Breastfeeding as a method of contraception?

When we were in hospital, one of the midwives told us we (well really I) needed to go and see my GP to restart contraception (unless of course I fancied Irish twins) and that in the meantime I should not assume breastfeeding was an effective form of contraception. “Ha!”, we said, “Who would think it was?”, rather haughtily bracketing this with other old wives’ tale nonsense like that having a hairy baby will give you heartburn. But I did wonder at her telling us that and so finally looked it up and it seems I was wrong, breastfeeding can be an effective method of contraception: old wives 1, Elly 0 (well maybe I should give myself a point for having a hairy baby with no heartburn).
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Using breastfeeding as a method of contraception is called the “The Lactational Amenorrhea Method” and if certain criteria are met then it is 98-99.5% effective, which is much more effective than condoms (86-97%) and in the same ballpark as pill-based contraception.
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Adapted from The Essentials of Contraceptive Technology – see 4-19 for the table in full.

So what is it?

As Access to Health explains:
“The Lactational Amenorrhea Method (LAM) is a modern, temporary contraceptive method based on natural infertility resulting from certain patterns of breastfeeding.

Lactational = related to breastfeeding
Amenorrhea = no vaginal bleeding (after two months postpartum)
Method = a modern, temporary (up to six months postpartum) contraceptive method”

Kellymom has a really excellent article on the subject, and explains that LAM is only effective where three conditions are met:
“1. Your baby is less than six months old
2. Your menstrual periods have not yet returned
3. Baby is breastfeeding on cue (both day & night), and gets nothing but breastmilk or only token amounts of other foods.”

For the “day & night” bit, some sources say that should be at least every four hours during the day and six at night.

If you are separated from your baby and pump instead of breastfeeding as a result then one study (Valdes 2000) show a higher pregnancy risk (5.2%) during the first 6 months.

Indeed LAM is a recommended method for exclusively breastfeeding mothers – patient.co.uk provides a summary of what methods are / are not recommended postnatally (for instance breastfeeding mothers shouldn’t take the combined pill).

So how does it work?

Epigee, a bizarrely named women’s health website, explains:

“In order to ovulate and menstruate, your pituitary gland (a small gland inside of your brain) produces two hormones: follicle stimulating hormone (FSH) and gonadotropin releasing hormone (GnRH). These hormones send signals to your eggs to mature and subsequently be released during ovulation. When you breastfeed, though, this process gets interrupted, thereby interfering with the production of both FSH and GnRH.

As your baby suckles, nerve impulses travel through your body and are received by your brain. This signals the production of a hormone called prolactin, which works to inhibit both FSH and GnRH. As a result, ovulation does not occur and menstruation stops”.

Now I have no plans for Elphie to have a little brother or sister just yet, so I think I’d be using LAM as a back-up but good to know it’s there and also heartening to know that I may be spared PMT for many months to come!

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