7 ways to overcome hair loss in pregnancy and after birth

Losing more hair than usual is upsetting at any time, and more so when your body is already changing every week. The good news is that most hair shedding linked to pregnancy is temporary. Knowing why it happens helps you tell ordinary shedding from something worth a blood test.

What happens to your hair in pregnancy

Each hair on your head grows for a few years, rests for a few months, then falls out and is replaced. At any time most of your hair is growing and a smaller share is resting.

In pregnancy, higher oestrogen keeps more hairs in the growing phase for longer. That is why many women find their hair feels thicker while they are pregnant, and shed less than usual.

After birth, hormone levels drop and all those extra hairs move into the resting phase together. Two to four months later they fall out. This is called telogen effluvium. The American Academy of Dermatology describes it as normal, and says most women see their hair back to its usual fullness by their baby's first birthday. It does not cause baldness.

Other causes of hair fall

If your hair is thinning during pregnancy rather than after it, or the shedding goes on past a year, something else may be involved.

Iron deficiency

Pregnancy raises your need for iron, and iron deficiency anaemia is common, particularly after pregnancies close together, with twins, or after severe vomiting (hyperemesis gravidarum). Besides hair fall, it can bring tiredness, breathlessness, a racing heart and headaches. Your antenatal blood tests check for it.

Thyroid problems

Both an underactive thyroid (hypothyroidism) and an overactive one (hyperthyroidism) can thin the hair. Hypothyroidism is the more common of the two in pregnancy. Its tiredness and weight changes are easy to mistake for ordinary pregnancy symptoms, so mention hair fall to your doctor.

Illness, stress and medicines

A high fever, surgery, a big emotional shock or some medicines can push hair into the resting phase too. The shedding usually shows up a couple of months after the event.

Tight styles

Pulling hair back tightly day after day, especially in the same place, can cause hair loss along the hairline. Under a tudung, a tight inner cap can do the same.

Seven ways to look after your hair

You cannot stop hormone-driven shedding, though you can reduce breakage and look after the hair you have while it settles.

1. Eat enough iron and protein

Lean meat, fish, eggs, lentils, beans, tofu and dark green vegetables such as kangkung and bayam supply iron and protein. Pair plant iron with vitamin C, such as a squeeze of lime or a piece of guava, to help absorption. Take the iron and folic acid supplements your clinic prescribes, at the dose they give you.

2. Loosen your hairstyle

Swap tight ponytails and buns for a loose plait or a clip. Choose a soft, breathable inner cap under your tudung and change where the pressure falls.

3. Use a wide-toothed comb

Detangle from the ends upwards with a wide-toothed comb. Brushing hard, especially when hair is wet, snaps strands that would otherwise stay.

4. Go easy on heat

Straighteners, curling tongs and hot blow-dryers weaken the hair shaft. Air-dry when you can, or use a cool setting.

5. Consider a shorter cut

A shorter style tangles less, weighs less, and makes shedding less visible while it settles. It is also cooler in our weather.

6. Wash gently

How often you wash makes no difference to how much hair you lose, because the hairs that come out in the shower were already loose. Wash as often as your scalp needs, massage gently with your fingertips, and use conditioner on the lengths to make combing easier.

7. Choose mild hair products

Pick a gentle shampoo and a conditioner that you like using. If your scalp has become more sensitive in pregnancy, a formula without heavy fragrance may feel more comfortable.

When to see a doctor

See your doctor or a dermatologist if hair is coming out in patches, if your scalp is sore, red or scaly, if shedding continues more than a year after birth, or if you also feel exhausted, cold or breathless. A simple blood test can check your iron and thyroid levels.

For more on what happens after birth, read postpartum hair loss: don't panic.