Contraception options for breastfeeding women

BREASTFEEDING & CONTRACEPTION

Is it true that nursing offers protection against pregnancy? Could the Pill affect your milk supply? Will the hormones harm baby? Lactation consultant Marie-louise Steyn gives you the information you need to choose reliable, breastfeeding-friendly birth control IN THE BEGINNING …

MOST FORMS OF contraception are compatible with breastfeeding, yet some are safer than others, especially shortly after birth. In the first six to eight weeks it is best to avoid all hormonal contraceptives, because… • your body needs about a month to establish milk production. During this critical period progesterone and/ or oestrogen might interfere with breastfeeding hormones and limit your milk supply. synthetic hormones do pass into your breastmilk. Since a newborn’s liver is immature he might not metabolise these effectively. The same goes for babies born prematurely or babies with health problems.

YOUR BIRTH CONTROL OPTIONS

First choice: Non-hormonal methods. Steering clear of artificial hormones is the safest for your health, your baby, and your milk supply. Non-hormonal options are the lactation amenorrhea method (LAM), natural family planning (NFP), barrier methods like condoms and diaphragms, and non-hormonal intrauterine devices (IUDS).

THE LACTATION AMENORRHEA METHOD (LAM)

Breastfeeding delays fertility and can, despite myths and cautionary tales, be an effective form of short-term birth control. The benefits? It is natural, free, and surprisingly simple.

“Lactation amenorrhea” is the absence of menstruation. The average non-breastfeeding woman gets her first period – and regains her fertility – around eight weeks after birth. A mom who nurses exclusively for six months and thereafter gradually introduces solids, usually won’t menstruate before her baby’s first birthday. This is the average, though, some women start menstruating after eight weeks, while a lucky few won’t need tampons until weaning their babies.

How does LAM work? Breastfeeding hormones suppress ovulation. Your body is designed to nurture and protect your baby – this baby. His nutritional needs come first, before your own and certainly before any new sibling’s. For as long as your nurseling frequently empties your breasts, your body will assume that you are his sole food source. The more breastfeeding hormones it produces, the longer pregnancy will be delayed. When practised correctly, LAM is as efficient as the Pill. If you can answer “no” to each of the following questions, your risk of pregnancy is lower than 2%.

ARE YOU A CANDIDATE FOR LAM? FOUR CRUCIAL QUESTIONS: 1: HAVE YOU HAD ONE OR MORE # PERIODS?

A “period” is defined as any bleeding that begins more than eight weeks after birth and lasts at least two days. During the first six months of breastfeeding, you will likely menstruate before you ovulate. In fact, your first few cycles will probably be infertile. However, consider your first period fair warning and use additional birth control if you feel strongly about preventing pregnancy. Don’t get too big a fright if your periods disappear again, it sometimes happens when a baby suddenly feeds more frequently. Still, you should consider yourself fertile and take the necessary precautions.

2: IS BABY GETTING ANY WATER, # FORMULA SUPPLEMENTS OR SOLID FOOD?

LAM is 98% reliable for the duration of exclusive breastfeeding, in other words while baby is getting nothing but breastmilk. As soon as things change, your pregnancy risk increases.

3: IS BABY NURSING INFREQUENTLY?

Your return to fertility is usually imminent when baby: • feeds less than eight times in 24 hours, • stretches daytime feeds more than four hours apart, and/or • sleeps six or more uninterrupted hours per night.

4: IS BABY MORE THAN SIX MONTHS OLD?

Some studies suggest that LAM remains reliable until nine months, provided the answers to the previous questions remain negative, but rather safe than sorry. Besides, the risk of ovulating before your first menstruation increases once baby is older and no longer breastfeeding exclusively.

Ask yourself these questions often. The moment you have a single “yes” answer your pregnancy risk increases dramatically. Also, be warned, if you express regularly instead of breastfeeding directly LAM may be less effective.