Breastfeeding & Natural Fertility - As a contraceptive? Is it really possible?
I wrote a quick Instagram post on breastfeeding and fertility a while ago and got so many queries, I thought it was timely to write a blog and answer those most frequently asked questions.
So if you haven’t seen or read by now and somehow just landed on this page, then I shall introduce myself as a mutli-modality trained holistic health/educator and birth support practitioner. Part of my role is working as an Accredited Natural Fertility Educator with Natural Fertility NZ. I offer fertility awareness and for couples wishing to achieve conception or avoid conception, I teach them the sympto-thermal method. I went on to complete further training in teaching perimenopause guidelines and breastfeeding & fertility. Here is what I have to offer specifically for those who are pregnant and considering contraception already (yes - you do need to think ahead!), or for those with a new baby and considering what may be the best option for them.
QUICK ANATOMY & PHYSIOLOGY LESSON:
Prolactin - A hormone secreted by the anterior pituitary gland. It increases during pregnancy, and acts together with progesterone in particular, to promote alveolar growth as well as playing a major role in milk production. Oestrogen, the growth hormone, and corticosteroids are the major hormones involved in the growth duct tissue. Prolactin is high in late pregnancy, but high oestrogen blocks its release.
After the birth, oestrogen levels drop and the prolactin is released in pulses 24hrs a day. Prolactin levels remain high for the first three months after birth. Prolactin is an important hormone in the initiation of lactation. Once the baby starts suckling, the nerves are stimulated and signal the hypothalamus, which in turn signals the anterior pituitary gland, to release prolactin.
Frequent suckling maintains adequate milk production and release the stored milk. Prolactin levels decline gradually after birth and return to normal levels 2-3 weeks after birth in the non-breastfeeding woman.When suckling is reduced, for example, when solid foods are introduced, or baby sleeps through the night, prolactin secretion returns to normal and menstruation and/or ovulation resume.
LAM OR LACTATIONAL AMENORRHEA METHOD:
Relies on EXCLUSIVE breastfeeding (Exclusive breastfeeding is: no formula/water given and no solid foods (but medictions if required), not having a bleed after 8 weeks and a baby that is less than 6 months of age. This method requires no charting, but a commitment to exclusive breastfeeding while using it. This method also works if you are expressing as well as breastfeeding e.g. express during the day and breastfeed at night.
Quick check list if LAM is right for you:
Is your baby less than 6 months old? If yes, then:
Are you amenorrhoeic? No bleeding OR spotting since 8 weeks? If yes, then:
Are you exclusively breastfeeding? If yes, then:
GREAT! Exclusive breastfeeding provides at least 98% protection from pregnancy and YES you can use this method.
If you answered NO to any of the above, the answer is NO as your chance of pregnancy is increased and you cannot rely on LAM for contraception.
BREASTFEEDING CHARTING:
Based on charting cervical mucus signs, vulva sensation and baby’s feeding and sleeping pattern to recognise infertility and the signs of returning fertility. This method requires detailed and thorough charting. This is an option for those who do not intend to exclusively breastfeed, those who return to work early, plan to introduce solids early, do not meet the LAM criteria as above.
If you do not meet the LAM criteria you may be eligible for Breastfeeding charting. This is a daily commitment which includes charting:
Date
Babys age
Number of breastfeeds in 24hrs
Longest time between feeds
Solids - How much/how often?
Bottle/supplement cups
Cervical mucus (colour, amount, texture)
Vaginal sensation (dry/damp/moist/wet/very wet)
Further notes e.g illness, medications etc
Further appointments with your educator include:
Help you to establish a BIP (basic infertile pattern), teach you how to check changes in your cervix (when you reach 12 week’s postpartum - called cervical palpation), guidelines to follow, things to look out for and when to contact your educator.
When your baby reaches 6 months of age, we switch you to a partial breastfeeding chart which includes daily temperature taking. A partial breastfeeding chart can be used by those who are not exclusively breastfeeding, by breastfeeding clients who are already breastfeeding charting but are showing signs of returning fertility.
When bleeding resumes, we switch you to a STM chart (using sympto-thermal method).
Your fertility educator will choose the appropriate method for you, support you while you are learning, help you with any queries and keep you informed about your charting along your journey.
QUICK FACTS:
Exclusive breastfeeding generally results in a delayed return to fertility. MOST (not all) women who exclusively breastfeed in a ‘cue based and responsive way’ will not have any menstrual periods or ovulate in the first 6 month’s postpartum
A publication printed in the British Medical Journal (BMJ) 2012 showed that menstruation on average occurred at 7 and a half months’ postpartum with ovulatory cycles ocurring at 8 and a half months
The maximum birth spacing effect of breastfeeding is achieved when a mother ‘fully” or nearly ‘fully’ breastfeeds and remains amenorrhoeic (bleeding before the 56th postpartum day being ignored). When these two conditions are fulfilled, breastfeeding provides more than 98% protection from pregnancy in the first six months. At six months, or if menses (period) returns, breastfeeding ceases to be full, or nearly full before the sixth month, then the risk of pregnancy increases.
References:
Contraceptive Technology & Reproductive Health Series, Lactational Amennorrhea Method (LAM), retrieved from: https://www.fhi360.org/sites/default/files/webpages/Modules/LAM/s1pg14.htm (October 12, 2021)
Natural Fertility NZ Incorporated - Advanced Practice Manual 2020
Panzetta S, Shawe J, Lactational amenorrhoea method: the evidence is there, why aren't we using it? Journal of Family Planning and Reproductive Health Care 2013;39:136-138.
Homeopathy For Morning Sickness
Pregnancy is a huge event in one’s life which comes with excitement, worry, anxiety, thinking & planning, choosing antenatal care providers, which bassinet/pushchair/carseat…… and for most, nausea and vomitting arrive along with the line indicating that you are pregnant on the test.
Nausea can be infrequent, popping up now and then and be unpleaseant, or it can be persistant all day, coupled with excess saliva, a metallic taste in the mouth, retching and vomitting, to hyperemesis gravidarum (a very severe form of pregnancy sickness which is severe nausea and vomitting - causing dehydration, dizziness and loss of weight - even hospitalisation).
Apart from the old tried and true remedies such as sipping ginger ale, ginger beer, nibbling on plain crackers or sweet plain biscuits…. what else can you do?
Here is where I am thankful for homeopathic remedies, which many midwives also swear by. They are safe, gentle and they DO work. I have heard everything from “tried homeopathics and they did nothing” to “tried one or two and it didn’t work”. When digging deeper, I have discovered that they took a ‘combintion’ homeopathic remedy (which has 4-5 of the most popular remedies) but unfortunately, the remedy that they would have responded to was not included. This is why it is always in your best interest to seek the advice of a qualified homeopath, describe your symptoms and let them prescribe accurately for you. This can all be done in 15 minutes, tops! If the first remedy only alleviates for a short period of time, or not at all, then we know our second choice that we had in mind is likely to hit the nail on the head. The thing with homeopathy is that it is very individualised - it is not a one fits all style of support!
MY 5 TOP HOMEOPATHIC REMEDIES FOR MORNING SICKNESS:
1) Nux vomica - When symptoms are WORSE in the morning. You will feel bloated, suffer constipation, be retching (with dry heaves) and feel HUNG OVER. Your mental state will be irritable, sensitive to noise/lights/smells. You want to get on with life, but the constant sensations of nausea keep you lying still.
2) Sepia - When symptoms are WORSE in the evening, around dinner time (6pmish) and the symptoms get worse as the evening goes on. You will also have bloating, constipation but feel totally exhausted and everything worsens with the sight/smell/taste of meat. You crave lemonade or lemony drinks. Your mental state will be irritable too BUT especially with partner and children and feel overwhelmed by responsibility.
3) Colchicum - When symptoms are WORSE in the evening, but may also occur during the day. There will be nausea AND vomitting WORSE by any motion at all. You will also be very, very sensitive to smells. You will be worn out by caring for others and any sleep deprivation will aggravate your nausea/vomitting.
4) Arsenicum - Key note here is worse from 1am - 3am, but you can feel weak and depleted all day long. You can have simultaneous vomitting with diarrhea. When vomitting, you break out in a cold sweat. You are likely to be VERY anxious with the effects of the nausea and vomitting, worried about yourself and baby. You will be so anxious that you are hesitant to eat for fear of nausea/vomitting, to the point that you work yourself up in a state.
5) Ipecacuanha - WORSE in the morning on waking that lasts ALL DAY long. Worsens from heat (sun/open fire or stuffy room), worse with rich foods and by leaning forwards. You will have NO thirst and a mouth that is always full of excess saliva. Mentally/emotionally you are hard to please - not knowing what you want.
POTENCY AND HOW TO TAKE HOMEOPATHIC REMEDIES:
I suggest 200c potency for pregnancy as this tends to match the intensity of the symptoms experienced by healthy, vibrant women (if they were not ill!). Using the correct potency will result in a faster action. If you can only find a 30c potency, this is still okay, you just need to repeat more often, which is not great when you aren’t feeling the best.
I prefer pilules over liquid as most individuals cannot tolerate the taste of liquid. To take the homeopathic remedy: place 2-3 pilules under the tongue and let dissolve (don’t touch the pilules, pour into cap of bottle then place under the tongue). WAIT for 15 minutes. If the feelings subside then you DO NOT need to repeat.
If you feel improvement and the symptoms return, then repeat. Sometimes it takes 2-3 doses to get the full effect. Stay with this remedy if it is working. However, when you no longer feel any change then you may need to try another remedy. This is where it is handy to have a qualified homeopath at the ready!
EXTRA HELP:
Dehydration: Often dehydration goes alongside morning sickness. To counteract dehydration and assist your body in rehydrating, you can take 2-3pilules of Phosphoric acid 200c, once a day for 3 days. Of curse, stick with water and electrolytes if required (coconut water is great).
**As always, this is written to be informative and never to replace any medical advice or to replace seeking any medical care at any time. It is wise and highly recommended that you do not self-prescribe and to seek the advice from a qualified homeopath where possible.
