By Mom Loves Best. Reviewed by Michelle Roth, BA, IBLCLC
In Part 1 of this guide, we discussed how your cycle changes after pregnancy, the hormones your body produces during breastfeeding and the link to your fertility, including two key rules for breastfeeding to be an effective form of birth control.
In this second part of the guide, we will examine the key fertility signs while you are breastfeeding, how to improve your fertility and when to seek advice.
How to Exclusively Breastfeed
Even though the World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of your baby’s life, only 32 percent of women who attempt to exclusively breastfeed for three months reach their goal (10).If you hope to exclusively breastfeed, better your chances of success by following these tips:
- Education: Learn as much as you can about breastfeeding before your little one arrives. This will help you feel more confident and prepared once you give birth.
- Consultation: Make full use of the lactation consulting you receive in the hospital after your baby is born. If you are able, have a lactation consultant come and visit you in your home to help ensure you and your baby are having the best breastfeeding experience possible.
- Avoid Supplements: The key to exclusive breastfeeding is to make sure no other food or liquid is introduced into your baby’s diet. This includes formula (unless medically necessary) and water.
- On demand: Breastfeed as often as your baby wants, both day and night. Because breast milk production is often determined by frequency and stimulation, it is important to feed frequently (11). Aim for 8-12 feedings per 24 hours.
- Feedings at night: Prolactin levels are the highest at night. If you are able, nursing or pumping at night will help increase your prolactin levels.
- Bottles: Do not use bottles or pacifiers. Oxytocin is stimulated by the sucking motion from your baby’s mouth on the breast.
Fertility Signs While Breastfeeding
If you are a woman hoping to become pregnant again, breastfeeding can become a confusing problem. While you want your baby to enjoy the benefits of breast milk for as long as possible, the hormones involved with breastfeeding obviously reduce your chances of becoming pregnant.According to WHO, mothers can breastfeed up to two years and beyond if they or their baby have a medical or emotional reason to do so (12). They also suggest waiting for two years after giving birth to have another child. Not spacing out your births can increase your odds of premature birth and it gives your body time to recover from the strain of your first pregnancy (13).However, every family is different and choosing when to add another child to your family is a very personal choice influenced by a host of factors. Regardless of the timeline, it is important you recognize the signs of fertility while breastfeeding.
Return of Your Menstrual Cycle
If your menstrual cycle has resumed, so may have ovulation and your chance to become pregnant. If you want to try to better understand your cycle, we suggest tracking your period with an app on your phone or computer.
You will be able to record your period days, symptoms, and more. You will then be able to discover when you are ovulating and the days you are most likely to become pregnant if you have unprotected sex.
Fertile women will notice a change in their cervical mucus when they are ovulating. Sperm needs a certain type of cervical mucus to thrive.If your cervical mucus becomes clear and wet, often described as the consistency of egg whites, there is a good chance you are currently ovulating or within a few days of ovulating.You can expect thick, sticky cervical mucus in the days leading up to the ovulation phase. It is a preparatory mucus and sperm can remain inside of it, but it is too thick to move through.After ovulation, your cervical fluid will lessen and become thicker. Right before you menstruate, it is likely you will experience fluid that is typically white, thick, and even glue-like (14).
Common side effects of ovulation and menstruation are breast tenderness nausea, cramping, and headaches. If you notice the return of these symptoms, it is a good indicator your body is beginning to resume its monthly cycle.
Some women experience these signs for a few months before their period actually resumes. This is a good sign your body is transitioning back to full fertility (15).
How to Improve Fertility While Breastfeeding
If you would like to improve your chances of becoming pregnant while breastfeeding, there are a couple of things you can do.
First, limit the number of times you nurse throughout the day and focus on using a breast pump. This will help decrease the amount of prolactin in your system while still producing breast milk.
A slow transition will be easier for your baby, but a more dramatic change in your nursing schedule will help you reach full fertility more quickly.
Second, it can be important to rule out a luteal phase defect. The luteal phase takes place after ovulation and is the time of your menstrual cycle when the lining of your uterus becomes thicker and prepares to implant a fertilized egg (16).
Because progesterone levels are often low when breastfeeding, the luteal phase can be shortened. This means there is often not enough time for the fertilized egg to safely implant itself in your womb before menstruation occurs.
Finally, relax and give yourself some time! Stress has been found to disrupt fertility (17). Unless you are facing other medical issues, your menstrual cycle will return to normal with time.
When to See a Doctor
In some instances, complications can arise with the return of your menstrual cycle. If you have stopped breastfeeding or dramatically limited how much you breastfeed and your period has not returned within three months, you may want to visit your doctor.If your period has returned and you experience any of the following symptoms, go in as soon as possible (18):
- Bleeding accompanied with sudden, severe pain.
- Excessive bleeding (going through a tampon or pad within an hour).
- Bleeding for more than seven days.
- Foul smelling blood and discharge.
- Trouble breathing.
Though women understand so much about their own bodies and the menstrual cycle, a lot can become unclear after giving birth. Do not fear reaching out to a professional for some peace of mind and more information.
Michelle is a writer, editor, and board-certified lactation consultant for two busy pediatric practices. She is a former La Leche League Leader, Lamaze Certified Childbirth Educator, and Certified Infant Massage Instructor.