Breastfeeding is a special time that you share with this little being that you gave birth to. It is an extension of the bond between a mother and her child, woven well beyond birth. But it is also, often, a vague period hormonally. Whether for avoid getting pregnant directly after this baby, or because we want to have a second pregnancy quickly, the question of fertility arises when breastfeeding. Navigating between postpartum, the desire for a new child or, on the contrary, the need to rest your body, requires understanding what is at stake biologically, emotionally, and intimately in this suspended moment.
What happens in the body while breastfeeding?
Prolactin, a key hormone during breastfeeding
During breastfeeding, a hormone is extremely important in the process: prolactin. It is she who stimulates milk production. But it also has another effect: it inhibits ovulation.
Concretely, as long as prolactin is secreted in large quantities which is the case when baby feeds frequently, including at night the body can pause the menstrual cycle.
It is an ancestral, protective mechanism: it allows the body to avoid launching into a new pregnancy while it is still breastfeeding an infant.
Menstrual cycles after childbirth
The return of periods, also called returning from diapers, is very variable:
- It may occur from 6 to 8 weeks postpartum in some non-breastfeeding women.
- Or make yourself wait several months, or even more than a year, in those who breastfeed on demand.
However, a return of period does not necessarily mean a return of ovulation. In some women, the first cycles are anovulatory. In others, fertility returns even without bleeding.
Is breastfeeding a reliable contraceptive method?
The MAMA method: what the science says
Breastfeeding can, under certain very specific conditions, play a role natural contraceptive. This is what we call the LAM method (Breastfeeding and Amenorrhea Method).
It is recognized by the WHO as more than 95% effective provided that three criteria are met simultaneously :
- The child is aged less than 6 months,
- He is exclusively breastfed, that is to say without any supplement (neither bottle nor solids),
- The periods haven't returned yet (no bleeding for more than two months postpartum).
In this very specific context, breastfeeding naturally blocks ovulation thanks to prolactin, which is produced in large quantities when feedings are frequent and spread over 24 hours.
Limits to know
The MAMA method remains a natural method, therefore very sensitive to the slightest variation. Its effectiveness diminishes as soon as one of the three criteria is no longer met:
- If baby sleeps through the night or space out your feedings (more than 6 hours without feeding at night, more than 4 hours during the day),
- If a milk supplement or solid foods are introduced,
- Or if the mother notices a return of her periods (even light).
In these cases, ovulation may resume without visible signs. It is therefore entirely possible to get pregnant even before your period returns.
It is important that women are informed of these limits in order to make a informed contraceptive choice, especially if a new pregnancy is not desired in the short term.
Of the complementary methods of contraception (such as a mini-pill compatible with breastfeeding) can be considered with a healthcare professional.
What methods of contraception are compatible with breastfeeding?
After giving birth, it is completely natural to wonder about your fertility, especially if you are breastfeeding. Although exclusive breastfeeding can delay the return of cycles, it does not constitute reliable long-term contraceptive protection.
As soon as one of the criteria of the LAMA method is no longer met, it is important to think about a suitable method of contraception to the new reality of the body, without harming breastfeeding.
Fortunately, several solutions exist, safe and compatible with this very special period.
1. The progestin-only pill (microprogestin)
This is one of the most commonly prescribed options while breastfeeding. Unlike the classic pill, it does not contain estrogen, which makes it without impact on lactation.
It must be taken every day at the same time to maintain its effectiveness. If your breastfeeding remains frequent, it allows a smooth transition to a hormonal contraception.
2. The IUD (IUD), hormonal or copper
THE copper IUD is a great hormone-free option. It acts locally and can be applied from 6 to 8 weeks after delivery (according to medical advice). He does not influence milk production and offers protection for 5 to 10 years depending on the model.
THE Hormonal IUD, for its part, diffuses a low dose of progestin into the uterus. He is also compatible with breastfeeding, with a rapid return to fertility after withdrawal.
3. The contraceptive implant
Inserted under the skin of the arm, the implant releases a progestin hormone over several years (3 years in general). He is fully compatible with breastfeeding and very effective.
This is an interesting option for women who want contraception without thinking about it on a daily basis.
4. Contraceptive injection (delayed progestin)
This intramuscular injection, administered every 3 months, is another hormonal option without estrogen.
It is less often used in France but remains compatible with breastfeeding. You should know that it can delay the return to fertility after stopping.
5. Natural methods (with caution)
Some women prefer to turn to natural contraception after childbirth, particularly through observation of cycles. However, during breastfeeding, cycles are often irregular, making the analysis of ovulation signs unreliable.
These methods may be suitable, but should be used with great rigor, ideally accompanied by a trained professional.
Please note that in all cases, you can continue to express your milk, whether or not you have contraception.
I am looking for a practical and discreet breast pump
Return of fertility: a unique process for each woman
What are the symptoms of returning from diapers?
To identify your return to fertility, you can listen to your body and observe it to know where you are in your biological rhythm. For example, you can look at:
- the increase in the cervical mucus ;
- there breast tenderness different from breastfeeding;
- if you have a peak of libido ;
- if you feel ovulation by identifying pain related to your cycle;
- if you have hormonal change. .
Each woman experiences this return in her own way, some feel it, others not. The important thing is to stay tuned of his body.
To guide you through your entire return to fertility, you can consult the site Reflection which offers fertility programs.
Variations depending on the intensity and duration of breastfeeding
The more frequent, longer and on demand breastfeeding is, the more fertility is delayed although this is not an absolute rule. women get pregnant while they are still breastfeeding exclusively.
Others, even after withdrawal, wait a long time before returning to fertile cycles.
Breastfeeding and the desire for a new child: a balance between body and personal choice
Sometimes we may want to get pregnant again quickly after our pregnancy and it’s normal to ask questions. There are many things to consider when it comes to getting pregnant again.
It does not only depend on biological factors, but also the state of fatigue, mental availability, personal well-being and each person’s life project.
Fatigue, libido, hormonal balance: what the body experiences postpartum
Breast-feed mobilizes energy, modifies the sleep patterns, and influence hormonal balance.
During the postpartum, it is therefore common to feel a drop in libido, linked in particular to the reduction in estrogen, as well as a need to find space for oneself, physically and emotionally.
The body is still in the recovery phase. It is normal that he is not immediately ready to consider another pregnancy and it is good to realize this without feeling guilty.
The weight of the social norm and the next baby
Some women express a quick desire to get pregnant again, others feel the need to take their time.
However, it frequently happens that a social, family or internal pressure sets in: that of not spacing births too far apart, or of corresponding to the ideal image of the close family.
These injunctions can generate stress or some form of confusion.
The most important thing is to be able to make this choice consciously, according to their real desires, their physical and mental capacities, and not a timetable dictated from the outside. There is no right or wrong timing, only yours.
You have the right to prioritize your recovery, your well-being, your privacy. What if the desire for a new child manifests itself, you also have the right to welcome it, even if breastfeeding is still in progress.
Every journey is different, and what matters is feel aligned with your decision.
How to gently support the return of fertility?
After giving birth, the return of fertility varies from one woman to another. It depends on many factors: breastfeeding rhythm, level of fatigue, diet, emotional state and hormonal history.
Even if this process is largely natural, a few guidelines can help to support it in an appropriate way, without forcing the body.
Support your body with a healthy lifestyle
A balanced and varied diet allows you to restore the reserves mobilized during pregnancy and childbirth. In particular, intakes of iron, essential fatty acids, proteins, iodine and vitamin D can help stabilize the hormonal system and promote the resumption of cycles.
If you want to get pregnant again it is also key to follow a diet that supports fertility.
THE sleep also plays an important role. Of course, it is often fragmented with a baby, but every period of rest counts. Lack of sleep disrupts hormonal balance, which can delay ovulation.
When to consult for a close baby project?
If you plan to have a close pregnancy but your cycles have not resumed, a medical support may be useful. It is recommended to consult:
- if you have not had your period return 6 to 12 months after giving birth (depending on whether you are still breastfeeding or not);
- if you have ever experienced fertility difficulties;
- if you want to design quickly and make sure everything works normally.
A healthcare professional will be able to assess your situation in an individualized manner, prescribe a possible hormonal or gynecological assessment, and direct you towards the best options for promote a new pregnancy safely.
