Q&A: Can I fall pregnant while breastfeeding?

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Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.

My baby is two months old, and my period hasn’t started again. I’m feeling more like myself now, and I’m sure my sex life is going to start happening again soon. Apparently, I can’t fall pregnant while breastfeeding, but I think it is best not to take any chances. What kind of contraceptives can I use now? The gynae tried to talk to me about it just after giving birth, but seriously, it was the furthest thing from my mind.

SISTER LINDA BRITZ ANSWERS: Adjusting to your ”new normal” once your baby is a part of your family can take time and some changes in all areas, and you will start to feel more confident and comfortable as the weeks pass. Usually by six weeks postpartum, your body has physically healed from birth and modified to producing breastmilk to nourish and grow your baby exclusively for at least the next six months.

As you are breastfeeding your baby, you have most likely settled into a good feeding pattern now, and your baby will regularly feed during the day and night, possibly starting to stretch a little longer between the night feeds. By 3 months of age, your baby will definitely sleep longer stretches between night feeds, as his tummy matures, and he no longer makes stools during the night-time hours. These longer times between feeds can cause the fine balance of hormones in your body to alter, and you may find that your supply is affected. It can also mean that your hormones vary according to your pattern of breastfeeding and can trigger the hormonal mechanism that causes ovulation.

Oxytocin, the ”love” hormone, is at play within your body throughout your breastfeeding experience, and helps you fall in love with your baby, and also makes you feel amorous towards your partner. So you’ll definitely start to feel more sexy now that you have come to terms with your new lifestyle.

There are many ways that you can plan your family, and contraceptives that can be used safely while breastfeeding.

The most modern, but temporary, contraceptive method used in family planning is called LAM, which is short for lactational amenorrhea method.

It’s based on natural infertility resulting from certain patterns of breastfeeding. This technique requires three criteria to be in place to ensure that it is effective.

It is based on the fact that:

CRITERIUM 1: regular full breastfeeding is in place, and at night, no intervals should be greater than six hours.

CRITERIUM 2: your menstrual periods have not started.

CRITERIUM 3: your baby is younger than 6 months of age.

Adhering to the above tool, which can be put in place directly after birth, can reduce your chances of becoming pregnant. After six months postpartum, and as you start to introduce solids to your baby, your risk of pregnancy increases.

You can then choose to use another method while continuing to breastfeed as recommended, for both you and your baby’s health. This will also help you ensure healthy birth spacing.

Combined oral contraceptive pills and injectables contain oestrogen, which will decrease your milk supply, so they can’t be used.

An oral progestin-only tablet, or more commonly known as the ”mini” pill, can be taken.

The mini pill may affect your milk supply for a bit as you start to take it, but if you breastfeed more regularly for a few days, it usually balances out again. There are also injectable contraceptives that are given intramuscularly.

These need to be given every two to three months. A side effect of injectable contraceptives is that you may have breakthrough bleeds that can take a few months to settle and may lead to anaemia. Another method is to have a contraceptive implant inserted subdermally, which means below the skin. Then there are intra-uterine devices (IUDs) that are inserted into your uterus to prevent a pregnancy.

There are different types. The progest in loaded IUD is safe and can be used for up to five years.

Before you spend the money, consider if it’s worth it for your ideal spacing between pregnancies.

An IUD that is copper based is safe but can cause heavy bleeding.

So, although breastfeeding is a feeding practice and not a family-planning method, you have some time in the next few months to adhere to the LAM until you make a decision for future pregnancies. ●