A few weeks or months down the line, things might be different. Your body is recovering. You’ve established a routine, or non-routine. You’ve worked out how/whether you can make breastfeeding work for you and your baby. You might even be ready for a bit of conjugal union with your other half, so it's worth having a think about contraception as you can get pregnant just 3 weeks after giving birth...
A temporary but effective option for breastfeeding women is the Lactational Amenorrhoea Method (LAM). Only about one in ten people know about this method of contraception and a 2012 survey from Mumsnet and BPAS (the British Pregnancy Advisory Service) complained of “particular inconsistencies” in the advice given to breastfeeding women by healthcare professionals. This ranged from “Oh, you’re breastfeeding, no need to worry about contraception”, to “You’re breastfeeding, that means you’re extra fertile”. Neither of which are very helpful responses if you want to avoid pregnancy.
Breastfeeding alone does not work as reliable contraception, however according to the Royal College of Obstetricians and Gynaecologists, breastfeeding and following the LAM rules is over 98% effective as contraception. That's better than condoms, though if you're nervous you could always use LAM and condoms. The (rather strict) LAM rules are:
Rule 1. You are fully breastfeeding. And I mean fully. This means your baby gets no formula at all, or any other food, and is still breastfed at night. You also need to avoid dummies and soothers, and feeding your baby anything from a bottle (even expressed milk or water) as this can reduce the amount of breastfeeding that your baby does and makes LAM less effective. There’s no need to worry if your baby occasionally sleeps through the night, or sucks their thumb, or has a longer nap than usual. Just be aware that the more you feed, the better it works. If you need any help with breastfeeding, contact the National Breastfeeding Helpline (0300 100 0212).
Rule 2. Your periods haven't returned. So long as your baby is less than six months old (Rule 3), your first period is likely to be an infertile one. This is either because you didn’t ovulate before your period, or because you ovulated but the luteal (post-ovulation) phase was too short to allow the egg to implant in your womb.
Rule 3. Your baby is less than six months old. You might not want to use LAM for the duration of this time, but it can be a useful interim method for a few weeks or months. According to the Infant Feeding Survey of 2012, while 17% of women are still fully breastfeeding at 3 months, only 5% are still doing so when their baby is five months old.
This is a temporary method, so be ready with alternative contraception for when any of these things change. For more information about your contraceptive choices, see the fpa (family planning association) website www.fpa.org.uk
If you don't want to return to your old method of contraception, then consider using fertility awareness (also known as natural family planning). It's not as strict as LAM and is up to to 99% effective (as good as the pill), so long as you learn it from a specialist teacher.
This article appeared in the Summer 2013 edition of the Tufnell Park Parents Support Group newsletter