[beginning fertility issues]

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Low-Tech Ways to Help You Conceive - Chapter 11

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Low-Tech Ways to
Help You Conceive


    11.1 Was she breastfeeding at the time of, or recently prior to, conception? Was the child breastfed exclusively / mostly / supplementally only? [breastfeeding is known to prevent or delay return of post-partum fertility; effects are variable from one mother to another]

11.1 Was she breastfeeding at the time of, or recently prior to, conception? Was the child breastfed exclusively / mostly / supplementally only?

RAH - Since ancient times, women who are breastfeeding a child regularly and frequently have known that during this time their periods cease, or rather, fail to return after pregnancy. This lack of monthly menstruation, called amenorrhea, almost certainly is evidence that the woman isn't ovulating, either. (An important exception, related to breastfeeding, is noted below.) While considerable debate takes place over how reliable lactational amenorrhea is as a birth-control method, there's little doubt that in the opposite quest, the quest for conception, delayed ovulation spells delayed conception. If you want to conceive while also breastfeeding, especially when exclusively breastfeeding on demand, the odds can be rather long, during the first year at least.

The reason that periods don't return while breastfeeding is that breastfeeding women have high levesl of the hormone prolactin, which indirectly leads to suppression of the hormones that lead up to and trigger ovulation. So, if you want to conceive during the first year, the trick is to arrange matters so that prolactin levels are reduced. Doing this naturally will probably mean altering the exclusive breastfeeding on demand schedule.

How to go about conceiving while breastfeeding? The details can be somewhat complicated, involving the old standbys of charting BBT and observing cervical fluid, but with some new rules of interpretation. Rather than explain in (probably confusing) detail here, I'll refer you to Appendix B and Appendix C in TCoYF (pp. 294-307), which explain clearly, including charts, what's involved.

Many of the posts that follow -- and indeed most of the information available about fertility and breastfeeding -- concern birth control and avoiding conception rather than trying to conceive. After all, many women are not especially anxious to have another baby very soon after giving birth! Of course, there can be many circumstances that would make this desirable. In general, keep in mind that when it comes to many fertility awareness techniques, contraception and conception are just two sides of the same coin.

The one important exception to the rule that no period equals no ovulation comes when fertility resumes after giving birth. In this circumstance, often the firt ovulation precedes the first retunred period; in other words 14 days (give or take) before your first postpartum period, it's quite possible that you ovulated. The lesson here is: Don't assume that you aren't fertile since you haven't had a period yet! - RAH

There has been several questions about getting pregnant while breastfeeding on alt.support.breastfeeding lately which is sort of along the lines of what you are doing. Actually, the questions are on gettting ones period back and getting pregnant. I've been following this since we want to have another child soon and I just got my first period a month ago when my daughter was 14 1/2 months old. Here's a short list of what I've learned from people. It's not very scientific, but I get the feeling you want the anecdotal stuff anyway.

    - When you start menstruating again while also breastfeeding depends a lot on the women. While you may ovulate [once] before your first period it is actually more likely that you will start with a few non-ovulating periods.

    - Skinny women may have more problems getting pregnant while breastfeeding, so if you want to get pregnant you might try putting on a couple of extra pounds.

    - You are more likely to not ovulate if you nurse several times a day and around the clock. If you want to get pregnant you should increase the longest interval where no nursing occurs. While it varies a lot from woman to woman, you may also have to cut down on the total number of feedings to get pregnant.

    - Even when your periods return, your cycle may be messed up. For example, you may ovulate too late in the cycle. You can plot your BBT to see what is actually happening. If you think that you should be ovulating even though your period has not returned, you can also plot your BBT to check.

My question is what are my chances of getting pregnant while exclusivly BFing [breastfeeding] my 10 month old? ... Can anyone give me a clue to tell when I am ovulating...without buying an ovulation kit?

Check out (at public library) or buy a copy of "A Cooperative Method of Natural Birth Control" by Margaret Nofziger. There is a chapter on post natal fertility. If you learn how to read your signs, you can find out if and when you are ovulating BEFORE you even get your first post-birth period. Mostly this is done with cervical [fluid], but basal temperature thermometer readings may also be helpful. Basal thermometers cost somewhere around $6-$10 last time I looked. Checking your [cervical fluid] is free!

There are women who exclusively breastfeed and ovulate within a few months of birth; for others even parttime breastfeeding inhibits ovulation. There's no hard and fast rule for every woman.

Good luck to you. There are babies who are born even 11 months apart, so it is possible.

Yes, its definitely possible to conceive again very shortly after birth. With my kids, my periods started again at 6 and 4 weeks, respectively. I started to ovulate that cycle.(by cervical [fluid] observation, I know its not entirely perfect, but reliable enough for me, I got pregnant 3 of the four times I had sex without birthcontrol and the other time I had my period). My kids were fully breastfed, never had soothers or sucked their thumbs or anything. I have a client who is pregnant every year, this years baby is due in May, she has an April baby and a March and another March already. She has never supplemented her babies.

My personal theory is that while there are many exceptions (I have had friends who had to wean in order to conceive) well-nourished people will be ready sooner for conception. (doesn't mean we want to). So don't use the breastfeeding as birth control!

One of my close friends conceived 5 weeks (yup, that's 5 WEEKS) after giving birth to her second child. She was breastfeeding on demand. Each woman is different but it can happen!!! BTW - the baby was born healthy and happy 10 months after her older sister!

Gotta agree with previous posters that [breastfeeding] inhibits, but does not prevent getting pregnant - I know one woman who got her period back on her daughter's first birthday, while still nursing 1-2 times a day, and got pregnant again that cycle.

But (as I'm finding out), even when the period returns and the cycles seem regular, bf can cause hormonal changes that skew the timing of ovulation (a form of 'luteal phase defect'). My doctor told me not to worry if I could not conceive until [child] is fully weaned.

According to my GYN, it is still possible although not as likely until periods are back (which could be any time--for me it was about 8-10wks). Most important thing to know is that BF is not a method of contraception!

Actually it is. It even has a name: The Lactation Amennhorhea [sp?] method. Though technically it isn't the bf itself that is the birthcontrol, it is the lack of ovulation that is CAUSED by the bf. Once ovulation/periods return, it is no longer effective.

From what my GYN said (seems they all have different twists on the same opinion) you can not rely on BF as a form of contraception -- you can [ovulate] while BF ...(albeit [this is] very rare).

No, I don't think it is very rare. But it might be pretty rare in the first 4 months.

BF does tend to suppress ovulation, but it is not reliable. And you don't menstruate until AFTER your first ovulation, so it is not a safe indicator.

I've heard that women do not get their periods while they are breastfeeding. Can someone please tell me if that is true?

It is sometimes true. Some women start up their periods fairly soon after delivery. Some women don't menstruate at all until baby is fully weaned (even if mother nurses for several years.) The majority of women resume mensturating sometime around the middle of the first year. (A common "trigger" is when the baby starts eating a fair amount of solids, or sleeping through the night.)

For the first 6 months, or until the periods return (whichever comes first), breastfeeding (if baby nurses frequently) is a very effective, although not 100% perfect method of birth control.

Breastfeeding is not perfect birth control. (Only abstinence is perfect birth control.) Women have conceived before menstruating in their early months of bf. Women have also conceived while using Norplant, birth control pills, condoms and every other method. For the first 6 months, or until the first period arrives (whichever comes first) Lactation Amenhorreah is 98% effective in preventing pregnancy, provided that baby is nursed on demand around the clock, with no supplements. (Adding solids late in the 6 month time frame, or the occasional bottle doesn't seem to affect effectiveness.)

In most women who mensturate during those first 6 months, the first period isn't preceeded by ovulation, so the odds of pregnancy are very small.

Lactation Amenhorrhea (can never spell that...) is 98% effective during the first 6 months, as long as the periods have not returned and baby is fully bf on demand and around the clock ... which mans that 1% of women will conceive during that time period. (Since effectiveness ratings are based on 1 year time frames.) After 6 months, the likelihood of conceiving before the first period goes up slightly (I don't have my stats with me, but I think it becomes around 96% effective), and after one year, it becomes gradually less and less effective. (This indicates that the likelihood of ovulating before that first period increases. [and it might also indicate that the no-longer-new-parents are having sex more often! :-)])

Obviously this needs to be reiterated. The lactational amenorrhea method is 98% effective for women who are exclusively breastfeeding their babies, until the baby is six months old. For the rest of the first year, as long as the mother is amenorrhic and breastfeeding at least seven times a day for at least 15 minutes each time, the method is 92% effective. One third of the time, the woman will NOT ovulate before getting her first period, and often the period will be very light. The other two thirds of the time, ovulation takes place, but because the hormones are not quite back to normal, there is an "inadequate luteal phase," which essentially means that the egg dies rapidly, and the few conceptions that do occur must be very well timed.

Obviously, conceptions will occur, as the method is only 98% effective. I have a friend who has two kids, the first of which was conceived while she was using a diaphragm, and the second while she was on the pill. Even knowing this, I still consider these to be reliable methods of birth control.

BF (sp?) is _supposed_ to be a form of birth control if:
1) The baby is 100% BF
2) The baby is under 6 mos old
3) Menstruation has not returned.

I would like to add to this, as it's a little more complex than this. There are 4 or 5 recent studies (since the late 80s) that show the above to be true. It's also true that in the second six months of the baby's life, if you are amenorrhic (no periods), and you are breastfeeding at least seven times a day for at least 15 minutes each, you have a 92% protection against pregnancy. You may ovulate before your first period (66% of women do), but in most cases the egg is not viable because the hormones are still in transition. This results in the high protection rates. Once you get your period, assume that your next ovulation will be normal and viable, though one study (maddeningly enough, I have only been able to get hold of the abstract!) found that even while menstruating, a breastfeeding woman's likelihood of pregnancy is reduced by a third (or is it two thirds? aaah! I will look this up!). If you stop breastfeeding before you get your period, assume that you will ovulate normally first, and that you may ovulate at any minute.

It is virtually unheard of for menstruation to return before the baby's 12 weeks old, if the baby is 100% breastfed. After that, probably six to nine months is the "average", though it may be years! I was hoping for years myself, but my baby was 8 months when my first period came. I figure that I did better than average, especially since you're more likely to be fertile sooner if you're younger (I'm 22).

I'm doing an intensive research paper on this subject and I'm hoping to turn it into a guide to using the Lactational Amenorrhea Method for as long as possible.

My period returned when my son was 3 months old, and completely, 100% BF (was not even in daycare yet getting EBM). So it does happen. I've heard through totally unsupported sources that BF is less effective at surpressing ovulation in heavier women (which includes me). My hormones are indominable!

I know a few women who have discovered to their surprise that it is possible to conceive during the first few months of breastfeeding. Everyone's cycle is different: some women begin ovulating as early as 2 or 3 months after baby's birth and some as late as 2 or 3 years after baby's birth (but both situations are rare)..even if they are still breastfeeding. My son is 10 months old, we are still breastfeeding, and I am not yet ovulating. The trickiest part is that you ovulate that first time before you get your first period. And that is what throws off a lot of women, because they think that they'll get their first period and then they'll start using birth control but of course then it's often too late. I think the average cycle starts up (if still nursing) at between 9 and 15 months after baby's birth. I don't know about when the cycle starts up in relation to when baby is weaned.

Don't wait for your periods to return as the single sign of the resumption of ovulation. A very good friend of ours relied on the 'you can't get pregnant while breastfeeding' advice. Her 1st and 2nd children are exactly 10 months apart. She breastfed exclusively and certainly didn't have a period. Our ObGyn makes it a point to tell all mothers that breastfeeding offers no protection at all against getting pregnant (a slight exageration, he will admit), that from a 'plumbing' point of view, a woman's body is in perfect shape to have another baby very soon after giving birth - he says it's like a cleansing, getting ready for the next time.

Something to keep in mind.

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