How to restore fertility while breastfeeding (and maintain breastfeeding)

Imagine a world in which women can sit down and share their wisdom about pregnancy, fertility, breastfeeding, and child spacing. Imagine how much support and love and information would be passed from to each of us to our friends and future daughters. While many of us did not get the benefit of this passed on womanly wisdom as it relates to breastfeeding and fertility, we can make sure that it’s there for future generations. This is what BIRTHFIT is all about.

We know that frequent breastfeeding suppresses fertility. But, most women do NOT need to wean entirely in order to return to fertility.

Helpful steps to return to fertility while breastfeeding.

1. Understand what’s normal in terms of returning fertility. According to the Couple to Couple League, “About 70% of [ecologically breastfeeding] mothers experience their first menstruation between 9 and 20 months postpartum. The average return of menstruation for EBF mothers in the North American culture is between 14 and 15 months” (1). For women who are breastfeeding, but not following ecological breastfeeding, it would be normal for fertility to return much sooner than 14-15 months postpartum.
2. Start charting your fertility signals. After 6 months postpartum, you may ovulate before your first period, and if you are charting, you will be able to maximize your chance of getting pregnant. For a great primer about charting, please read the book Taking Charge of your Fertility by Toni Weschler.
3. Consider reducing at least one nursing session during a 24-hour period. Depending on the age of your baby, the most simple, non-disruptive, and abrupt change to breastfeeding may come in the form of night weaning. According to Kelly Bonyata, BS, IBCLC, “Changes that are more abrupt tend to bring fertility back faster (e.g., cutting out one nursing session abruptly, rather than gradually decreasing nursing time at that session) —even if you continue to breastfeed a great deal— this is why many mothers experience the return of fertility when their child sleeps through the night or starts solid foods… Current research indicates that nursing frequency and total amount of time at the breast per 24 hours are the most important factors, rather than the time of day that the suckling occurs” (2).
4. Dial in your nutrition game. While you are breastfeeding, especially if you are trying to return to fertility in order to get pregnant again, nutrition should be on your mind. You do not need to eat perfectly in order to breastfeed successfully, nor do you need to eat perfectly in order to have a safe pregnancy; however, pregnancy and breastfeeding deplete your body of key nutrients. For your own sake, the sake of your current baby, and your potential future baby, you want to eat in a way that will nourish your body well and help you continue to heal from birth. Use the BIRTHFIT nutrition guidelines to focus on healing, warming, and nutritionally dense foods. This BIRTHFIT blog gives some great ideas for maximizing nutrition during the postpartum phase:

A couple things to note: if you start charting, reduce the number of times you breastfeed in a day, and dial in your nutrition game, you should start to see signs of returning fertility. If you do not, it may be time to check in with your chiropractor, your functional medicine doctor, and/or your midwife/OB. A small percentage of women may need to completely wean to have a return to fertility, and there may be some other issues going on that your practitioner can investigate. In addition, if you needed medical help to get pregnant previously, you will want to check in with your doctor about what to look for and when to come back to check in about future fertility treatments. Some fertility assistance does not require weaning, but some may. If your doctor advises weaning in order to pursue fertility treatments, it’s time to check in with your goals for breastfeeding and your family. You know what’s best for you. You will also want to put in a call to The Infant Risk hotline; they can give you the latest information about safety of medications and breastfeeding.

Molly Hankins

BIRTHFIT Fox Valley @birthfitfoxvalley

References

http://www.nfpandmore.org/The%20Seven%20Standards%20Summary.pdf

https://kellymom.com/ages/older-infant/fertility/