Fertility - La Leche League International

Breastfeeding can have an effect on your fertility, particularly in the early months. While for some this is a benefit, it can also be a source of frustration for those hoping to grow their families.

The simple answer is that you can get pregnant while nursing.

However, many experience a time of delayed fertility during breastfeeding. This is very common and is referred to in many places as the Lactation Amenorrhea Method (LAM) of contraception.

As described in The Womanly Art of Breastfeeding, the Lactation Amenorrhea Method of using breastfeeding to delay fertility needs all the following to be true:

Your periods have not returned.

Your baby is exclusively and frequently fed from your breasts – this is especially important to remember when your little one begins sleeping through the night. It means not just that your baby does not have bottles, but also that they do not use a pacifier, in other words that all of your baby’s sucking needs are met at your breast.

Your baby is less than 6 months old. If your little one is older and eating solid foods, your chances of ovulating and risk of pregnancy increases. Some moms will find it takes more than six months for their cycles and fertility to return, while other mothers find that their cycles and fertility return earlier than six months. It is also important to mention that after six months, there is a higher chance that you might ovulate and possibly become pregnant before your first postpartum period. If you suspect you are pregnant, you will want to check with your health care professional.

For some individuals, the contraceptive effect of breastfeeding is a very welcome side effect, but it can be worrying and upsetting if over a year has passed since your baby was born and you still have not noticed any signs that your body is returning to being fertile.

You can read more about breastfeeding and menstruation here. The Womanly Art of Breastfeeding states that most breastfeeding mothers will resume their periods between 9 and 18 months after their baby’s birth. Some will find that once their baby starts sleeping for longer spells at night, or if they are separated in the day time (for instance through return to work outside the home) this is enough to reduce the effect that breastfeeding has on reducing estrogen levels, so that their bodies can start to menstruate again. Others find that while their baby is still nursing at all, this seems to be enough to suppress menstruation completely.

It can be very hard emotionally if you feel that you are needing to choose between your future hoped for child and meeting the needs of the child currently in your arms. You might like to think of this as an experience of their bodies being in tune with their babies’ needs: when our babies are feeding from us often enough to suppress our fertility, this might be because they are not yet ready to share us with a sibling.

If you need fertility treatment such as IVF to grow your family, you may find yourself faced with some difficult choices. This is a complicated and under-researched area. Some drugs used in fertility treatment are safe to use while breastfeeding; others are not harmful to your baby but can affect your milk supply; and still others could be dangerous.1 You will need to talk carefully to your healthcare provider about the proposed plan, and weigh up the length of time you would like to continue nursing your first child for, with the timing of when you would like to begin treatment.