Can You Get Pregnant While Breastfeeding?

Not being able to get pregnant is on a list by The Lactation Network on Old Wives’ Tales on pregnancies. It has long been held traditionally that breastfeeding mothers cannot get pregnant. This may have been true in days when mothers used to breastfeed exclusively. However, in this new modern era, when mothers and hospitals are more likely to use formula on small babies, this is no longer true.

The situation differs from mother to mother. After all, when it comes to science and medicine, there is no one-size-fits-all kind of action. However, scientifically, there are certain ways that make it more likely that breastfeeding will act as a natural contraceptive. So let’s look at the science behind breastfeeding and ovulation, to answer the question: can you get pregnant while breastfeeding?

The Science: Prolactin and Lactational Amenorrhea

Prolactin is a hormone produced by the pituitary gland, and released into the bloodstream (often called the “milk hormone”). When a woman becomes pregnant, her prolactin levels rise by as much as 10 to 20 times her normal level. Prolactin is the hormone that helps make breast milk in pregnant mothers.

To keep the prolactin levels high, a mother has to breastfeed regularly and continuously. It signals the body to keep producing the hormone for regular milk production. High levels of prolactin also suppress the hormones that enable ovulation and egg growth and maturity. In this way, they play a part in lessening (not stopping) fertility.

When there is no ovulation, and therefore no chance for a menstrual cycle to start, the condition is called amenorrhea. However, there is a specific kind of amenorrhea that occurs when a mother is breastfeeding. This kind is lactational amenorrhea. Because the prolactin levels increase, suppressing the ovulation and egg growth cycles, amenorrhea occurs.

The Application: Breastfeeding and Natural Family Planning

Because of lactational amenorrhea, natural family planners have come up with the Lactational Amenorrhea Method of Family Planning, or LAM. This focuses on naturally inducing prolactin levels to remain high so that a mother continues to have reduced fertility after her pregnancy. Traditionally, mothers should not get pregnant at all during breastfeeding.

Scientifically, however, there are certain conditions that need to exist for a couple to be able to use LAM. According to the World Alliance for Breastfeeding Action or WABA, there are 3 conditions that must be present if a woman wants to use LAM.

Condition #1: The Mother Still has Lactational Amenorrhea

For the first 56 days after childbirth, very light bleeding or spotting is normal. For those days, it is not likely that ovulation has begun or that the amenorrhea has ended. If there is regular bleeding after those days in the nature of a menstrual cycle, the mother has begun to ovulate again. The LAM cannot be used anymore.

What the LAM tries to do is to postpone the return of the woman’s body to its regular fertility cycle. Once it begins again, the fertility cycle has officially begun again. It cannot be easily postponed or halted after that. Therefore, it is best for the mother to begin LAM as soon as she begins to breastfeed.

Condition #2: The Mother is Feeding the Baby on Demand

For LAM to work, the mother should be feeding the baby whenever he needs feeding, not placing him on a strict schedule. She should also be feeding him regularly throughout the night, instead of teaching the baby to sleep through it. No formula or other liquids should be fed to him so that he will always be looking for milk.

In that way, the body will be encouraged to produce as much prolactin as possible. As the prolactin levels remain high, lactational amenorrhea will be induced and the mother should be less able to conceive.

Condition #3: It’s Been Less than 6 Months Since Birth

Mothers who are breastfeeding exclusively and unrestrictedly can maintain their lactational amenorrhea for up to 6 months. Past 6 months of birth, babies are expected to start on some more solid foods, and the mother will have less of a chance to use LAM.

As long as it has been less than 6 months since the birth, and the first 2 conditions were met, a mother can use LAM. In some mothers, the period of infertility will extend past a year. In others, the period will not last past 6 months.

How Effective is the Lactational Amenorrhea Method of Family Planning?

In studies conducted independently by the Institute for Reproductive Health and by Family Health International (cited in WABA), LAM is just as effective as artificial contraceptive methods. In a total of 4 studies, the effectivity rate was 99.4%

More specifically, one study was conducted in Chile, by the Institute for Reproductive Health. For 422 breastfeeding mothers, the LAM came out 99.5% effective, with 1 pregnancy occurring. A similar study conducted in the Philippines by Family Health International had 485 respondents. The method was 99% effective, with 2 pregnancies.

So can you get pregnant while breastfeeding? The answer is yes. If prolactin is not being produced because you are not regularly breastfeeding, or if prolactin levels have lowered because the baby is now on solids (or you are using supplements), lactational amenorrhea will end. Using LAM simply reduces the possibility by 99%.

What If It Is Hard to Breastfeed?

Because there are fewer mothers, doctors, and nurses who either have breastfed or intensively studied breastfeeding, new mothers today are suffering from a shortage of knowledge. You might be thinking of LAM after your first child, or you are on your second or third child and want to use LAM.

However, you have always had some difficulties with breastfeeding your baby. The answer that would make the most sense is to seek professional help in the form of an IBCLC (International Board Certified Lactation Consultant). IBCLCs go through intensive training in both theoretical and practical skills.

Their one and only job is expertly helping breastfeeding mothers. Whether the problem is medical, emotions- or stress-related, they can help mothers who have a hard time producing milk or have a difficult time feeding their babies.

Science Vs. The Old Wives’ Tale

There was a time when that Old Wives’ Tale had some truth to it, and it still does. Now that we know the science behind breastfeeding and pregnancy, we can take advantage of the knowledge to implement natural family planning.