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 but I'd rather not while I'm still nursing. I have heard that breastfeeding offers protection against pregnancy. Is this the case?

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Toni Weschler, MS

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While exclusively breastfeeding, nature will reward you with one of the simplest and most effective forms of natural contraception available. You'll benefit 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 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 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, so 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.

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.

 

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