WILL BREASTFEEDING PREVENT ANOTHER PREGNANCY?
Q:
I’m breastfeeding exclusively. Since giving birth I haven’t had my period. Is breastfeeding an adequate contraceptive, or can I still get pregnant? Can I fall pregnant before menstruation starts?
A:
A variety of family planning methods are available for breastfeeding mothers, including natural measures, non-hormone containing methods, and hormone-containing methods. Chat to a healthcare worker about the options, so they can take into account how healthy you are and what your needs are. Exclusive breastfeeding in the first six months of your baby’s life will protect you against another pregnancy. This is called the lactation amenorrhoea method (LAM). It’s 98 percent effective if your baby is only getting breastmilk from you and no other liquid or food whatsoever, if menstruation has not started again, and if baby is younger than six months and feeds during the daytime at least every four hours and at night at least every six hours. Continued breastfeeding after six months, when baby is already eating solids and is still being breastfed, can still suppress ovulation and menstruation, but it isn’t as effective in preventing pregnancy as in the first six months of breastfeeding. Continued breastfeeding can, however, be used in combination with other methods of family planning. Condoms, diaphragms and other devices can be used if you prefer non-hormone containing methods. These give you around 90 percent protection. If you use hormonal methods, a tiny amount will end up in your breastmilk. Experts agree that progestincontaining pills are compatible with breastfeeding and have little to no effect on breastfeeding. Currently it’s recommended that you start taking progestincontaining pills from six to eight weeks after birth. The pill that contains oestrogen isn’t the best choice for breastfeeding women, as oestrogen affects milk production. During your pregnancy, high levels of oestrogen suppress breastmilk production. Shortly after birth the level drops rapidly and breastfeeding is then supported by the hormones prolactin and oxytocin. It’s recommended that mothers who want to use an oestrogen-based pill wait until their baby is at least six months old and starting on solids before they start with this pill. The newer combination pills that contain both progesterone and oestrogen contain less oestrogen than years ago and can therefore now be used safely from six to eight weeks after birth.