Breastfeeding As Birth Control?

It is a well known fact that breastfeeding suppresses a woman’s fertility in the early months after giving birth. However, many women do not feel comfortable relying on breastfeeding as a form of birth control or natural family planning because they have been told it is unreliable, or perhaps because they know someone who became pregnant while breastfeeding. As a Certified Lactation Educator, I can tell you breastfeeding alone is not fool-proof. Many women mistake breastfeeding with the Lactational Amenorrhoea Method (LAM).

How does LAM work?

While breastfeeding continuously, your body doesn’t produce a hormone called prolactin which is needed to release an egg. Ovulation, and therefore pregnancy, cannot occur if an egg is not released.

What does continuous breastfeeding mean?

Exclusive and continuous breastfeeding around the clock. That means not going more than four hours without breastfeeding in the day or more than six hours at night when more prolactin is secreted. Prolactin is a hormone that suppresses ovulation. This also means no pumping.

But what if my period hasn’t returned?

You can still ovulate (and therefore get pregnant) in the absence of your period. Here are three ways to detect ovulation if you aren’t menstruating:

1. An increase in vaginal mucus: If you notice an increase or change in your vaginal discharge, especially if it transitions from thick and white to thin, clear and elastic, you are probably ovulating.
2. Temperature spikes: If you monitor your temperature as a preventive measure, watch for increases that aren’t related to illness because your body temp rises during ovulation.
3. Discolored discharge: As your menstrual cycle returns, it might not look like a normal period at first. Many women notice small amounts of brown or pink discharge instead of red blood, but that discharge can still mean that fertility has returned.

How effective is LAM?

When LAM is used correctly, less than 1 out of 100 women will get pregnant each year. That is less than the mini-pill breastfeeding women are cost commonly prescribed.

What are the other requirements?

• All sucking demands are met at the breast. No artificial nipples, pacifiers or bottles are given to baby.
• No supplemental feedings of water or formula.
• Your menstrual cycle has not returned. Menstrual bleeding is the most important indicator of fertility. After the initial 56 days postpartum, two consecutive days of bleeding/spotting or the woman’s perception that her period has returned, whichever of the two comes first, should be considered an indication that fertility is returning.
• Baby/babies are younger than six months. This is partly because a lot of people introduce solids by this age and partly because after 6 months, a woman will usually ovulate first and then bleed or not bleed 2 weeks later, depending on whether she has become pregnant or not. Before six months postpartum, bleeding will usually come before ovulation.

As soon as there is a decline in breastfeeding or any deviation from these requirements are made, the protection of this method decreases and additional and/or other methods should be considered.