Fatigue or exhaustion is one of the most common concerns I see in mothers in my clinic. It’s so common for mothers to feel this way that it’s become accepted as normal when being exhausted all the time is far from normal – even in new motherhood.
All too often this fatigue is blamed solely on sleep deprivation, dismissing any chance of taking a thorough look at all aspects of a mother’s health and wellbeing. Now, don’t get me wrong, chronically broken sleep is no joke and without question a major contributor to maternal exhaustion. But it’s also not uncommon for me to see mums who also have some of these other factors going on at the same time, only adding to the load of their fatigue.
I know lots of mothers who want to go with the flow of their baby’s natural sleep needs but are finding sleep deprivation challenging. So, if your parenting values are saying ‘keep going,’ but your body is saying it needs help, perhaps it’s worth looking into some of these other areas to make sure you’re not being weighed down unnecessarily.
First, let’s address the most common and most obvious factor – sleep deprivation. No meaningful discussion about maternal fatigue can be had without first acknowledging the impacts of chronic broken sleep, which inevitably impacts how rested and energised you will feel each day. However, as many mothers know, it’s not as simple as just ‘getting more sleep,’ since sleep can be a factor that is very difficult to control, particularly if you have a wakeful baby or a baby with low sleep needs.
Regarding wakeful babies, there are some things that can interfere with babies’ sleep, such as food intolerances, food and/or environmental allergies, some nutritional deficiencies, low muscle tone, and other underlying medical conditions. You can have your baby screened for any of these to rule out any factors that might be making your baby more wakeful than they need to be.
Whether you choose to try modifying your baby’s sleep patterns versus taking a more go-with-the-flow approach will depend on a variety of factors unique to you and your family (e.g. parenting values, temperament, tolerance for sleep deprivation, your baby’s wakefulness, working life, support around you, etc.). Ultimately, it’s a decision that can only be made by you.
Another potential contributor to fatigue that is distinct from sleep deprivation itself, is when the sleep you are getting is not as restorative as it could be. This can happen if you’re not dropping down into the deep sleep states of each sleep cycle where repair and restoration happen.
This might look like feeling unrefreshed in the morning (although this can be tricky to tease apart from the effects of broken sleep) and can be the result of altered melatonin production, circadian rhythm dysfunction, or an overactive nervous system.
These systems are influenced by a variety of factors like light exposure, temperature regulation, stimulant consumption (i.e coffee and caffeine), blood sugar regulation, eating patterns, and nutritional status.
Taking a close look at your own sleep in terms of both quality and quantity can be useful. There are often at least a few tweaks we can make to your lifestyle, diet, and daily habits that can improve the quality of the sleep you are able to get.
Disrupted thyroid activity is common in the first year after birth as the thyroid gland (and other systems that work with the thyroid, e.g. the immune system) recalibrate after pregnancy. This is known as postpartum thyroiditis and it can be a common cause of maternal fatigue.
Thyroid dysfunction is also commonly seen past the first year after birth, triggered or exacerbated by factors like chronic stress, sleep deprivation, nutritional insufficiencies, food allergies, and poor gut health.
To begin looking into your thyroid, your levels of TSH (thyroid stimulating hormone), and the thyroid hormones T4 and T3 can be checked with a blood test.
Our stress response, which is essential for our survival, can be hijacked into a negative, chronic pattern when we are subject to unrelenting stress. This response was never supposed to be switched on for such long periods of time, as it often is in our busy, fast paced modern lifestyles. Fatigue is a common symptom of this system being overworked.
Stress can come in many forms and can be present even if you don’t feel necessarily feel stressed. Stress can be emotional, perceived psychological, immediate environmental, physiological, or dietary & lifestyle related.
In early motherhood, there are many potential sources of stress – from the huge emotional & identity shifts that occur when you become a mother, to the physical factors involved in birth, to the disruptions to sleep, to the nutritional demands of breastfeeding a small baby, and more.
Although new motherhood is an inherently stressful time of life, you can support yourself through the challenges by nurturing the adrenal glands and nervous system with good nutrition and supplements to build physical resilience, as well as engaging with practices that build emotional resilience, for example, mindfulness.
You can investigate how your stress response system is operating by looking at tests such as serum AM cortisol, DHEAs, or 24-hour salivary cortisol.
Blood sugar dysregulation
Our blood sugar levels are usually tightly regulated to allow for constant supply of glucose to cells for energy. However, levels can become dysregulated if insulin resistance develops and our cells can’t access the glucose they need from the blood, resulting in fatigue.
Reactive hypoglycaemia can also occur when there are frequent blood sugar spikes that are inevitably followed by rapid drops, for example as might happen after eating something high in sugar or carbs (especially if they are ‘naked’, i.e. eaten without protein, fat, or fibre) or those foods with a high glycaemic load.
Both states can contribute to fatigue. Blood sugar regulation can be assessed by measuring fasting glucose and fasting insulin in the blood. The good news is both can be managed with some simple diet changes.
Our digestive system is the epicentre of where food transforms into the nutrition we need for energy. Without well-functioning digestion, we are unable to break down the food we eat, let alone absorb the nutrients in the food. Energy production pathways are left without the substrates they need to produce energy and the enzyme cofactors that are essential to power the process along.
To add, some conditions affecting digestion can also contribute to feeling fatigued, for example intestinal permeability (aka leaky gut), food allergies and intolerances, constipation, and dysbiosis.
Mood and mental health challenges
Our mood is intricately connected to our sense of vitality and wellbeing, and lethargy is a common experience in maternal mental health conditions, including those that don’t fall neatly into a well-established diagnosis, for example maternal overwhelm.
The connection between mental health and energy is multifaceted – in some cases, the underlying physiology contributing to a mood imbalance can also impact energy production (for example, if neuroinflammation is present or if gut health is an issue), while it’s also common that low mood contributes to a feeling of flatness, mentally and physically.
If you want to feel more energised and look into the possible causes of your fatigue, even if your baby is wakeful and you’re sleep deprived, we can work together to understand more about your current health and what role some of the factors discussed in this article may be playing.
We can run blood tests or you could talk to your doctor about having some routine blood work done as a starting point to assess your postpartum health.
From here we can make a plan to address the suspected cause/s using diet changes and food as medicine, with nutritional supplements and herbal medicines as needed.