Postpartum Hair Loss: Why It Happens And What Actually Helps

If you are finding hair in your shower or on your pillow a few months after having a baby, then you are experiencing postpartum hair loss, which is one of the most common changes that your body will go through after having a baby. In fact, up to 50% of all women will experience this kind of hair loss, which is clinically known as telogen effluvium, and although it is alarming, it is not long-term hair loss for most women. The one thing on every new mum’s mind is not “Will this stop?” (because it will stop eventually), but “What’s actually going on here in terms of hair loss?” and “Is there actually anything you can do about it?”

If you would like to speak with someone directly to help clarify these questions, a practitioner at Floralia Wellness can arrange specific blood work and develop a personalised recovery plan based on your individual needs.

What causes hair to fall out after giving birth

Your hair did something unusual during your pregnancy, and what is happening right now is the return to normal. To understand what is occurring with postpartum hair loss, it is helpful to understand what is occurring with the hormones and your hair growth cycle.

The oestrogen drop and your hair growth cycle

Human hair grows in cycles. It starts with the anagen phase, which is the growth phase. The anagen phase can last between two to six years. After this period, the hair follicle goes through a short phase before it reaches the resting phase. During this phase, the hair is shed. Out of the total number of hairs on your head, 85 to 90 per cent are in the growth phase, while 10 to 15 per cent are shedding.

However, during pregnancy, this balance is disrupted by large amounts of oestrogen. This means that the anagen phase is extended, resulting in fewer hairs entering the telogen phase and falling out. This explains why pregnant women often report that their hair feels thicker during pregnancy. The truth is, you were losing less hair than usual.

Oestrogen levels drop dramatically after childbirth. All those hairs that were in a growth pattern longer than normal suddenly go into a telogen phase. This is where shedding happens, and a lot of people will see a lot of hair falling out. Yes, a lot of hair is falling out, but at the same time, you're also returning to where you would have been if those hormones had not stayed in place. If you're also experiencing other symptoms, hormone tests will be able to help you figure out what's going on.

Why shedding peaks around three to four months postpartum

This delay in hair loss after hormonal changes is due to the hair cycle. When hair goes through a telogen phase, it stays there for two to three months before it actually falls off. Therefore, although your estrogen levels drop right after delivery, hair loss will not become evident until three to four months later.

This is the time when women will experience the most hair loss, and the hair loss will most likely be visible in your drain, your hairbrush, and wrapped around your little one's fingers. Research completed in 2023, which was a cross-sectional study, found that on average, hair loss started three months post-pregnancy, the peak time for hair loss was five months post-pregnancy, and the time when hair loss stopped was eight months post-pregnancy, with over 90% of women experiencing some level of hair loss post-pregnancy. The shedding phase, although dramatic, is the time when the hair that was held onto during pregnancy is released, over a short time frame.

For most women, the peak is past in a matter of weeks. At five or six months postpartum, the rate of hair loss slows down and new growth begins to replace the lost hair.

Nutritional deficiencies that make postpartum shedding worse

Although hormonal changes are the main cause of hair loss, your nutritional state is directly related to the severity of the hair loss and the rate of hair growth. In the clinic at Floralia, this is one of the factors most frequently overlooked. Women are often advised that hair loss is caused by hormonal changes and that nothing can be done except wait for it to resolve. But this is only half the truth.

Your body has already been through the process of pregnancy, delivery, blood loss, and now the continuous process of feeding a newborn. All these processes have taken a tremendous toll on your nutrient reserves. Once the nutrient reserves are depleted, the process of hair growth is adversely affected. Hair growth requires the continuous supply of certain nutrients to keep the hair in the growth phase, also known as the anagen phase, to support healthy, strong, and well-anchored hair growth. Once the nutrient reserves are depleted, more hair is pushed into the resting phase, resulting in hair growth that is thinner in quality. The research carried out on the comprehensive panel of nutrient markers in patients with telogen effluvium in 2024, published in the Journal of Cosmetic Dermatology, supports the argument for comprehensive testing rather than guesswork.

Iron, zinc, vitamin D and B vitamins

The most common nutritional cause of hair thinning in the postpartum period, which practitioners see most often, is iron deficiency. This is because most postpartum women are iron-deficient, especially if the mother was iron-deficient before delivery or had a heavy post-delivery bleed. Iron is required for the production of haemoglobin, which is required for oxygen transport to your hair follicles. Therefore, if a person is iron-deficient, oxygen will not reach the hair follicles, and this causes thinning of the hair since the hair growth cycle will not be as long as usual. A person will experience hair loss if the level of iron is less than 30 µg/L. However, most practitioners will want the level of iron to be greater than 50 for hair to grow. In a retrospective study conducted in 2023, it was seen that iron deficiency is the most common cause of alopecia in women. More than 70% of women suffer from alopecia. The level of iron required for hair growth is much higher than the level required for the diagnosis of anaemia.

Zinc has a less well-known, though equally significant, function in supporting cell division for hair growth, as well as maintaining the structural integrity of the hair follicle. Zinc is also depleted during breastfeeding, and a deficiency can cause a general thinning of hair that is virtually identical in appearance to hormonal thinning following pregnancy. It is very easy to attribute thinning to hormonal imbalances when, in fact, a deficiency is contributing to the thinning.

Vitamin D helps in the development of new hair follicles as well as in the hair growth cycles of existing ones. There is a high incidence of vitamin D deficiency in postpartum women, especially when people spend more time indoors in the early stages of parenting, where people are not exposed to enough sunlight. If a patient suffers from a deficiency in vitamin D, which is less than 50 nmol/L, this will hinder the healing process. The systematic review and meta-analysis conducted in 2024 revealed that over half of the patients with telogen effluvium suffered from a deficiency in vitamin D, which was significantly lower than in the control group.

B vitamins, especially B12 and folate, play an essential role in the formation of red blood cells and energy for the cells. Both vitamins are required for proper hair growth. Vitamin B12 is especially important, as many women are surprised to learn that they are lacking this essential nutrient after having a baby, especially if they do not eat well or have difficulty digesting food. If the level of this vitamin is absent, the hair is brittle, thin, and no new hair growth occurs, which is required to cover the hair loss experienced during the process. Working with a clinical nutritionist can help identify exactly where these gaps are and offer the support needed to address the problems.

How breastfeeding affects your nutrient stores

Even after the initial postpartum recovery period, your body is still directing nutrients toward your baby rather than your own tissues, including your hair. Your body is in a state of prioritising your milk production above almost everything else, so your body is using the nutrients you have to give your baby what they need.

This is why so many breastfeeding mothers find that their hair loss persists for longer than expected. The hormonal imbalance may have been corrected, but if your iron levels, zinc levels, and vitamin D levels are depleted due to the nutritional requirements of breastfeeding, your hair simply doesn't have the building blocks it needs to regrow. We see this often at Floralia. Women come in six or eight months post-baby, sometimes ten or twelve months post-baby, experiencing significant hair loss and thinning hair, and in most cases, lab work indicates a nutritional deficiency of some kind.

The cost in terms of calories and nutrients is similar to running five to seven kilometres every day. When you are not getting enough food or the right food, your body will take what is available and make milk from it. It is not a priority for your body to grow hair when it is trying to sustain your baby. Your body is doing exactly what it is designed to do.

The main point to take from this is that if you're breastfeeding and still losing hair well past the four to six months mark, it can be more helpful to have your levels tested and address what's actually depleted, rather than waiting. A study done in 2024 also found that increased postpartum hair loss was independently associated with higher levels of anxiety in new mothers.

When postpartum hair loss might be something else

The majority of postpartum hair loss can be attributed to telogen effluvium, which results from the fall in oestrogen levels. Although this pattern is quite predictable, it's still important to prioritise foods that can support healthy hair. Not all postpartum hair loss follows this pattern, so a large part of assessing postpartum hair loss is in determining when to investigate.

Postpartum thyroiditis and hair thinning

Five to 10 per cent of women can develop an inflammatory thyroid problem in their first year after delivery. This can directly impact hair growth and can initiate a phase of hyperthyroidism (a phase of overactive thyroid) and/or hypothyroidism (a phase of underactive thyroid), or either of these two conditions.

The hypothyroid phase is the one most likely to affect your hair. If your thyroid levels are low, your hair growth cycle will be slowed down. More hair will go into a dormant state and grow more slowly than usual. The hair that does grow can be brittle and dry. This type of hair loss can occur alongside normal postpartum hair loss and is why it can be so easily overlooked. It can even appear identical to normal hair loss caused by hormone fluctuations. Unless you are actively looking for a thyroid problem, it can be very easy to assume hormone fluctuations are the cause. Further thyroid testing can help determine whether this is normal postpartum hair loss or hair loss caused by a thyroid problem.

Other symptoms that point to a thyroid issue include fatigue that is beyond what is expected for new parents, unexplained weight gain or difficulty losing weight, constipation, feeling unusually cold, and brain fog that feels disproportionate.

Signs that warrant blood work

Not all cases of shedding need to be investigated, but some specific patterns should not pass unnoticed:

Hair loss that continues beyond 12 months postpartum, with no signs of improvement, is one such symptom. At this point, the hormonal change has long since normalised, and continued hair loss often points to a nutritional or thyroid issue that requires specific treatment.

Another symptom to watch out for is "patchy hair loss." Normal hair loss after childbirth is diffuse, meaning that the hair is falling out evenly. However, if you're seeing patches of thinning hair, this is worth looking into further, as it may be something other than telogen effluvium.

Marked fatigue and sudden weight changes, in addition to the hair loss, should also be considered, and an itchy scalp or irritation should not be dismissed either. These can be signs of thyroid problems or iron deficiency anaemia, and sometimes rarer autoimmune conditions that require specific support. A functional medicine approach, taking in all of these aspects, can help to clarify what is happening and provide your practitioner with a clear starting point to begin treatment.

What you can do to support hair regrowth

The approach that works best for you will depend on whether your hair loss is caused by hormones alone or also exacerbated by nutritional deficiencies.

Dietary and supplement support for the postpartum period

If your blood tests reveal low iron, zinc, and vitamin D levels, then the most effective way to replenish these nutrients is a combination of diet and practitioner-grade supplements. A balanced diet rich in protein and iron will help provide your body with what it needs to support normal hair growth. This includes a diet rich in meat and legumes for iron content, eggs and fish for vitamin B12 and zinc, leafy greens for folate content, and sufficient calories to support healing and nursing.

However, diet alone is not always sufficient in the postpartum period, particularly if your levels are already depleted. This is where practitioner-grade supplements can help. A supplement plan based on actual blood work can help replenish nutrients much more quickly than food alone. Iron bisglycinate is better absorbed and gentler on the stomach than the standard iron tablets most GPs recommend. B vitamins can be more effective for those with MTHFR, which is common enough in the population to warrant consideration. If you’re not sure whether or not methylation is a factor for you, genetic methylation testing can help clarify whether or not your body efficiently utilises B vitamins.

The main difference between this method and the one in which you purchase a generic "hair vitamin" is one of precision. Your supplement plan should be based on what your body actually needs, not what the average woman needs in the postpartum period.

Scalp care and gentle hair practices

While you are focusing on the nutritional aspect, the external care of your hair should not be neglected either. The aim during this shedding phase is to minimise hair loss.

Tight ponytails, braids, and similar styles should be avoided, as they put strain on weakened hair follicles, causing them to shed more. For now, loose hairstyles are gentler.

Since hair is in a weakened state when it is wet, it is better to use a wide-tooth comb or detangling brush on dry hair instead. Detangling can cause the shedding of hair that is not yet ready to fall.

Another gentle step is to reduce heat styling. Flat irons and blow dryers can weaken your hair, causing it to break easily. If you really need to use these, using something with less heat and a heat protector can help.

A daily scalp massage can be quite supportive. You can do this by applying circular pressure using your fingertips during your hair wash routine. This can help increase blood circulation in your hair follicles. Other natural topical approaches to hair growth have been shown in studies to have positive results as well. A review in 2024 in a dermatology journal showed that rosemary oil has similar efficacy in hair growth as minoxidil, although these were done in androgenetic alopecia and not directly in telogen effluvium postpartum.

A volumising shampoo and conditioner will help your fine hair or thinning hair look fuller while you wait for new growth to come through. Intensive conditioners used on the mid-lengths and ends, rather than the roots, will add volume to your hair without weighing it down.

What to skip (and why most "hair loss treatments" miss the point)

If you’ve been searching for postpartum hair loss online, you’ve probably seen a whole list of supplements and products that claim to help your hair regrow. Biotin gummies. Collagen powders. Expensive shampoos that claim to be the best shampoo for postpartum hair loss. Hair growth serums. Most of these products miss the point entirely.

Biotin deficiency is quite uncommon. Unless you know you have a deficiency (which the majority of women do not), taking additional amounts of biotin will not help your hair grow any faster. Collagen is similar. Collagen does contribute to the structure of your hair via the amino acids it provides, but it's like adding fertiliser to your lawn without fixing the irrigation.

The issue with generic hair supplements is that they are made with standardised levels, which may not align with what your body needs. If your ferritin levels are already at 15 µg/L, a multivitamin with 5 mg of iron will not change much for you. What you need is a therapeutic dose, based on your blood work, not a maintenance dose for a healthy individual.

The same is true of topical formulas. A volumising shampoo can make your hair look and feel better during the shedding phase, and that matters in terms of how you feel day to day. However, no shampoo can correct an iron deficiency or replace zinc in your system. They are two different things.

What works is identifying exactly what nutritional deficiencies or hormonal issues your hair is responding to, then addressing those in a targeted way.

A realistic postpartum hair loss timeline

While every woman’s story is a little different, there is a general pattern that is true for most.

During the first zero to three months postpartum, your hair is still thick. Many women do not experience hair thinning during this time because the hormones from pregnancy are still clearing from their system, and the hairs in the growth stage have not yet reached the resting stage.

The time period between three and five months postpartum is when most women will start to notice hair loss postpartum. This is the peak shedding time. The amount of hair in the shower, in your brush, on the floor, even on your baby can appear to be a lot. And in most cases, it is. It's just the bulk of what's to come.

The rate of shedding slows down from six to nine months postpartum. You might notice the appearance of short new hairs around your hairline. This is a sign that your hair cycle is restarting.

Most women return to their normal hair density by 12 months postpartum. There are some cases when a woman may return to her pre-pregnancy hair density, and some cases when there is a slight change in hair texture or density. All these are in the normal range. If a woman is still breastfeeding or has not addressed her nutrition issues, hair loss may continue up to 12 to 15 months postpartum. There is often something that can be done about it.

When to speak with a naturopath or healthcare professional

For the vast majority of women, postpartum hair loss is a normal process, and this process will resolve on its own without specific intervention. However, there are certain conditions in which professional help will accelerate this process and help in the early detection of any complications.

If you still experience thinning or shedding hair at six months post-delivery, it is a good time to have your levels checked. This will determine if iron, zinc, vitamin D, or thyroid issues are affecting your recovery.

If you are experiencing extreme shedding along with other signs and symptoms such as fatigue, mood changes, weight gain, or brain fog, these signs and symptoms, taken together, warrant investigation, as they may indicate postpartum thyroiditis, which needs specific treatment.

And if the hair loss persists beyond 12 months or becomes patchy rather than thinning, then it might be worth investigating other possible causes. If there is ongoing hair loss, six months or more, then it may be time to discuss it with your GP or naturopath.

At Floralia Wellness, our process begins with a blood test and clinical history. From there, your naturopath will be able to develop a plan of care that will work to correct the deficiencies or imbalances causing your hair loss. This may include supplements and dietary changes, or a referral to your GP for further investigation. If you would like to learn more about our postpartum care services and how we are able to assist new mothers, you are welcome to reach out to us.