Does Breastfeeding Prevent You From Getting Pregnant?

posted on March 24, 2018 by Cassie Moriarty Cassie Moriarty

For many women, Fertility Awareness Based Methods (FABM) are remarkable at making our bodies’ cycles much less mysterious and much more understandable. This is no less true than for the postpartum period—yes, even that period after giving birth when hormones are all over the place. Whether you’re charting or not, this can be a confusing time for many women who are hoping to add some space between the new baby and the next one. The good news is there are methods available for women to naturally avoid pregnancy.

postpartum mom breastfeeding fertility awareness methods natural avoid pregnancy nfp

Right after labor and delivery, the expulsion of the placenta and baby result in a dramatic shift in a mom’s hormonal makeup. It is safe to assume the two weeks following birth a woman will not ovulate—nursing or not (although intercourse is likely far off the list of priorities at this point!). But what happens with a woman’s fertility cycle after those first two weeks postpartum is unique for every woman based on her environmental factors, hormonal constitution, and her baby’s feeding habits. Once ovulation hormones start activating, many women will find that their cycles to be irregular, long, difficult to chart, and particularly hard to find “infertile days.” So let’s clear up some of this, shall we?

Lactational Amenorrhea Method (LAM)

The idea that breastfeeding prevents pregnancy is actually based in the sound science of how lactation affects reproductive hormones. Prolactin wants to be the dominant hormone. Nursing results in prolactin. Therefore, technically speaking breastfeeding makes your infertile. This is where the idea of the Lactational Amenorrhea Method (LAM) comes from. According to LAM, you can consider yourself infertile if:

1.      Your baby is younger than 6 months old.
2.      You have not had a period yet.
3.      Your baby has not received supplemental food (formula or solids), or artificial nipples (bottles or pacifier).

Item #2 to me is always a bit of a head scratcher—seems the qualification itself disputes the method, but let’s run with it for now.

What complicates things is when women follow mainstream advice on breastfeeding that neutralizes the power nursing hormones have to suppress ovulation. For instance, many women believe the pump produces the same hormonal effect as a baby sucking, but it actually is quite different. A pump works on suction rather than suckling and fails to provide the same stimulation on the nipple as a baby’s latch; as a result, it does not produce as much prolactin. That’s very important to know!

Ecological Breastfeeding
There is also something called ecological breastfeeding (EBF) that extends the period of non-ovulation past the first 6 months and has more rigorous stipulations. This includes co-sleeping, on demand nursing, limited (if any) separation between mother and baby, and no pumps, bottles, or pacifiers. The Fertility Appreciation Collaborative to Teach the Science (FACTS) notes that while EBF is a form of fertility awareness methods for avoiding pregnancy, it is not one with sufficient current research of effectiveness for them to consider it evidence-based.

Still, many women swear by it, while other mothers find meeting all the standards darn well impossible, particularly moms who work outside the home. In our culture today (i.e. not living in a village with people offering helping hands left and right), it can be very hard for moms to sustain without significant exhaustion. Even still—some moms doggedly follow all the rules to a tee, and aunt flo decides to show up anyway. This reminds us the priority of charting biomarkers when it comes to predicting fertile periods.

Charting with other Fertility Awareness Based Methods 

The good news is that our biomarkers give us a pretty good window into what’s going on with our hormones. For moms seeking to avoid pregnancy, it’s important to choose a fertility awareness method and pay attention to these biomarkers, rather than believe the blanket statement that nursing moms can’t get pregnant.

LAM and EBF can be used in conjunction with charting, whichever fertility awareness based method a mom decides on. Billings, SymptoThermal (also taught through the Couple to Couple League), and FEMM all have postpartum protocols, and I’d recommend a mother choose one method and stick to it. The most important factor is to work with a certified instructor.

The postpartum period is a transitional time difficult for even the most seasoned charter. Your instructor should help you find which biomarkers you want to prioritize for this particular moment. Because what you need this month might be different than last month. And heaven knows what will be helpful next month.

Thankfully, technology is advancing and there are more options than ever for making charting as seamless as possible. Wearables like temp drop make temping easy for the mom who has unusual (and sporadic) sleep patterns. The Clearblue Fertility monitor gives moms an objective look at hormone levels. And the Ovulation Double Check progesterone strips can work as a nice cross check post ovulation. With the help of these tools, an instructor can help piece together what’s working (or not) for a postpartum mom in deciphering fertile and infertile days.

Lastly, patience is a new mom’s best asset. It really is a season. Those cycles will get back on track, they just need time. According to FEMM’s protocol, it can take up to 6 cycles for hormones to regulate. If after 6 cycles, cycles are still irregular and difficult to decipher, it’s worth looking more in depth at hormonal levels.

So does breastfeeding help to prevent pregnancy? Yes, it can. Should new moms still be recording and paying attention to biomarkers like cervical fluid that tell them about their fertility? Yes. But since every woman’s experience can be so different, charting biomarkers always comes first.

Oh, and kick back, don’t forget to enjoy your new bundle of life!

Posted by Cassie Moriarty Cassie Moriarty
Cassondra Moriarty is a fertility awareness educator, postpartum doula, and lactation mentor based in New York City, where she lives with her 2 year old daughter and husband. She manages a local wellness clinic that focuses on hormonal health, and she leads monthly La Leche League meetings to help nursing moms connect and get guidance on breastfeeding. After ditching hormonal birth control in 2012, she became an ardent fertility awareness enthusiast. Now, as a FEMM certified instructor, she teaches women and teens how to chart their cycles. When not running after her toddler, she enjoys attempting to make her thumb green and listening to live jazz music.

6 Responses to Does Breastfeeding Prevent You From Getting Pregnant?

  1. Avatar ana says:

    I was disappointed to read the comments about ecological breastfeeding. There is a lot of research about ecological breastfeeding and I will post a couple of links. It seems that possibly much research has been done to show ecological breastfeeding’s effect on fertility, so that no more is needed, or no one is interested to do more research, who has the money necessary. I am a registered nurse and am pleased with the research that I have seen; I also personally went 12 to 14 months w/o cycles with my children and found the “standards” to be quite “natural” to do / second nature, and not burdensome at all. Additionally, there have been 2 studies regarding working mothers. One study showed working moms at home still averaged 14 months w/o cycles and another study showed working moms doing all 7 standards, outside the home, still having an average of 8 months of breastfeeding amenorrhea. Thanks for mentioning ECO-breastfeeding –> the organization that promotes this, NFP International, additionally mentions in their book, “NFP:The Complete Approach” , to chart mucus, temperature and cervix signs while nursing, IF a serious need to avoid pregnancy exists, so it is not promoted in any “old-wives-tales” genre. Here are the links I hope you can take a look through. http://www.nfpandmore.org/nfpresearch.shtml http://nfpandmore.org/wordpress/?cat=5

  2. Avatar sheilakippley says:

    LAM is not defined properly. 1) The baby is exclusively breastfed. The baby receives only his mother’s milk directly from her breasts for his nourishment. He does not receive any other food or liquid. 2) The mother has no menstrual bleeding after the first 8 weeks postpartum. and 3) The baby must be younger than 6 months of age. There were 2 published research studies on eco-breastfeeding. In both studies, American nursing mothers following the Seven Standards averaged 14.5 months without menstruation. Dr. Bill Taylor also did studies in the 1990s but these seem to be ignored. You also did not define the Seven Standards. In these studies we deleted 3 mothers who went over 40 months without menstruation. If we included them, the average without menstruation due to eco-bf would have been longer. An Italian mother who translated one of my breastfeeding books went 37 months without menstruation recently due to eco-breastfeeding. Following nature, mothers who follow the Seven Standards may go 1, 2 or even 3 years without menstruation due to breastfeeding. That is perfectly normal. To have a period in the early months with eco-bf would be an exception.

  3. Avatar Gina Marie Krokar Peterson says:

    I am the executive director of the Catholic Nursing Mothers League which is a non profit organization that supports nursing moms and promotes ecological breastfeeding. I was an LLL leader for 12.5 years and have been an IBCLC for 10 years.

    Yds, there are a few women who practice ecological breastfeeding and still have a return to fertility early on but many women have months and years of amenorrhea. I have five children and did not have any problems practicing ecological breastfeeding while caring for my other children. I made this type of parenting a priority and we even lived on one income during college. I realize that there are women who must work but often there are creative ways to enable the mom to stay home too. I am not a napper but always let my babies and toddlers nurse to their heart’s content while falling asleep for a nap. I also coslept with all of them. I had anywhere between 21 months and 31 months of amenorrhea with each child. I think that by practicing ecological breastfeeding which then led to a good amount of spacing between children, it was easier to breastfeed on demand. However I also know families with a little less spacing that practice ecological breastfeeding successfully. I do not have family thgst live in my state and we also hardly used babysitters when my oldest children were little. Babies and toddlers are little for such a short time. I tried hard to avoid separation. I took my youngest to Europe as a nursing lap child when she was 18 months old. When my children were little, I even took the nursing baby on my husband and my date night.

    Ecological breastfeeding works extremely well for child spacing for many families and the closeness it encourages is so special and not to be missed!

  4. Avatar Lauren says:

    I’d also like to see the Creighton method mentioned.

    I’ve had great success with ecological breastfeeding. The book “The Seven Standards of Ecological Breastfeeding: The Frequency Factor” by Sheila Kippley is loaded with sound research.

    Some trends I have noticed on why ecological breastfeeding “fails” for some are 1) health issues (especially hormone related- more research needs to be done here). These are not always obvious until you start asking questions. 2) Mothers are so influced by culture they THINK they are nursing on cue or following the standards but if you examine closely they are not 100%. You touch on this sort of by saying how hard it is for women to meet the standards- I see so many moms who attempt to use ecological breastfeeding but put baby down too much to get work done or transport other children around and the focus is off baby. They automically make timelines in their heads and dismiss offering the breast enough. I’ve witnessed this first hand had a mom is at a get together and her baby sits in a car seat sucking in their hand. If you look at Sheila’s research in her book I mentioned, you will see most cultures who practice this nurse their babies several times per each hour. Moms who claim to “nurse in demand” usually don’t even come close to this. There is another fertility book out there that mentions how quickly hormones go back to that of a non nursing mother after four hours of not nursing, declining up until then. It’s very common to hear mothers refer to baby nursing every hour as “cluster feeding” when a tribal baby would have nursed 3 times as much normally. This standard needs to be further defined to help women.

    Also, we need to shift priority back and look at this mothering as the healthiest style of mothering regarding attachment and bonding. When we go back to this, it will make it easier for women to place priority on it. I’ve seen a lot of comments from people who will say “I wish I was privileged enough to stay home”. We barely make over poverty level but have managed just fine over the years. I think the number of women who truly cannot work in our society is low. The most common thing I hear is women just don’t like being home with the children and get more pleasure outside the home. So I think it’s totally realistic for most people, but they aren’t making it a high priority.

  5. Avatar Therese says:

    Why no mention of the Creighton Model? Thirty years ago I researched methods and chose the Creighton Model specifically due to its post partum/ breastfeeding management. Twenty years later I began teaching this method, and have successfully navigated the return of fertility of all my post partum clients-all!

  6. Avatar Barbara Cohen says:

    One thing that really needs to be discussed in this current mommy culture that is steeped in sleep-training dogma, is how long stretches of sleep and no milk removal during the night impacts return to fertility. It is the feeding in the night, in the dark, that drives the continued heightened release of the hormones of lactation, which tamps down fertility. Night feeding is not only an effective way of meeting baby’s needs and keeping mom’s breasts producing milk optimally, it is also a very effective way to delay the return to fertility. An essential component of LAM is breastfeeding on baby’s cues day and night. Sleep-training interupts that significantly as the goal is often to have a baby sleeping 12 hours continuously at a very early age.