Breastfeeding and Fertility



I find breastfeeding and fertility so fascinating. Just another one of those miraculous hormonal things our body does to help us out! Did you realise that the Lactational Amenorrhea Method (LAM) is 98% effective for most mothers of babies under 6 months old?

Do You Want to Increase Fertility Naturally?

The healthiest outcomes for mothers and second or subsequent babies occur when there is a gap of 2-3 years between births and a period of 6 months of no breastfeeding. All the more reason to keep breastfeeding through the night for a while (does that make you feel better about waking up at night?!)

LAM is a well studied and well recognised method of family planning. To be able to use the Lactational Amenorrhea Method you need to make sure:

  • Your period has not yet returned
  • You are fully or nearly fully breastfeeding
  • Have a baby who is less than 6 months old

(This does not include any bleeding or spotting for the first 6 weeks after birthing - it is normal to continue bleeding during this time. If the bleeding continues seek advice from your doctor.)

To be nearly fully breastfeeding you will need to be offering your breast milk at every feed before supplementing.

So How Does it Work?

In general you're aiming for the balance of breastfeeding and fertility hormones to stay more in the breastfeeding side. That means you need to have not more than four hours between breastfeeds during the day and not more than 6 hours between breastfeeds at night.

I'm putting together some research from increasing milk supply now, but in general, if you feed around 3am (or anywhere between 2 and 4am ish) you'll get the most breastfeeding hormones going - great for supply and for keeping your period away!!

Studies show that LAM is more effective if your baby is fed at least 8 times a day, and better again if it's more than that. Demand feeding fits very well with this type of family planning.

The advantages of using LAM for breastfeeding and fertility are numerous. Some examples are:

  • Cost effective
  • You won't run out of a prescription
  • You don't need to remember to take a pill
  • It can be started immediately after the birth
  • You don't have to prepare anything during intercourse
  • There are no hormonal side effects

So What Do I Need to Be Careful Of?

I know lots of girls who have been fully breastfeeding and fertility has returned anyway (imagine getting your period only 3 months after giving birth, and bleeding for 6 weeks after birth anyway.....

Some really important things you need to know if you're going to use this method are:

  • Pacifiers/Dummies can interfere with a regular feeding schedule. If used you need to make sure that the 8 feeds are still being given and time between feeds is not exceeding the frequency of 4 hours day feeds and 6 hours night feeds
  • Supplementary bottle feeds or introducing other liquids of foods will also interfere with the frequency of breastfeeding and should be avoided to maintain the proper hormonal balance in the mother
  • If your stress levels are high your hormonal levels may change regardless of your frequency of breastfeeding and you need to use other contraception during these times
  • Illness can also affect your hormonal levels and you should also be cautious about your fertility levels during or after periods of illness
  • This is a short term method and is only effective during the first six months of your baby's life
  • This method does not protect you against the risk of any sexually transmitted disease and this needs to be considered
  • Basically, if you're really worried about having another baby too quickly, use protection or abstain!

    I've Used Natural Family Planning Before, What Do I Need to Know After 6 Months of Breastfeeding and Fertility Increases?

    For those who've used natural family planning before their pregnancy it is advisable to be a little cautious initially. The Lactational Amenorrhea Method for breastfeeding and fertility will only be reliable for the first 6 months after birth. After this you may begin to ovulate despite still breastfeeding frequently as the introduction of solid food begins and your milk production slows. The symptoms of ovulation are often a little different after the birth of a child and your old symptoms may not be reliable any more. It is wise to use something like a fertility test in the months after your baby reaches 6 months old until you establish a definite pattern of fertility.

    So What Do I Do Once My Baby Is Older Than 6 Months or if I Don't Breastfeed as Frequently as 8 Times a Day?

    If breastfeeding and fertility is still of concern and you are considering other methods of contraception such as a hormonal injection, a diaphragm or the oral contraceptive pill just be aware that they are not all compatible with breastfeeding.

    Any oestrogen containing contraceptive should be avoided, particularly in the first 6 weeks after birth, because they decrease your production of breast milk. If you are interested in taking a pill you will need to use one which only contains progesterone.

    If you have used a diaphragm in the past and would like to use one again it important to keep in mind that your uterus will continue to contract after the birth for around 6 weeks. This can dislodge a diaphragm and they are often not inserted until after this time.


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