Contraception Through Breastfeeding

Once again, worldwide, this method of contraception can take the credit for keeping the birth rate lower than it might be otherwise. However, like withdrawal, it is far more effective at increasing the time between babies than at preventing them altogether. Many, many couples have been let down by relying on breastfeeding as an absolute contraceptive.

Lactation delays, but does not prevent, the return of ovulation after childbirth by reducing the body’s luteinising hormone which stimulates ovulation. Women are infertile for the first four weeks after childbirth, particularly if they are breastfeeding. If full breastfeeding continues, i.e. if milk alone is given to the baby, on demand, round the clock, this time may well be extended. Most people will know a couple who did not conceive for many months while the woman was breastfeeding; most people will also know a couple who conceived by accident when the woman was breastfeeding. Many cases in which the mother weans a baby early (with the loss to that baby of the continued benefits of the breast milk and breast contact) are because the woman has discovered that there is another child on the way.

At the moment it is impossible to predict just when after childbirth a particular woman will ovulate. Nearly eighty per cent of women ovulate before they have their first period after childbirth, so it is no good waiting for this sign before you start using contraception. The contraceptive benefit during breastfeeding occurs because the decrease in LH inhibits ovulation, but it may not prevent it completely. Reduction from full to partial breastfeeding often causes the menstrual cycle to resume, if it hasn’t already.

If you are breastfeeding, don’t rely on this as an absolute method of contraception. If you are happy to take a chance, then you can increase the contraceptive effect by breastfeeding fully, on demand, round the clock. If it is important that you don’t become pregnant again straight away, then use an alternative method of contraception. Barrier methods, mini-pills, spermicides and sterilization are all good alternatives, although a cap may be difficult to fit immediately after childbirth. Kos can also be used during the later weeks of breastfeeding, although I wouldn’t recommend them. The combined pill should not be used, as it reduces the quantity of milk produced.