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Breastfeeding 1-2-3

Are You Willing to Risk Getting Pregnant Again So Soon?

by Angela White, J.D., breastfeeding counselor on November 5th, 2006

Taking Charge of Your Fertility, 10th Anniversary Edition: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive HealthMany women consider amenorrhea (absence of periods) as one of the great advantages of breastfeeding. Other women lament the fact that their fertility has not returned by the time they are ready to conceive another child. For those women who celebrate the absence of their periods (the ones who think the pronunciation of amenorrhea sounds suspiciously like “Amen, no horror period!”), is exclusive breastfeeding an effective method of birth control?

If a woman follows the Lactational Amenorrhea Method (LAM) exactly, she has less than a 2% chance of becoming pregnant in the six months after giving birth. LAM has three requirements:

1. The woman’s menstrual period has not returned.
2. The baby is breastfed on demand throughout the day and night with no more than four hours between feedings during the day and six hours at night.
3. The baby is less than six months old.

Is LAM still effective if you’re pumping and bottle-feeding? No. The baby’s suckling at the breast plays a role in suppressing ovulation.

Keep in mind that not everyone feels comfortable with the Lactational Amenorrhea Method of birth control. This Pregnancy Guide article from November 2, 2006, cautions against it:

Some experts believe that if you’re exclusively breastfeeding, you’re protected from pregnancy. The theory goes like this: Breastfeeding curbs hormones that trigger ovulation. Some experts say that as long as you’ve had no periods since you gave birth, are nursing at least every four hours during the day and every six at night, and your baby is less than 6 months old, you won’t get pregnant. But BabyCenter lactation expert Susan Condon says every woman’s body responds differently to the hormonal influences of breastfeeding, so even if you’re nursing your newborn all the time, you might be wise to consider yourself fertile. LAM is risky because you’ll probably ovulate before you get your first period, so you can get pregnant without warning. And studies have shown that getting pregnant too soon after giving birth can increase your chances of pregnancy complications, such as preterm labor, and of having a low-birthweight baby.

I tend to agree that LAM is a bit risky. I believe I ovulated and had a period within eight weeks after giving birth (although my periods subsequently went away due to postpartum hyperthyroidism). LAM would not have been reliable for me.

I still think LAM has its merits, particularly when combined with other natural family planning methods. I highly recommend the book pictured above, Taking Charge of Your Fertility by Toni Weschler (click on that title link for more information about the 10th anniversary edition that just came out on November 1, 2006). Taking Charge of Your Fertility simply and clearly explains how to monitor fertility signs such as basal body temperature, cervical fluid and cervical position. By paying attention to those signs a woman can better prevent or achieve pregnancy as she desires. (Keep in mind that getting an accurate basal body temperature requires adequate amounts of sleep–something rare for most new mothers!)

What do you think? Would you or have you relied on LAM as birth control? Have you experienced difficulty with the return of your fertility while breastfeeding?

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POSTED IN: advantages of breastfeeding, books, health of the mother

38 opinions for Are You Willing to Risk Getting Pregnant Again So Soon?

  • Jen
    Nov 5, 2006 at 8:04 am

    We wanted our children to be close together — well, really we wanted twins, but we didn’t get that, so close together was the next best thing. So after my son was born, we didn’t use any birth control at all.

    Unfortunately, LAM worked for us… for twenty months! Eventually we had to start weaning before I could get pregnant.

    It was awful, really. Because I wasn’t having periods, I was constantly hoping that I was pregnant, but I never got any symptoms. I was still hopeful. One time, I needed to have a dental x-ray, so I took a pregnancy test the night before so I’d know if it was safe. I was so sad to see the negative test! All that time, I was delusionally assuming that I was pregnant, but just not far enough along to have symptoms yet. To find out that I wasn’t pregnant at all was very depressing.

    Finally, we quit allowing my son to nurse at night. I got a period three weeks later, and was pregnant the following month. I hadn’t planned on weaning, but we decided that having another child would be more beneficial for our family than any benefit he was still getting from night-nursing.

    Since a few months after my daughter was born, I’ve been on the pill because we aren’t sure yet whether we want another child, or how soon we will. Unfortunately, being on the pill means that I have periods again, even though I PROBABLY wouldn’t if I weren’t on the pill. Oh well! I guess that having only one period in 46 months (10 months pregnancy, 20 months amenorrhea, 10 months pregnancy, 6 months amenorrhea) was as much as I could ask for. I guess it gives me a chance to use my new Diva Cup, right?

  • angela
    Nov 5, 2006 at 8:32 am

    Say it loud, say it proud, “I’m a Diva!” LOL

    Seriously though, I know firsthand how awful infertility is, no matter the reason. Night-weaning is the first thing to try but that’s a big step and I think it shows a lot of sensitivity to the needs of your first child that you waited as long as you did.

  • Andi
    Nov 5, 2006 at 10:44 am

    Breast feeding as birth control didn’t work for me. I got pregnant when our son was 11 months old and I was still nursing. Not unintended, but definitely unexpected. Oops!

  • angela
    Nov 5, 2006 at 12:51 pm

    While it wasn’t in the plan I bet you can’t imagine it any other way now!

  • Susan (5 Minutes for Mom)
    Nov 8, 2006 at 1:43 am

    I’m still breastfeeding my 18 month old, but I’m worried that it’s a factor in me not-getting-pg. But I probably wouldn’t get pg anyway, so it’s hard to quit breastfeeding just to try. (It took me over 3 yrs to get pg with her.)

    But I’m still not quite ready to wean her… I think I’ll give it a few more months.

  • Breastfeeding 1-2-3 » Reviews of Breastfeeding Products, Books and Clothing
    Mar 4, 2007 at 7:53 pm

    […] Breastfeeding and Parenting Books: The Baby Sleep Book (Breastfeeding 1-2-3) Babyproofing Your Marriage (Mama Knows Breast) The Breastfeeding Book (Breastfeeding 1-2-3) Fresh Milk — The Secret Life of Breasts (The Lactivist) How Weaning Happens (Breastfeeding 1-2-3) Medications and Mothers’ Milk (Breastfeeding 1-2-3) The Milk Memos: How Real Moms Learned to Mix Business with Babies–and How You Can Too (Black Breastfeeding Blog) A Mother’s Gift magazine (magazine especially for black breastfeeding mothers) (Black Breastfeeding Blog) Mothering Your Nursing Toddler (Breastfeeding 1-2-3) The No-Cry Sleep Solution (Breastfeeding 1-2-3) Siblings Without Rivalry (Breastfeeding 1-2-3) Super Baby Food (Breastfeeding 1-2-3) Taking Charge of Your Fertility (Breastfeeding 1-2-3) Your Personal Guide to Breastfeeding fold-out chart (Black Breastfeeding Blog) […]

  • Chloe
    Mar 30, 2007 at 1:23 pm

    My baby is three months old and I am breastfeeding her exclusively. From birth, she has slept through the night (7-11 hours) without a feed and throughout the day she feeds very regularly (every 1-2 hours).I have had two periods since I have had her although my doctor says this is impossible. Could I get pregnant?

  • Angela
    Mar 30, 2007 at 5:05 pm

    Hi Chloe,

    From what you’ve said, two of the criteria for LAM are not met in your case — your period has returned (I’m not sure what the doctor means in saying that’s impossible — it’s entirely possible) and your daughter goes more than six hours at night without nursing. I certainly wouldn’t rely on the LAM if I were you! In any case, there’s no point in taking chances.

  • Chloe
    Mar 31, 2007 at 1:33 am

    Thanks Angela. From what I’ve read, I thought that could be the case. The midwives in the hospital told me that breasfeeding alone was 98% effective as a contraceptive. Does anybody know how reliable the mini-pill really is?

  • Lisa
    Apr 2, 2007 at 9:35 am

    I have a 5 month old . I am 8 weeks pregnant. I have been exclusively bfing. My period returned at 3 months.

  • sanae
    Apr 8, 2007 at 7:47 am

    I have a 3month old baby and since I gave birth to him I received one time periode after 7weeks of my labor ,now I missed my seconde periode and I am wondering what happen to the milk If I am pregnante again and is it ok to breasfeed at same time with pregnancy and how long it takes for the milk to go away?

  • Angela
    Apr 8, 2007 at 7:55 am

    Sanae, it is possible to breastfeed while pregnant. See my story here:

    http://www.breastfeeding123.com/my-breastfeeding-story-part-ii-breastfeeding-while-pregnant/

    I highly recommend the book Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond. Good luck!

  • Breastfeeding 1-2-3 » The Milk Memos: A Book Review
    May 20, 2007 at 8:06 am

    […] the discussion of breastfeeding as birth control troubled me. The book accurately states that the Lactational Amenorrhea Method is not a foolproof method of contraception, especially if you’re not nursing frequently and […]

  • debbie
    May 30, 2007 at 4:27 am

    i have a 7months 2week old baby and i’m not sure but it looks like i’m pregnant again. please help? could it be true?

  • Angela
    May 30, 2007 at 5:02 am

    Hi Debbie. It certainly could be true. As always it’s best to consult your doctor if you think you may be pregnant. Best wishes to you.

  • Tacey
    Jun 1, 2007 at 1:23 pm

    Hi Angela- I have a 8mth old baby whom I have been brestfeeding exclusively.I still have not had a period.In the last week I have had really bad cramps, breast tenderness, lower back pain, fatigue, and a slight discharge( clear). At first I thought I was getting ready to have my period, but it has been over 5 days now and still nothing. I have had intercourse in the last 2-2.5 weeks. Can I be pregnant? I took a test last night and it read negitive! When should I try another preg. test? Thanks.

  • Angela
    Jun 1, 2007 at 2:28 pm

    Hi Tacey! I can’t offer medical advice and suggest your doctor is the best resource. You’re certainly out of the window in which LAM can be relied upon with 98% accuracy if all the rules are followed. I imagine it can be hard to distinguish pregnancy symptoms from the return of your menstrual cycle. Certainly the safest thing to do would be to care for yourself as if the possibility were true — take all the precautions you’d take if you were pregnant. It can take up to 14 days after conception for a positive pregnancy test to appear. Count the days until you know a test should clearly be positive, or you can trust the negative. Good luck!

  • chaz
    Jun 12, 2007 at 4:00 am

    hey, i have a 3month old boy and the father wants another should i agree~???????????

  • Sally
    Jul 26, 2007 at 11:47 am

    I have a 10 week old baby .. i had bleeding for 2 weeks after labour, then quit for a week and then I had more bleeding after that week for about 2 r 3 weeks, was that my period returning? I havent had another period since, which would be over 5 weeks since they finished? Myself and my partner have had unprotected sex using the withdrawal method .. could I be pregnant again????? surely not so soon??

  • Chloe
    Jul 27, 2007 at 12:08 pm

    It is possible that you could be pregnant but it would be very difficult to tell by your periods at this time. The second time, you bled it may not have been your period-it may have been some left over from the birth or cervical erosion. If it hurts after you have had sex or you bleed after sex, you should see a doctor. The only way you can tell if you are pregnant is to take a test which will only be accurate 2 weeks after you last had unprotected sex. If you want to be pregnant, good luck. If not, be careful!! x

  • Rach
    Aug 16, 2007 at 9:31 am

    I have been exclusively bf my 12 week old
    I have been feeling really sick, terrible tiredness, dizzy spells, headaches and weeing loads
    we have had unprotected sex a few times
    what are the chances that i could be pregnant again so soon?

  • Lisa
    Sep 28, 2007 at 8:35 pm

    I have a two month old and was planning on relying on LAM for birth control until 6 mos, but I am taking metformin for pre-diabetes that resulted from gestational diabetes. I have heard that metformin helps women get pregnant. Do you know anything about metformin and its affect of the effectiveness of LAM or know of any resources that I could look into?

  • samantha
    Oct 24, 2007 at 5:10 am

    my son is 3 and 1/2 months old and i realy want to have another one i went on depo before i gave it a tought and one more week before i need to go for the 2 shot im feeling sick and headacks and cramps on my tummy and im tired i am breast feeding and had no period how do i know if im pregnant

  • Juliette
    Nov 2, 2007 at 6:48 pm

    Hi, I have used LAM (unconsciously) with almost all of my kids. I breastfed exclusively with all but the twins. After my first baby, I didn’t get a period until he was 6 months old. I became pregnant when he was around 9 months, and I weaned at 10. My second baby it was about the same. I miscarried twice, and then had my 3rd baby. I got an IUD after him, too worried about another miscarriage and the stress of pregnancy. When he was 18 months old I took the IUD out and conceived my daughter. I breastfed her for 7 months, and then weaned due to going back to work. I conceived when she was 11 months old. Again I miscarried, but got pregnant again a few months later. It was twin boys! I am still nursing them, but they have had one bottle a day of formula. I haven’t had my period return yet and they are 11 months old!!! I think it is from nursing two though. They have been sleeping through the night since about 3 months. I am in the process of weaning them, and I feel very crampy etc. I think af is on her way finally.

    Long story short, it worked for me! I never got pregnant before my period returned while breastfeeding, and usually it took a couple of cycles to get back to normal enough to conceive.

  • Return of Fertility for Breastfeeding Mothers: A Poll
    Nov 17, 2007 at 7:21 pm

    […] back? Do you think you ovulated before you got your first period (I ask because it relates to the Lactational Amenorrhea Method of birth control)? (My answers are: at 3 months postpartum, even while exclusively breastfeeding, […]

  • MARIE
    Feb 5, 2008 at 3:45 pm

    HI. I HAD A LITTLE BOY IN OCTOBER. I BEGAN BLEEDING RIGHT AFTER I HAD HIM LIKE NORMAL PEOPLE, AND SINCE THEN I HAVE BEEN BLEEDING ALMOST EVERY SINGLE DAY. HE IS NOW 4 MONTHS OLD AND THIS STILL HAPPENS. THE BLEEDING HAS CALMED DOWN ALOT, HOWEVER I STILL SPOT HERE AND THERE. I GOT MY FIRST NORMAL PERIOD JANUARY 10TH AND IT LASTED UNTIL THE 18TH. TODAY IS THE 5TH OF FEBRUARY AND HAD HARDLY ANY BLEEDING OR SPOTTING. MY HUSBAND AND I HAVE SEX WHENEVER I AM NOT BLEEDING BECAUSE WE WOULD LIKE TO HAVE OUR CHILDREN CLOSE IN AGE BUT THE DOCTOR TOLD ME THAT BECAUSE OF THE BLEEDING THAT WOULD MEAN I AM NOT OVULATING. IS THIS TRUE, AND IF NOT THEN IS IT POSSIBLE I COULD BE PREGNANT NOW?

  • Noelia
    Mar 6, 2008 at 2:36 pm

    I have a five month old, and I have exclusively breastfed until two weeks ago, when we started introducing solids.
    Since he was one month old I’ve been taking the pill (special contraception for lactating moms), and I still haven’t had my period. It’s been 15 months already!
    Well, here’s the thing, about a week ago (on Friday) I finished my pills, and didn’t get any more until Monday. We did have unprotected sex, and I’ve been wondering if I might have gotten pregnant! Is that possible?

  • Autumn Clarkson
    Mar 7, 2008 at 7:56 pm

    Hi I have a 7 month old and am still bf. No period yet and we supplement about twice a day while I am working. Lately I have been having pregnancy like symptoms (nausea, tiredness, sore breasts). Have taken two tests and both are negative but I heard that if you are still nursing that sometimes the test will be negative and you can only know if you take a blood test. Just wondering if anyone else has heard this or knows anything about this. Thanks

  • nay
    Mar 11, 2008 at 9:12 pm

    I JUST HAD MY BABY 3 1/2 MONTHS AGO AND AM SUCCESFULLY BREAST FEEDING. I HAD UNPROTECTED SEX WHEN HE WAS ABOUT 2 MONTHS I HAD ONE PERIOD SINCE I HAD UNPROTECTED SEX IT WAS A NORMAL PERIOD. COULD I B PREGNANT AGAIN

  • Kelli
    Mar 12, 2008 at 7:36 am

    I have an 8 week old daughter. I stopped bleeding about 3 weeks after delivery. I have been spotting for 3 days and it’s only been 5 weeks since I stopped bleeding. I breastfeed only, but I spent one night away from her…could I be pregnant again this early?

  • Amanda
    Mar 20, 2008 at 10:03 am

    I have a 1o months old daughter that will be turning 1 next month on the 21st. A couple of months ago when my daughter was 6 months old i didn’t have a period for that months so we thought that i might be pregnant and took a test and it said neg but still no period the next week and so we desided to go to the docotr for me to get tested and their test also came back neg and the doctor told me it was just my hormones acting us…Well this month i didn’t start my period and took a test and got back a very light positive and so i went to the docotor to confirm to make sure and their test also came back as a light pos. but this time I’m not feeling hardly any systoms of pregnancy. Last time when i got pregnant with my daughter i was always feeling sick and time time i’m not. DO you think its just my hormones acting up again or could i really be pregnant? I’ve heard of women testing pos on a test before and not really be pregnant.

  • Tee
    Apr 22, 2008 at 8:40 pm

    I have a 3 month old baby, and i’ve gotten my period twice regularly but then about 2.5 weeks ago I had sex with my partner, and the condom broke, but we didn’t realize until later on that it was broken , so I’ve waited for my period, it should’ve came already so now this wekeend I was spotting.. could this mean i’m pregnant.. AGAIN?:| Please Help:(:)

  • Tee
    Apr 22, 2008 at 8:44 pm

    If I were to take a pregnancy would the hormones still not be in my body to make it show a +…
    i’m also breastfeeding still..
    what could the spotting mean…?!

  • Shiloh
    Jun 14, 2008 at 9:09 am

    HI I am a mother of three, I had my first in 2004, my second in 2006 and got pregnant with my third when my second was only 9 months old…. She was born december of 2007… Now because of what we think may be a failed birth control method, I am late for my period which has been regular for three months now… With my daughter being only six months old and after the closeness of my last two pregnancies Would there be any danger for the baby or myself if i were to continue the pregnancy…. It may sound cold me asking.. but i do have 3 other kids that i need to worry about as well

  • Chloe
    Jun 16, 2008 at 4:44 am

    Hi Shiola,
    If you are pregnant because of failed birth control (the combined pill or the mini-pill), there is no risk to yourself or the baby if you let the pregnancy continue.This has happened to me recently and my doctor has assured me that although it is unusual and unlikely, it is perfectly safe: The pill tricks the body into thinking it’s pregnant anyway while you are on the pill. You should take a test to determine whether you are pregnant and if you are, discontinue taking the pill and see your doctor.
    It doesn’t sound cold what you are saying. You have been through so much physically and emotionally since you got pregnant with baby number one that it is not surprising you feel the way you do. It must be hard work having young children so close together in age, but how wonderful it will be for your children when they are a little older and have each other.
    I hope it all works out for you.

  • Chloe
    Jun 16, 2008 at 4:45 am

    Sorry I spelt your name incorrectly Shiloh!

  • Allison
    Jul 9, 2008 at 8:25 am

    I have a 3 1/2 month old (my 1st) and have not gotten my period back. I breastfeed, but I work full-time, so I pump twice a day at work. When I am with her, she eats about every 2 hours & 2-3 times during the night, but what about those 8 hours at work? I don’t know if the LAM would work for me since I work. I have had unprotected sex 3 times since she was born, and I have been feeling really nauseous this morning. Please help!

  • Carla
    Jul 28, 2008 at 9:18 am

    My son is 3 months old and I bf exclusively. My periods have been regular since his birth. We want to have children close in age and feel that time is running out. I am 39 and healthy. What are the pregnancy risks in concieving so soon after giving birth?

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