Breastfeeding, Your Period, and Fertility - What to Expect
Pregnancy, childbirth, and breastfeeding do incredible things to a woman’s body. The process that your body goes through to create a life, bring it into this world, and then nourish it is nothing short of miraculous. While you’re reveling in the power and beauty of your body, you no doubt have questions about all these new changes. If you’re breastfeeding, you may be wondering when to expect your first postpartum menstrual period and have questions about how breastfeeding affects your fertility.
Questions about menstruation and fertility top the list for new breastfeeding mothers. With so many hormonal changes going on, what can you expect in terms of getting your period and returning to regular monthly cycles? The answer is different for every woman.
Menstruation and Breastfeeding
We’ve long known that there’s a direct connection between breastfeeding and fertility. Many consider breastfeeding to be nature's contraception, with the perception being that breastfeeding offers protection against pregnancy, at least for some amount of time. This is true, but it’s important to note that when we look at exactly how breastfeeding affects menstruation and fertility, we find there’s an incredible range of what’s considered normal.
Some women resume their regular cycles shortly after birth, even when breastfeeding exclusively. Others won't see their periods return for months, sometimes more than a year. It’s also completely normal to have a non-ovulatory period (meaning no egg is released) sometime between one and six months postpartum, and then go several months before periods return more regularly.
It's enough to leave a nursing mother continually looking at the calendar, wondering when her first period will appear, and if she is fertile.
What’s Behind the Delay in your Periods Resuming?
Almost all breastfeeding mothers who exclusively nurse their babies are menstruation-free for the first three to six months postpartum. Your baby’s nursing pattern inhibits the production and release of hormones that regulate your normal menstrual cycle. It’s a phenomenon that is called lactational amenorrhea. Lactational amenorrhea is mother nature's way of ensuring your newborn receives all the nourishment he needs from you before preparing your body for another pregnancy.
In most cases for lactational amenorrhea to kick in, a mother needs to be exclusively feeding her baby at the breast, with baby relying on mom for all of her sucking needs. In this situation, exclusively breastfeeding is defined as:
Each family is different, but many begin introducing new foods into the baby's diet at around six months. As the baby starts to get nourishment from other sources, he will depend less on breastmilk. These new changes lead to less frequent feedings and the eventual return of your period. Supplementing with formula, bottle feeding breastmilk, and offering a pacifier can also shorten the period of lactational amenorrhea.
For some women, their period will return much sooner, even if they are exclusively feeding and comforting the baby at the breast. Each woman's physiology is different, and while there is a range of standard, your body may respond differently than most.
What About Fertility While Breastfeeding?
This is the million-dollar question that is on the minds of many breastfeeding mothers. If you haven't resumed regular menstrual cycles, does that mean that breastfeeding is a reliable method of contraception? On the flip side, you might also be wondering if breastfeeding will interfere with your plans to space your children closer together. Here’s what we know.
There is an actual method of contraception called the Lactational Amenorrhea Method (LAM). There are two very different points of view when it comes to breastfeeding and fertility. The first is that
breastfeeding, even exclusively, is never reliable in preventing pregnancy. The other is that breastfeeding, in any amount, offers protection until regular periods resume. The truth is somewhere in the middle for most women.
If a woman is nursing a baby who is under the age of six months and is nursing on demand and taking in no other source of nutrition, she has a high likelihood of being protected against pregnancy until her first post-pregnancy menstrual period. Given this specific set of circumstances, the LAM method results in 0.5 pregnancies per 100 women with perfect use. Typical use results in 2 pregnancies per 100 women.
These numbers change drastically once any one of the three conditions mentioned above aren't met. After the age of six months, baby nurses less frequently and takes in other sources of nutrition. The effects of these changes on a woman’s fertility happen quickly, and you should be prepared to use a backup method of contraception if you want to avoid pregnancy during this time.
The LAM method is also considered unreliable once a woman begins menstruating, regardless of how frequently she may be breastfeeding her baby. It would be best if you also kept in mind that unless your first period is non-ovulatory, you ovulate before your first period arrives – meaning you may be fertile, not even know it.
If you want to become pregnant while breastfeeding, it isn’t necessary to wean your baby (here’s a helpful article to reassure you). Fertility if often halted or diminished as cycles eventually resume to normal. However, while breastfeeding might mean it may take longer to become pregnant, your fertility will ultimately return, and continuing to nurse your child will not affect your ability to sustain a pregnancy.
Does Your Period Affect Breastfeeding?
Another common question mothers have focuses on whether the hormonal fluctuations caused by their period will affect their ability to nurse their baby. Of course, some changes happen to your body, and it's important to be aware of them. That said, your period may not affect breastfeeding at all. If it does, there are simple solutions to the issues some moms encounter.
For instance, your nipples might be more sensitive before or during your period, making breastfeeding uncomfortable. Unless you're ready to begin weaning, it's crucial to maintain normal breastfeeding patterns as much as possible to prevent engorgement and clogged ducts.
Another issue some women experience is a dip in their milk supply caused by the shift in hormones. As your cycle regulates, you can begin preparing for this dip by taking steps to boost your supply about a week before your period. Pumping or nursing more frequently can help keep supply up. Staying hydrated, getting lots of rest, and consuming galactagogues (foods, herbs, and medications that increase milk production) can also help. If you’re still having issues with supply, speak to your trusted lactation consultant for advice.
Connect with Other Breastfeeding Mothers
Do you have more questions about your period and breastfeeding? Do you want to connect with a community of women who encourage and support each other through their unique breastfeeding journey? Find the support and connections you’re looking for by joining us at our Luscious Letdown support group on Facebook.
References
Howie, P. W., McNeilly, A. S., Houston, M. J., Cook, A., & Boyle, H. (1982, October). Fertility after childbirth: infant feeding patterns, basal PRL levels and postpartum ovulation. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/7139964?dopt=Abstract
Menstruation. (n.d.). Retrieved from https://www.llli.org/breastfeeding-info/menstruation/
The Lactational Amenorrhea Method (LAM) for postpartum contraception. (2016, June 1). Retrieved from https://www.breastfeeding.asn.au/bfinfo/lactational-amenorrhea-method-lam-postpartum-contraception