Breastfeeding: How Does Nursing Impact Fertility Charting?
I have been exclusively breastfeeding my four month old and have not had a period yet. My doctor wants to put me on the mini pill. I'd rather not be on the pill when I am breastfeeding. I have heard that breastfeeding offers protection against pregnancy. What do charts of breastfeeding moms look like?
Question:Toni Weschler, MS
Toni Weschler is the author of the popular book Taking Charge of Your Fertility. By offering a simple and effective means of identifying... Read more
One of the best gifts you can give your baby is the lifelong health benefit provided by breastfeeding. Not only is it excellent nourishment, but it offers important immunological protection against disease and allergies. Yet in order to fully attain such advantages, you should breastfeed around the clock, whenever your baby is hungry. Ideally, no supplements should be given the first six months. Since you said that you are exclusively breastfeeding, it sounds like you are doing just that.
While exclusively breastfeeding, nature will reward you with one of the simplest and most effective forms of natural contraception available. You will be able to use the Lactational Amenorrhea Method (LAM) if you meet the following three criteria:
- Your menses have not returned.
- You are fully or nearly fully breastfeeding.
- Your baby is less than six months old.
The first criteria of LAM is that you have not resumed menstruating. What this means in practice is that any vaginal bleeding before the 56th day is almost always anovulatory (and therefore can be ignored), assuming you are fully or nearly fully breastfeeding. However, any bleeding after the 56th day should be considered a sign of resumed ovulation.
Full breastfeeding means that you are not giving your baby any supplements or pacifiers. However, the Institute of Reproductive Health at Georgetown University has shown through extensive studies that the contraceptive effectiveness of LAM is maintained even if your breastfeeding is nearly full, meaning that you supplement no more than 15 percent of all feedings.
Of course the risk of resumed ovulation is on a continuum, and thus you should try to breastfeed as close to fully as possible. In addition, full or nearly full breastfeeding means that intervals between feedings should not exceed four hours during the day or six hours at night.
With LAM, you don't need to chart your fertility signs at all if you meet the criteria above, since it is considered to be at least 98 percent effective. If you were to chart during this time, what you would probably find, though, is that your temps bounce around, never achieving a bi-phasic pattern of lows and highs, since you would probably not ovulate. Also, your cervical fluid would probably tend to be dry day after day until you start weaning and your cycles begin to try to resume their pre-pregnant pattern.
Not charting during these six months is a tremendous advantage because observing your fertility signs while breastfeeding can be somewhat challenging. However, if you do not meet the LAM criteria, you will need to follow the Fertility Awareness Method rules for breastfeeding if you want a natural method. I would encourage you to read Appendix C of my book, Taking Charge of Your Fertility.
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