Hormonal contraceptives (the pill/Mirena/patch) containing greater than 35 mcg of estrins will diminish a woman’s milk supply. In general, hormonal contraceptive use is not recommended for a breastfeeding mother because of the risk of contamination of her milk supply with synthetic hormones.

We all know someone who said:  “I didn’t know I could fall pregnant while I was breastfeeding.”

You are only infertile for the first 56 days post delivery of your baby. After 56 days, fertility can return at any point.

The frequency of a woman’s breastfeeding is one of the main factors that boosts lactation amenorrhea and postpartum infertility (the body’s natural ability to suppress ovulation and thus the return of fertility in women). There are two types of breastfeeding:

  1. Partial breastfeeding
  2. Total breastfeeding

Both these styles of breastfeeding will affect the degree of your body moving from an infertile state, as ovulation is suppressed towards a fertile state where ovulation takes place.

Total breastfeeding (also known as ecological or full breastfeeding):

  1.  The infant does not take in any other food – including supplements or liquids – except that of breast milk.
  2. The infant is fed on demand.
  3. Feedings are no greater than six hours apart.
  4. The infant does not use a pacifier (i.e. a dummy).
  5. Ovulation is further suppressed by the amount of mother-child physical contact that occurs. If the infant sleeps with the mother or has times of continued physical contact, ovulation is suppressed and thus a woman remains infertile.
  6. Total breastfeeding longer than four months does not significantly change the incidence of menstrual return.

In many cases women generally total breastfeed for the first three to six months of an infant’s life. After this, mothers will start supplementing their infant’s diet with a bottle or solid food.

Women transfer from total breastfeeding to partial breastfeeding when:

  1. The infant takes in food sustenance from a source other than breast milk such as a bottle or solid food.
  2. The infant uses a pacifier.
  3. The infant is not fed on demand.
  4. The infant sleeps through the night and does not sleep with the mother.

After a woman has breastfed for several weeks or months, the transitional stage from total breastfeeding to partial breastfeeding will cause the return of menstruation within an average of three to four weeks as partial breastfeeding is the beginning of the weaning process (whether this process is a couple of days or months). Therefore, if a woman is partially breastfeeding she has moved into a possible phase of fertility and thus it is imperative that she understands that there is a chance of falling pregnant at this point if she has intercourse without the use of a barrier.

Remember that ovulation occurs prior to your menses, so the only way to know if you are ovulating is through charting. Charting will equip you with the knowledge to know if you are gaining your fertility back or if it still is on the distant horizon.

Breastfeeding is an effective method of birth control only when ALL the criteria are met.