Breastfeeding and Your Fertility

Joyful dark skinned wife leans shoulder of her husband, look positively at pregnancy test, going to have child. Family couple on bed in modern apartment

A common question surrounding is breastfeeding is how will it affect my fertility? Whether you plan to try for pregnancy while you are breastfeeding, or you want to wait, it is important to understand how breastfeeding can affect reproduction.

 

Does breastfeeding prevent pregnancy?

 

There are many benefits of breastfeeding for mothers, and for many, one of those is delayed or lack of menstruation, also known as Lactation Amenorrhea. Lactation Amenorrhea can be different for all women – some may experience a delay the entire time that they are breastfeeding, but some may not. Each mother’s fertility will be affected differently.  Because of this, we cannot say that breastfeeding is a reliable form of birth control.

 

Lactation Amenorrhea Method

 

“LAM is a form of natural birth control that relies on the new mother feeding her baby only breastmilk for up to six months and having no periods or spotting during that time. LAM is a temporary form of birth control when used correctly. LAM requires exclusive (only), frequent breastfeeding (at least every four hours during the day and at least every six hours during the night) of an infant less than six months old.” U.S. Dept of Health and Human Services

 

Breastfeeding as Birth Control

 

If ALL of the criteria in the list below are met, LAM (lactation ammenoreah method) can be an effective, temporary method of contraception.

 

–       Menstrual bleeding and spotting has NOT returned after 8 weeks postpartum

 

–       Infant is fed on demand (at least every 4 hours during the day and 6 hours at night), exclusively from the breast, and is not offered any other liquids, water, or food.

 

–       The infant is less than 6 months old

 

In order to prevent pregnancy, another method of contraception should be used if:

 

–       Infant reaches 6 months of age

 

–       Menstruation or spotting returns

 

–       The frequency or duration of breastfeeding is reduced (this includes the introduction of solids or supplementing with formula or previously pumped milk)

 

–       Bottle feeds are introduced

 

 

Can I continue breastfeeding if I become pregnant?

 

In most cases, it is fine to continue breastfeeding while pregnant. The hormones and stimulation from breastfeeding may cause uterine contractions, so if you are at high risk for pre-term labor, it is very important to consult with your doctor before continuing.

 

Also important to understand is that the hormones associated with early pregnancy differ from those required to make breastmilk. Progesterone takes the place of prolactin, and for some mothers, this means a decrease in milk supply. If your baby is over 12 months, you likely don’t need to worry and can continue to nurse on demand. The toddler may continue to “comfort nurse” through the dip. If your baby is under 12 months, supplementation may be necessary.

 

Discuss your specific circumstances with your lactation professional and pediatrician. Some mothers also experience nipple tenderness and nursing aversions, due to pregnancy hormones. Again, it is different for everyone, but many mothers report these symptoms lessening during the second trimester, which is also the time (14-16 weeks pregnant) that milk production resumes.

 

Does breastfeeding affect fertility treatments?

 

Some parents may need assistance with getting or staying pregnant. Because breastfeeding can delay ovulation and menses, some fertility treatments may require that you discontinue breastfeeding before starting. We also know that some fertility medications are not compatible or safe for breastfeeding. These situations are very unique and your fertility specialist is the best person to consult with when making these decisions.

 

Hormonal birth control and breastfeeding 

 

According to research from the Infant Risk Center, “Although most contraceptive methods are probably safe and should not put the infant at risk, some contraceptives can adversely affect milk supply and therefore should not be used by breastfeeding mothers. These include all estrogen-containing products such as oral contraceptives, vaginal rings (i.e. NuvaRing), and transdermal patches (Climara)… Therefore, if estrogen-containing contraception is chosen, it is advised that women use the lowest estrogen dosage appropriate and monitor their milk supply.  Mothers who have problems with milk production and those who are breastfeeding an older child (one-year-old or more) should be especially cautious. Progesterone-only pills are preferred as they are less likely to decrease milk supply.” Infant Risk Center

 

Again, each mother may be affected in different ways by these hormones, so working with your lactation professional and ob/gyn is the best way to determine which method will be best for you.

 

Navigating your fertility is an ongoing journey. It is important to have a solid support team, including a medical provider and lactation professional you trust, to help you make these important decisions and handle any potential issues. Our lactation team is available to answer questions and provide resources – send us an email at [email protected] 

 

 

References 

https://www.infantrisk.com/content/safe-use-birth-control-while-breastfeeding

https://www.hhs.gov/opa/pregnancy-prevention/birth-control-methods/lam/index.html