Breastfeeding and Fertility - How to Avoid or Induce Pregnancy

You might need to know if you can fall pregnant while breastfeeding, either because you want to prevent pregnancy naturally or if you're going to have another baby.

Loss of fertility while breastfeeding could either be used to a mother's advantage to help avoid pregnancy, or it could seem like a stumbling block for those who wish to fall pregnant and continue breastfeeding.

The effects of breastfeeding on fertility are different for everyone and influenced by many factors.

Breastfeeding and Fertility Fact
Is a pregnancy test accurate while breastfeeding?
Yes, the levels of HCG are not affected by breastfeeding. Therefore, a pregnancy test will be just as reliable while breastfeeding.

The Facts

• Half of all breastfeeding mothers have their periods return within the tenth month after their baby’s birth.
• About 20% of all mothers who breastfeed will become pregnant by the year mark if they have not taken contraceptive measures.
• Ovulation in a woman who has stopped breastfeeding can occur within three weeks of weaning.
• The chances of an exclusively breastfeeding mother, who has not had her period return, has a less than 1-2% of being fertile.
• The exclusive breastfeeding method of birth control is 98-99.5% effective in preventing fertility if LAM (below) is followed correctly.
• After six months postpartum, there is a 6% chance of falling pregnant before your first period.

How to Prevent Fertility while Breastfeeding
'Ecological Breastfeeding'

LAM 'lactational Amenorrhea Method': Lactation-induced amenorrhea is when a mother keeps her prolactin levels high to stay infertile. How do you accomplish this?

• Your infant must be less than six months old.
• Mom is amenorrheic (She has not started menstruating yet).
• Baby is breastfed around the clock and not given any other foods, supplements, or pacifiers. This will keep your prolactin levels up, which will delay fertility.
• Baby should be breastfed at least every three hours, including night feedings. Once the baby starts sleeping through the night, a mother has a higher chance of becoming fertile again.

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Tips to Maximize Your Infertility Window

• Nurse as much as possible; even comfort nursing will help; nipple stimulation increases prolactin levels.
• Nurse your baby at night, and co-sleeping will help too.
• Kangaroo care and wearing your baby in a sling will also help.

Breastfeeding and Fertility Fact
Women who fall pregnant while breastfeeding, are more likely to fall pregnant with twins! The non-lactating population has a 1.1% chance of conceiving twins, but a breastfeeding mother's chances are 12.4%.

Boosting Fertility While Breastfeeding

• A mother might have to decide to wean her baby (more about gentle weaning here).
• In other cases, a mother might only need to cut out some feedings at night. She can also decrease the duration of feeds. Cutting out some of the comfort feedings after a breastfeeding session can also increase the chances of fertility returning.
• Start with solid foods or increase the amount of solid foods your baby eats to boost your fertility. (Only for babies older than six months of age.)
  

Can I fall pregnant while breastfeeding?

Yes, a breastfeeding pregnancy is achievable; implantation is more difficult because of your high prolactin levels, but pregnancy while breastfeeding is possible, and a mother can continue to breastfeed while pregnant.

Breastfeeding and Fertility Fact
Can I fall pregnant before I get my first period?
It is very rare, but yes, you can fall pregnant before your first period arrives. Mothers should keep an eye on their cervical mucus as mentioned above.

Signs That You Are Becoming Fertile

• Some mothers report period pains months before their first period returns.
• Moms should check their cervical mucus; fertile mucus is thick and stretchy.
• Your first period should be seen as a 'warning period,' and contraception methods should be implemented if a mother does not want to fall pregnant.

Preferred Contraceptive Measures While Breastfeeding

• Condoms.
• Diaphragms.
• Non-hormonal IUDs.
• Contraceptive sponges.
• Cervical caps.
• If you decide to go on the pill, ask your doctor for a progestin-only pill, as this will not reduce your milk supply as much as estrogen-containing pills.