Con­tra­cep­tion op­tions for breast­feed­ing women

BREAST­FEED­ING & CON­TRA­CEP­TION

Your Baby & Toddler - - The Dossier -

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.

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