Boosting Fertility while Breastfeeding
From NEW BEGINNINGS, Vol. 21 No. 3, May-June 2002, pp. 114-6
"Staying Home Instead" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help parents who choose to stay at home with their children. Various points of view are presented. Not all of the information may be pertinent to your family's life-style. This information is general in nature, and not intended to be advice, medical or otherwise.
I'm breastfeeding my 15-month-old and enjoying being at home with her. I'd really like to have another baby (maybe even two), but I'm not fertile yet, even though she seldom breastfeeds at night. I'm 38 years old, and I feel some pressure to have my babies close together, both for biological and financial reasons. What have other mothers done to increase their fertility without weaning? Is it even possible or a good idea?
I understand your dilemma. While you want to have another child for financial and your own biological reasons, you are very sensitive to the needs of your 15-month-old and to the preservation of your breastfeeding relationship. When confronted with a dilemma and concern such as this one, the La Leche League Bibliography is a wonderful resource. The Bibliography contains books that have been carefully evaluated by the LLL Book Evaluation Committee. Each book is read and reviewed at least three times before it is considered approved for use in the Group Libraries. All books are consistent with LLL philosophy, purpose, and mission. The complete LLLI Bibliography can be found on LLLI's Web site at http://www.lalecheleague.org/BEC/BEC.html?m=0,5,0.
The Bibliography contains several titles that address your concern. Toni Weschler's Taking Charge of Your Fertility is a comprehensive guide to many aspects of fertility and includes a positive and encouraging chapter on breastfeeding and fertility. Fertility, Cycles, and Nutrition by Marilyn Shannon explores how food choices and combinations can increase or decrease a woman's ability to become pregnant with a supportive stance concerning breastfeeding. Your Fertility Signals: Using Them to Achieve or Avoid Pregnancy by Merryl Winstein provides basic fertility information and also discusses fertility concerns while breastfeeding. Nikky Wesson's Enhancing Fertility Naturally: Holistic Therapies for a Successful Pregnancy takes the basics one step further by incorporating information on acupuncture, aromatherapy, and relaxation as it relates to fertility. Of course, the classic book, Breastfeeding and Natural Child Spacing by Sheila Kippley, continues to be a valuable resource for a clear understanding of the impact of breastfeeding on fertility. Incidentally, all of the above-mentioned books are available through the LLLI Catalogue except for Toni Weschler's Taking Charge of Your Fertility. Check your Group Library as well. Since each of these books has been approved for use with LLL Groups, you may find them at your next meeting. Good luck.
Akron Ohio USA
I understand your concern about wanting to have your next baby soon, but not yet having seen the return of your fertility. My cycle took over a year to return after each of my children, and I felt a biological imperative to have them before I reached a certain age. I did some research into the factors that would influence the return of fertility, and found that the things to try, in this order, are: night wean (go at least six hours overnight without nursing), start the baby on solids and supplemental drinks, limit daytime nursing to less than every four hours, and then if fertility still hasn't returned, complete weaning would be the next option. A valuable resource for me on this topic has been the book Taking Charge of Your Fertility by Toni Weschler. This book is also a big help in understanding other factors in your fertility, such as when in your cycle you are most fertile.
Brookeville MD USA
Some women seem to require very little stimulation at the breast in order to keep from ovulating, while others seem to ovulate shortly after giving birth. I have come into contact with this issue quite frequently as a natural family planning instructor. Sometimes it takes only a slight decrease in nursing frequency to resume ovulation and menstruation to achieve another pregnancy.
Since your baby doesn't seem to nurse at night anymore, perhaps looking at her nursing patterns during the day might give you an idea about another time of day when you might put limits on her nursing. When does she nurse? When she's tired? When she's thirsty? How about when she's bored? Can you find ways to distract her or provide alternatives to meet her needs during one or two of those nursing requests? That might be all it will take for your body to decide to ovulate.
Many mothers find that simply reducing the nursing by just this small amount will bring a return of fertility without complete weaning. However, other mothers require complete weaning before normal menstruation will resume. Hopefully, you will fall into the former category!
Two things to consider in your situation might be the relative ease with which you became pregnant with your first baby, and also the possibility of waiting just six months before making a lot of changes. If becoming pregnant with this baby required little time, then even though you are in your late 30s, it's possible that when your fertility returns, your chances of becoming pregnant are very good. If, however, you used fertility treatments or tried for more than a year, your timetable might be different because the length of time involved does introduce a sense of urgency.
Also, even though you're not breastfeeding a lot at night, the average time for return of menses for ecologically breastfeeding mothers is 14 months, according to Sheila Kippley in her book, Breastfeeding and Natural Child Spacing. Therefore, you're quite within the normal range and night-weaning and/or partial day weaning tend to be easier, I believe, with a baby closer to age two. At that age it is possible to reason or substitute more easily than with a 15-month-old. You might consider waiting three or six months and see if your situation doesn't resolve itself naturally.
La Grange KY USA
Even though I wanted -- and subsequently achieved -- a three-year gap between my babies, I remember I started to feel a little anxious when my periods hadn't returned when my eldest child turned two. It seemed as if my fertility was never going to return until my daughter weaned, and I felt myself in a predicament. Should I wean the baby I had and whose needs were real for a baby I wanted but might never exist? In the end, I comforted myself with the knowledge that this was my body's way of telling me that I wasn't ready for another pregnancy yet, and perhaps my daughter's way of telling me that she wasn't ready to share me with a sibling. Sometimes it is hard to accept that we can't always control our plans. As it happened, my period returned at 26 months postpartum, and two months later I was pregnant with my son. I'm sure that when both you and your daughter are ready, your fertility will return and you can look forward to a new nursling in your family.
Cardiff Great Britain
There is no perfect answer to this question, because our bodies and our situations are so varied. The trick to returning fertility is to have the amount of nursing finally go below the amount of suckling your body requires to suppress ovulation. If nursing is simply a beloved habit, gentle and patient encouragement to gradually reduce the amount of nursings should eventually bring you to the point that your menses return. For most mothers, this does not mean total weaning, just less nursing than previously. Keep in mind that return of menses does not automatically mean ovulation. It is possible to have several periods before the whole reproductive cycle starts up again.
However, if you find that efforts to reduce the amount of nursing are causing problems for you and your daughter, it may not be time to consider trying for another baby. Waiting a little longer before trying for reduced nursing may be worth it in terms of your daughter's maturity. It is amazing how things change in only a few months.
It is natural to be concerned about getting pregnant again when you are in your late 30s and want more than one child, but be careful not to let your desire for more children get in the way of enjoying the little girl you already have. It is possible to sacrifice the present moment for the sake of future hopes and then regret having done so, so make your decisions carefully.
Anne Marie Miller
Lilburn GA USA
My cycles resumed when my son was 19 months and I thought I was in good shape because I had periods of fertile mucus. When my son was two, I started actively trying to conceive. After a few months with no luck, I started reading more about fertility and breastfeeding on Web sites and found short references in books. I found that I had the classic cycle of someone breastfeeding with high prolactin levels: long fertile periods with a short luteal phase. The luteal phase must last at least 10 days to allow a fertilized egg to implant; mine was consistently eight or nine days.
During some of this time, I was very much yearning for a new baby, but a big part of me was watching the child in my arms and seeing that his needs were still quite great. Eventually, I came to the realization that my son was not ready for a sibling and that my body would let me know when it was time. After what I figured was about 12 months of infertile cycles, I finally was able to get pregnant. Sadly, I miscarried twice.
Katherine Dettwyler has an online article entitled "Fertility and Breastfeeding." It was enlightening for me to read that the return to fertility is gradual. It may happen quickly or slowly, but there are steps. For me it seems that the steps were very drawn out.
Almost four years after my son's birth, I am currently 37 weeks pregnant and the long-awaited baby will be here soon!
Webster NY USA
It is wonderful that you continue to breastfeed your toddler even though you seem to be feeling the pressure to conceive due to age and desire for more children. We also wanted more children, and while continuing to breastfeed my first child, I was happy to conceive again when she was 15 months old. So when we again desired another child, I imagined it would be easy and along the same time line. It was not. I also was doing the math in my head regarding my age, and was becoming more eager each month. I was tandem nursing both children and thought perhaps that would delay the next conception a bit. Month after month rolled by. I was consistent in keeping a calendar documenting symptothermal details, and nothing seemed suggestive of ovulation. I spent a fortune on ovulation tests kits as well.
Finally, as my second child approached 22 months old, I made an appointment with a doctor to discuss infertility. His answer was that I wouldn't become pregnant until I weaned, and that I should reschedule a visit after weaning to review options. (I neglected to offer the fact that I was tandem nursing!) Well, to my shock and delight, I tested positive later that month with a pregnancy test. How ironic that I was already pregnant while sitting in that doctor's office while listening to the "weaning" monologue.
There is nothing that I did or didn't do to increase fertility. For whatever reason, time was the factor for this latest pregnancy. So yes, it is possible for you to become pregnant again while you continue to breastfeed. Not knowing if you are monitoring ovulation by charting, testing, or other means, I would offer that suggestion. And perhaps by the time you receive all of the reader's responses, you may already be pregnant! Best wishes to you.
Camp Zama Japan
Web address in article updated 11/17/06