Sunday, April 13, 2008

Lactational Amenorrhea

A fancy name for something that has just come to an end for me: the suspension of menstruation due to breastfeeding. It's funny--Eric had a dream just a few days ago that my period came back. I was actually quite excited to discover today that my cycles have returned, 17 1/2 months after I gave birth. I would love for Zari to have many siblings, so the return of fertility is a very welcome change.

I was conceived when my mom was exclusively breastfeeding my 5-month old sister. The pregnancy came as a complete surprise since my mom had not yet had a period. I do know that most of us siblings slept through the night fairly early on, as evidenced by my mom's frequent asking "So is Zari sleeping through the night yet?" starting when she was about four months old. I suspect that the cessation of frequent night nursing explains why I was conceived when, stastically, I shouldn't have been!

Some information about Lactational Amenorrhea from Kellymom, much of which came from Jen O'Quinn's Natural Child Spacing and Breastfeeding:
The Exclusive Breastfeeding method of birth control is also called the Lactational Amenorrhea Method of birth control, or LAM. Lactational amenorrhea refers to the natural postpartum infertility that occurs when a woman is not menstruating due to breastfeeding...

Exclusive breastfeeding (by itself) is 98-99.5% effective in preventing pregnancy as long as all of the following conditions are met:
  1. Your baby is less than six months old
  2. Your menstrual periods have not yet returned
  3. Baby is breastfeeding on cue (both day & night), and gets nothing but breastmilk or only token amounts of other foods...
You can achieve higher effectiveness by practicing ecological breastfeeding:
  • keeping baby close
  • breastfeeding on cue (day and night)
  • using breastfeeding to comfort your baby
  • breastfeeding in a lying-down position for naps and at night
  • using no bottles or pacifiers
If you practice ecological breastfeeding:
  • Chance of pregnancy is practically zero during the first three months, less than 2% between 3 and 6 months, and about 6% after 6 months (assuming mom's menstrual periods have not yet returned).
  • The average time for the return of menstrual periods is 14.6 months.
  • Moms whose cycles return early tend to be infertile for the first few cycles. Moms whose cycles return later are more likely to ovulate before their first period.


  1. What a wonderful gift during your time of loss (Zeke)!

  2. :) hey there Rixa's little ova ready to pop out, LOL. I hope Zari does have many sweet siblings.

    It's so amazing how intricately related our miraculous bodies and babies are. The trinity of sleep, nursing, and fertility can really work like one entity. My good friend B who practices 'textbook' ecogolical bf (and tandem nursing) conceived 3 babies before the return of her period, each roughly a year and a half apart...

    Myself OTOH had my period return 4 months PP on the dot both times! Argh. The difference is definitely bed sharing. I certainly was exclusively breastfeeding, but not with baby by my side all night. My newborns were sleeping 7+ hour stretches at night from about 6 weeks of age... for several months, and my milk supply certainly adjusted to that as well. The motherbaby dyad is so delicate! I'm sure mine would have woken much more frequently to feed, had we been in physical contact through the night. I (personally) don't regret the uninterrupted sleep, but it does have other consequences and it's essential to know what one is choosing. Nice post!

    So, are you now officially TTC?

  3., 9:30 AM

    Congrats :) I for one am always amazed to hear of women who actually achieve L.A. for such extended periods (no pun intended LOL). Despite practicing ecological breastfeeding (and tandem nursing with the girls on top of that!), my cycles returned within 6-10 weeks with all three kids. Boo hoo.
    Anyway, I'm excited for you - and will be sending conception vibes across the states for you! *yay!*

  4., 9:33 AM

    Cross-posted with judit! Have to comment though, co-sleeping and constant night-waking sure didn't help my cause! :(

  5. Wow, how I wish this worked for me! I have exclusively breastfed my babies on demand and for comfort. My period has always returned around 6 weeks!! It's really devistating for me honestly. My two youngest are 12 months apart in age and my two oldest 14 months apart. Right now I'm so scared of getting pregnant again because I'm so exausted. I would love to be able to have a "natural break" My kids don't sleep through the night either, usually up to nurse every 3 hours. There really should be no reason I should concieve this soon!! I sling my babies often too. Sounds like you've got a wonderful space, I hope you're able to have lots of wonderful babies and always have that space!!

  6. Hahaha... I exclusively breastfed both my boys too for the first six months. But I had to return to work on the night shift when they were each 8 weeks old. I think this is what caused my periods to return so quickly (lack of sleeping at night and the hormonal effects). Even though I was pumping frequently, it's not the same and I think my hormones were totally wacky. Hmmm... nothing has changed in 6+ years... I'm still working nights and still wacky!

    Congratulations on the return of your fertility!! Perhaps we'll be hearing of a new little Freeze soon!

  7. Yay for the Red Lady! I hope a sibling for Zari will soon follow!
    I think we are all so different in how sensitive we are to prolactin. I had a fairly long period of LA (10 mos 3 times and 13 mos 1 time) despite my first child sleeping 8-10 hours at night starting at 7 weeks, and always having a crazy job that I returned to by 6 weeks at the latest - including some overnights away for attending births. I always pumped when away, but I know that doesn't help a lot of folks.
    I had one client who practiced absolutely ecological breastfeeding, whose baby was never out of her arms, who conceived a sibling with no return of menses when baby was 4 mos old. She nursed through that pregancy and the second baby was born when the oldest was 13 mos. She then tandem nursed both babies - and conceived a third when the second was only 3 mos old! #2 and #3 were a few days shy of 1 year apart. I always tell people about lactional amenorrhea, but encourage them to use some back up if it's really important to them to not get pregnant again soon!

  8. Interesting. My cycle just returned last month. The first in 3 years!

    My daughter is 27 months and my son is 10 months. I was still breast feeding quite a lot when my son was conceived though she was regularly sleeping through the night and had begun to eat quite a lot of food. My son is there now, still I was surprised.


  9. LA works wonderfully for me, for about the first year. Though I do have to say I'm usually ready for my body to resume some type of normalcy by then, hehe.

  10. Let's just say I'm officially NTNTC, which I suppose is basically the same thing as TTC. How's that for an acronym!

  11. I wasn't quite in the ecological breastfeeding department, but sort of had one foot in each area. Even with my third who nursed more than the others at night, and I wore her almost all the time, my periods still came back at about 14 weeks. I'm SO glad I didn't rely on LA as birth control with any of my kids, LOL.
    (Although I DID want my kids much closer together than they are, LOL, 13 months apart would not have been good!)

  12. Cool, Rixa!
    My Aunt Flo (haha) came back at 17 months, 10 months, 9 months and 9 months---exactly a few weeks after we kicked the babies out of our beds! : ( poor dears. See how we got meaner and meaner each baby?!

    For me, it was absolutely the night nursing that kept it at bay...and for you moms who got their periods back right away, I am so sorry! That is a rip off!

    What surprised me was a solid case of "Secondary Infertility" between baby #2 and baby #3. I was charting and everything...but I took some Vitex (tincture, 3X a day, full dropperful) as I self-diagnosed a bit of "too much prolactin" still. My Luteal phases were only 8 or 9 days.

    Off topic, kind of, but was quite shocked and dissapointed when period return did not = pregnancy right away.

    In hindsight, I am glad for my kids' spacing! But just wanted to share about my taking Vitex in case you were TTC. Cool subject, so many different experiences!

  13. Wow, pointless prego-brain, sorry!

    My point about the Vitex was that the very first month I took it, we got pregnant with Casey. thats all.

  14. I think I took Vitex back when we were dealing with infertility. I can't remember if it was before or after we discovered dh's low sperm count. My luteal phases are quite short, so that's something to keep in mind and see if it helps at all.

  15. Ha! I have to agree with - my period came back exactly 4 weeks after my son was born. We were exclusively breastfeeding (and he was, and still is, a barracuda - 16 lbs by 3 months!) AND cosleeping (nursing 4-5 times a night). And my period still came back...

    Still trying to figure that one out. :)

    Maybe I'll get a reprieve with this next baby (due in Sept!)

  16. I just got my cycle back after three years! Like your mother, I never got my period in between my two girls.

  17. at 6 months we started my son on solids, by almost 7 months i was pregnant. and this was only substituting a couple of feedings a day for solids. he was still nursing during the night.

    BUT i got my period back at 2 months pp.

  18. ...eek! all of which is to say, generalizations often don't hold LOL. It seems in our small sample, more of you were exceptions to the rule than not! How is that possible? (Small sample, I guess.) Hm, I guess I don't have to blame my not cosleeping any more.

  19. Amenorrhea can be treated by taking natural supplements and vitamins! Progesterone supplements are the most effective to be taking, as they are hormones found in the ovaries that promote proper functioning of the female reproductive system.

  20. "Amenorrhea can be treated by taking natural supplements and vitamins! Progesterone supplements are the most effective to be taking, as they are hormones found in the ovaries that promote proper functioning of the female reproductive system."

    Confused about what you mean by this anon. Most women are happy when they have a longer period of amenorrhea. I just don't get what you mean about proper functioning, not having a post partum period for a least a little while, if not longer, is perfectly normal functioning. Theoretically, fertility is temporarily impeded in order to protect baby's milk supply...

    I don't get it, lol. But that might just be because I'm tired.

  21. Woohoo! Fertility! Congrats on the return.

    My periods returned when my daughter was 14 months old. I was pregnant by time she was 17 months! I wasn't even having regular periods yet, I had only had two. So, sounds like you could be in the baby booming business again soon!

  22. About 16m PP, I began having intense baby fever - though menstruation hadn't returned yet.
    It returned 17m PP, and by 18m PP - I conceived.

    The entwined mother-baby hormonal connection is amazing.


    What is the significance of nursing while laying down for naps/bedtime?

  23. This is one of those things that bug me about the commercials saying "3rd world countries need birth control" while you see a young mom in squallor with children all around. If Nestle would just get the heck OUT with their "free" formula, perhaps these moms wouldn't have so many kids!

    I "worked & pumped." Cycle came back around 5 months each time. But I was infertile until about 11 months each time due to too short of a span between ovulation and menstruation. I've gotten pregnant on artificial birth control 3 times. I quite confidently can say that the only birth control that has "worked" for me is abstinence and breastfeeding.



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