Rumors and old wives tales are passed from woman to woman regarding breastfeeding and menstruation. Some say that nursing prevents all periods, is a form of birth control, or that mom's milk goes sour if a period does return. Sorting out fact from myth is essential to your breastfeeding relationship and reproductive health.
Breastfeeding and Menstruation Basics
After having a baby, many women experience post partum bleeding. This is not menstruation. If breastfeeding, a period will return at some point in the mom's life. However, this point is not universal. The World Health Organization considers any bleeding 56 or more days after birth to be menstruation.
Some women will experience a period within the first few months of breastfeeding, once baby begins to sleep longer at night. If mom needs to supplement baby or when baby starts taking solids, menstruation may occur. However, some women have been known to go a full year or more with no period while breastfeeding. The absence of a period during breastfeeding is called "lactational amenorrhea."
If you are breastfeeding and menstruation does occur, it may be different from your prior periods. Flow may be heavier or lighter, and the length of time your period lasts may vary. Do not expect your period to be regular for several months, as your body works to regulate itself.
Menstruation does not mean you have to quit breastfeeding. Your milk supply may have a slight decrease, but your child may compensate by simply nursing more often. If you have supply issues to begin with, speak to your doctor if you feel you need help during this time. Additionally, while your milk is not "soured," your baby may notice a slight difference and not eat as well during your period.
Moms who experience menstruation may notice more nipple or breast tenderness. They may also feel different while nursing. These feelings will pass after you finish your period.
Conception While Breastfeeding
Even if your period does not return while breastfeeding, it is still possible to conceive. The absence of menstruation does not mean that you will not ovulate. Therefore, some form of birth control should be used once you have been given the okay by your doctor to resume sexual activity.
The chances of getting pregnant while breastfeeding and menstruation has not returned range somewhere between one and two percent for the first six months of breastfeeding. After your baby turns six months, the chances of conceiving while breastfeeding (with no menstruation) goes up.
Using breastfeeding as an exclusive form of birth control is known as the lactational amenorrhea method (LAM). While many advocate this as an effective form of birth control when done correctly, some women find it difficult or are uncomfortable following all the necessary guidelines, like no pacifier use and nursing frequently for long periods of time. For this reason, doctors often recommend another method of birth control to be used in conjunction with LAM.
Methods of Birth Control
Breastfeeding women have several options for birth control. Most doctors do not recommend using hormonal birth control that combines estrogen and progesterone, because it may decrease supply. This leaves barrier methods and progestin-only birth control as methods.
These methods of birth control can be taken in the form of:
- Progestin-only birth control pills ("mini pill")
- Progestin-only implants
- Progestin-only injections
- IUDs (intrauterine devices)
- Cervical caps
Depending on the method of birth control you choose, you may have to wait several weeks before being able to use your first choice. Most doctors require a waiting period of four to six weeks before having intercourse or inserting anything into the vagina after birth.
To learn more about breastfeeding and menstruation, speak to a lactation consultant at your clinic or hospital. Talk to your doctor about the best method of birth control to use while you nurse your child.