Keeping Abreast: Nursing and Fertility
When I was newly pregnant, a female relative staying with us got her period. Rather than expect her to run to the nearest drugstore, I happily surrendered my warehouse-club sized box of tampons to her. “I won’t need them for nine months,” I assured her when she protested. Then, after I had my baby, I didn’t even think about stocking back up – as long as I breastfed, I wouldn’t have to deal with my period, right?
Wrong. Menstruation resumed at a measly three months post-partum, while I was still breastfeeding exclusively. My cycle has functioned like clockwork ever since. What’s the deal?
As it turns out, misinformation abounds when it comes to breastfeeding and the return of a woman’s fertility. Many nursing moms are under the mistaken impression that as long as you’re lactating, you can’t get pregnant. But you can. Once you ovulate, breastfeeding or not, there’s nothing to stop sperm from meeting egg.
Technically, using breastfeeding as birth control can be as much as 98 percent effective – but only for the first six months of your baby’s life, and only if you do it exactly right. The method is known as the lactation amenorrhea method (LAM), and it works because prolactin, the milk-producing hormone, suppresses reproductive hormones so you don’t ovulate (release an egg).
For LAM to work, though, you have to play the game by some very strict rules, and all it takes is one slip-up to forfeit the contraceptive benefits of breastfeeding.
Therefore, you can consider it highly likely that you are fertile:
…if your baby is sleeping through the night.
I was clapping my hands with glee when my breastfed daughter started sleeping through the night at two and a half months old. Alas, this blissful reprieve from night wakings was to be short-lived – but it was long enough for my body to take notice and start my fertility machinery up again.
Generally speaking, if your baby is going more than four hours during the day and six hours at night without eating, your body will get the message to start ovulating. And once you ovulate, you’re a Fertile Myrtle.
…if you aren’t feeding on demand.
Breastfed babies grow and develop optimally when they are fed “on demand” – that is, without a schedule. Sometimes this means feeding every two hours, or even once per hour during growth spurts. Unfortunately, decades of believing that babies are supposed to be fed by the clock have altered our collective maternal and medical brains. If you schedule or time your feedings, your milk production may be compromised, and as a result, ovulation could resume.
…if your baby uses a pacifier.
For LAM to be fail-safe, experts recommend that all babies’ sucking needs be met at the breast. True, it can be rough being a human pacifier, so many moms opt for replacements to appease their babies’ need to suckle. Just remember that once you unwrap that binky, unprotected sex may once again equal procreative sex.
…if you’re supplementing with formula.
Any supplemental formula your baby consumes equals that much less milk your breasts will produce. In terms of contraception, you’re playing a “use ‘em or lose it” game.
…if you’ve introduced solid foods.
Most moms of my own mother’s generation were told to start putting rice cereal in their babies’ bottles by three weeks of age. Luckily, science has taken a few giant steps forward and we now know that babies are designed to be breastfed exclusively until at least their six-month birthday. But the moment you start pureeing those peas or mashing up that banana, it’s in your best interest to find another form of contraception.
…if you’ve gotten your period.
It may seem obvious, but it’s worth noting that once you menstruate, you can guarantee that your fertility is alive and well.
…or even if you haven’t.
The female reproductive system decrees that we ovulate before menstruation, but this usually doesn’t happen with the first post-partum period, which is often called a “warning period” for this reason. However, in Dr. William Sears’The Breastfeeding Book (Little, Brown) he says that “about 5 percent of women do ovulate before having their first period” – and the longer you go without menstruating, the more likely this is to happen. So even though you haven’t had a period, you still could be harboring the perfect environment for sperm to meet egg.
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