By the time new mothers get to bed, they're often too exhausted to keep their eyes open. When they manage to find the time -- and energy -- for intimacy, the potential interruptions can make their sex life a distant memory.

"The demands of my children and juggling a job exhausted me the first year, and definitely affected our sex, or at least the quantity of it," says Drue Ann Ramirez of Pomona, Calif., who breastfed her oldest son for 26 months and has nursed her younger son for 28 months. "The doctor gave the OK after six weeks, but I was disinterested the first six months."

Sore and tender breasts, vaginal dryness and fatigue were all factors that made sexual relations infrequent for Tullahoma, Tenn., mother of three Tina Warren.

"Before Baby, it was Husband and Wife as lovers -- now it's Mother and Father," says lactation consultant Susan Condon of The Breastfeeding Helpline in San Francisco, Calif. "The family is adjusting to the many changes a new baby brings. Sleep deprivation and days on end where mothers can't even take a few minutes to shower can cause jangled nerves and fatigue. There may not be much time for the parents to even be alone with one another."

Sex and the Lactating Woman
This common reality for new mothers can be compounded by other factors for those who breastfeed, says Condon. "The baby's needs come first, as the baby is totally dependent on the mother for food," she says.

Going through childbirth and the postpartum period may bring other changes. A less-than-optimal birth experience, or an episiotomy or cesarean section, can result in painful stitches. Other complications, such as health problems with the baby, may leave mothers feeling disappointed or vulnerable and decrease their desire for sexual intimacy, Condon notes.

"Both our boys suffered from colic, but the first one was really tough, so my poor husband walked around in almost as much of a daze as I did," says Ramirez. "Also, because I was nursing, my husband felt my breasts were off limits to him. Even though I desired him to stroke them during sex, he wouldn't, feeling they were taboo."

The point at which new mothers cease to feel "sexually challenged" differs for every woman. "Some are able to feel sexually responsive even before the generally recommended recovery times of six weeks for a vaginal birth and eight to 10 weeks for a cesarean section," says Condon. "Some may take nine or more months before they feel 'normal' again. Some women experience bladder incontinence for many months after a vaginal birth."

Jeannine Petriel of Weare, N.H., who breastfed her three children, found that "breast leakage bugged me. I didn't like having them touched because they would start to hurt."

For Margaret Helmstetter of Sierra Vista, Ariz., challenges included "leaking all over, engorged breasts, or the baby waking up to feed just about the time things got interesting. My husband called the kids 'organic birth control.'"

Hormones and Harmony
"Hormonal changes following childbirth can fluctuate tremendously, causing mood swings, unexplained crying or postpartum depression, all of which affect a woman's sexual desire," says Condon. "Low estrogen levels during breastfeeding are attributed to a lower interest in sex and may cause vaginal dryness. There is also some speculation that an increase in sexual desire is linked to a resumption of the menstrual cycle."

"There is definitely a decrease in libido for me when I am breastfeeding. It is more of an effort to 'get in the mood,'" says mother of two Chris Sofge, currently stationed overseas in Germany with her family. "During my first pregnancy, I wanted sex all the time. I thought that would happen during my second pregnancy as well, but I think the fact that I was still nursing my first child may have had a lot to do with that lack of sex drive. When I was forced to stop breastfeeding my son for medical reasons, my sex drive seemed to bounce back to normal."

For nursing mothers, the dynamics of the nursing relationship itself can affect a couple's sexual intimacy.

"With nursing, there is this bond that is hard to explain," says Warren. "It is more difficult to go from mommy-mode to wife-mode. It's like I sort of feel uncomfortable for a second or two going from loving my hubby to sticking my breast in my son's mouth to breastfeed so quickly."

"Mothers expend a huge amount of emotional energy on their babies. Their ability to give of themselves to other family members is naturally less," Condon says. "The mother is fatigued from interrupted sleep or may simply feel 'touched out' at the end of the day."

Some women, however, experience enhanced sexual desire and a deeper sexual bond with their partner because of the breastfeeding relationship, Condon says. "The feelings of tenderness and love that come with caring for an infant spill over into the sexual relationship."

"I always felt sexier when I nursed," says Helmstetter. "Sex before and after nursing was only a problem if my breasts were leaky or engorged, and then changing positions eliminated the problem."

Have it Your Way
"It's important for couples to keep lines of communication open," says Condon. "Most fathers just need reassurance that the mother's lack of sexual desire isn't a rejection of him."

Many women consider the time that dads spend doing household chores a true sign of love and caring, which, in turn, helps mothers to relax and feel more positive, Condon says. "The less chores she needs to worry about may translate into finding more time for sex."

"When a father insists on resuming a sexual relationship when the mother isn't ready, this makes the mother feel pressured and very uncomfortable," Condon adds. "The couple can spend time together helping one another to adjust to parenthood. They can be intimate in other ways such as a romantic meal at home by candlelight."

Spending time together as a couple doesn't necessarily translate to outings away from Baby. Breastfeeding mothers tend to feel more comfortable and relaxed when they are close to their babies. The couple can spend private time at home or take the baby out with them, says Condon.

"A 'date night' once a week, even if it is just for an hour or two, can do wonders and bring you closer," Sofge says. "I know my husband needs the physical intimacy, and if we have shared a romantic evening, it is much easier for me to relax and make love (even if I don't really feel like it physically)."

Vary your routine, says Ramirez. "We've found that we can sneak out of our own bedroom to the guest room after the kids fall asleep in our room, and cuddle there for one or two hours, then come back to our own bedroom.

"We also adopted a family bed, which simplified nursing, especially at night for me, allowing me to get a bit more rest," Ramirez adds. "Cuddling together with our baby sandwiched between us had its own intimacy, beyond sex."

"We find other ways to show our love for each other," says Petriel. "Intimacy doesn't have to mean intercourse. Just touching one another can make a very tired mom feel loved."

About the Author: Phyllis Edgerly Ring, mother of two, is a contributing writer for iParenting.