleep and energy, realistically
Sleep may still be fragmented. Focus on what you can control. Step 1: Protect one 4–5 hour stretch for yourself every few nights with partner or family help. Step 2: Keep your sleep space dark and cool; avoid screens 30 minutes before bed. Step 3: Fit 10–20 minute daytime “rest windows” rather than chasing long naps. Step 4: Keep caffeine to earlier in the day. Step 5: Ask your clinician to screen for anemia or thyroid disease if fatigue is profound despite reasonable sleep opportunities.
Work, pumping, and your rights
If you’re pumping, aim to express as often as your baby normally feeds—typically every 3–4 hours—to protect supply. Label and store milk using current safety guidance: at room temperature up to about 4 hours, in the refrigerator up to 4 days, and in the freezer about 6 months best quality (12 months acceptable) (CDC). In the United States, most workers are entitled to reasonable break time and a private space (not a bathroom) to pump for up to one year after birth (U.S. Department of Labor, PUMP Act). Check your local laws if you live outside the U.S.
Preventive care and vaccinations
Re-engage with routine preventive care if you haven’t already: blood pressure checks, diabetes follow-up if you had gestational diabetes, cervical cancer screening on your regular schedule, and dental care. Most vaccines are safe while breastfeeding, including flu and COVID-19 vaccines and boosters; if you were non-immune to MMR or varicella and didn’t receive them after birth, ask now (CDC). If you’re planning another pregnancy in the next year, discuss preconception health, including folic acid supplementation.
Red flags: when to call a clinician
Contact your healthcare professional urgently for any of the following: new or worsening headaches with vision changes; heavy or irregular bleeding that soaks a pad in an hour or returns after having stopped; chest pain, shortness of breath, or leg swelling; fever with breast redness or severe pain; signs of severe depression, anxiety, or thoughts of self-harm; persistent urinary or fecal incontinence; a vaginal bulge or pelvic pain that limits daily life; or symptoms of thyroid dysfunction (palpitations, tremor, unexplained weight change, heat/cold intolerance).
Build your support team
You don’t have to do this alone. Consider adding a pelvic floor physical therapist for persistent core or pelvic symptoms; a lactation consultant for feeding changes; a mental health professional for mood or anxiety; your primary care clinician for long-term health; and a trusted friend or partner as your day-to-day ally. Small, consistent steps add up—and you’re doing more than enough.
References
American College of Obstetricians and Gynecologists (ACOG). Optimizing Postpartum Care. 2018. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care
ACOG. Postpartum Birth Control (patient guidance). https://www.acog.org/womens-health/faqs/postpartum-birth-control
ACOG. Physical Activity and Exercise During Pregnancy and the Postpartum Period. 2020. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period
ACOG. Interpregnancy Care. 2019. https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2019/01/interpregnancy-care
Centers for Disease Control and Prevention (CDC). U.S. Medical Eligibility Criteria (US MEC) for Contraceptive Use, Summary Chart, 2024. https://www.cdc.gov/contraception/media/pdfs/2024/07/us-mec-summary-chart-color-508.pdf
CDC. Breast Milk Storage and Preparation. https://www.cdc.gov/breastfeeding/recommendations/handling-breast-milk.htm
CDC. Caffeine and Breastfeeding. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/caffeine.html
CDC. Alcohol and Breastfeeding. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html
CDC. Vaccinations and Breastfeeding. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/vaccinations.html
American Academy of Pediatrics (AAP). Breastfeeding and the Use of Human Milk (policy). 2022. https://www.aap.org/en/patient-care/breastfeeding/
Academy of Breastfeeding Medicine (ABM). Clinical Protocol #36: The Mastitis Spectrum. Revised 2022. https://www.bfmed.org/protocols
Cochrane Review. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. 2020. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007471.pub4/full
NIH Office of Dietary Supplements (ODS). Calcium and Vitamin D Fact Sheets. https://ods.od.nih.gov/factsheets/Calcium-Consumer/ and https://ods.od.nih.gov/factsheets/VitaminD-Consumer/
NIH NIDDK. Postpartum Thyroiditis. https://www.niddk.nih.gov/health-information/endocrine-diseases/postpartum-thyroiditis
American Academy of Dermatology (AAD). Postpartum Hair Shedding. https://www.aad.org/public/diseases/hair-loss/types/postpartum-shedding
U.S. Department of Labor. PUMP for Nursing Mothers Act. https://www.dol.gov/agencies/whd/pump-at-work
LactMed (Drugs and Lactation Database). https://www.ncbi.nlm.nih.gov/books/NBK501922/
This guide offers general information and is not a substitute for personalized medical advice. Always consult your healthcare professional about your unique situation.