Yes, You Can Get Pregnant While Breastfeeding – Here’s What to Know
As a new mom, you probably have your fair share of questions about postpartum — especially when it comes to breastfeeding. Combine this with the goal (or risk) of getting pregnant again and there is no shortage of old wives’ tales and scientific studies to dig through.
In this post, we’re going to answer some of your most-asked questions about breastfeeding and postpartum fertility.
Can you get pregnant while breastfeeding?
Yes, it is possible to get pregnant while breastfeeding! However, it is less likely as most women experience a period of delayed fertility while nursing. This owes to irregular ovulation while breastfeeding.
Not every woman ovulates regularly while breastfeeding, and many do not get a menstrual period. In fact, some may even use breastfeeding as a form of contraception, known as the Lactation Amenorrhea Method (LAM). However, LAM is not guaranteed and only effective for a maximum of six months following your baby’s birth. After six months, it becomes more likely that you will get pregnant.
What happens to your body during breastfeeding?
While you are breastfeeding, your body’s main focus is caring for your new baby and maintaining your breast milk supply. Your body releases a hormone called oxytocin, which is responsible for milk production and helps suppress the hormones that stimulate the ovary to grow an egg. It also encourages bonding between the new mom and her baby.
When your baby attaches to your nipple, they stimulate nerves that send the signal to your brain to release oxytocin. This sets in motion the let-down reflex and release of breastmilk. A breast pump can’t send the same message to the brain as a latching baby, so you must be breastfeeding — not pumping — for it to work as a form of birth control.
This decreased fertility occurs only when you are breastfeeding exclusively or on a consistent basis. As time goes on, the effect of oxytocin on the body’s hormones gradually decreases until you begin to ovulate again. This usually takes around six months after giving birth.
Breastfeeding as a means of birth control
If you are going to use breastfeeding — a.ka. LAM — as a form of temporary natural birth control, you need to ensure you are doing it correctly. Here is everything you need to know about breastfeeding as natural birth control.
How does it work?
When you are breastfeeding your baby exclusively and/or often, your body naturally stops ovulating. This occurs because the release of oxytocin during breastfeeding interferes with your reproductive hormones, preventing ovulation from occurring. As a result, you probably will not get your menstrual period while breastfeeding — hence the word “amenorrhea” in LAM.
However, you should know that LAM only works if you follow a strict set of rules regarding breastfeeding. According to La Leche League International, here are the guidelines you need to follow for breastfeeding to be an effective form of birth control:
- Your baby must be less than six months old
- You must be breastfeeding at least every four hours during the day, and every six hours at night
- You must be feeding your baby only breast milk — no formula or solid foods
- You cannot be using a breast pump
- Your baby cannot be using a pacifier
- Your menstrual period must not have returned and you cannot have any spotting
Is it effective?
No birth control method is perfect. When done correctly, Planned Parenthood states that LAM can be as effective as hormonal birth control. Only 2 out of every 100 breastfeeding women who use LAM will get pregnant in the first six months after their baby is born, making LAM 98% effective.
Because of its strict rules, however, LAM won’t work for every woman. It’s important to note that if you aren’t following the rules of LAM exactly, it’s still possible for you to get pregnant while breastfeeding. If you need to use a breast pump or formula, for example, LAM will not be an effective means of birth control for you.
What are some better alternatives?
Not every woman may want to or be able to use LAM as a means of birth control. Some alternatives you might consider are:
- Hormonal birth control. Hormonal birth control is as effective as (or more effective than) LAM when used correctly. However, unlike LAM, you can still use hormonal birth control while formula-feeding or breast pumping. Progestin-only methods like implants, IUDs, and the Depo-Provera shot can be used immediately while breastfeeding. If you want to use hormonal methods containing estrogen, such as the pill, you’ll need to wait three weeks after giving birth to start.
- Non-hormonal birth control. Currently, there are several methods of non-hormonal birth control available if you cannot use hormones or prefer not to. The copper IUD is one option that contains zero hormones and lasts up to 10 years. Another, less effective option are fertility awareness methods (FAM), which requires you to closely track symptoms of ovulation, such as hormonal changes and changes in your cervical mucus. Like LAM, this method requires you to follow strict rules, such as avoiding sex when you are most fertile. The Mira fertility tracker can help you use FAM more effectively by more accurately pinpointing the hormonal changes leading up to ovulation.
- Barrier methods. Non-hormonal birth control methods that can be purchased over-the-counter, called barrier methods, include male and female condoms. These methods prevent sperm from reaching an egg by collecting the sperm inside disposable latex. One benefit of using barrier methods is that, unlike other types of birth control, they protect against sexually transmitted infections (STIs) as well as pregnancy. They are also easy to access and relatively inexpensive. When used perfectly, barrier methods can be as effective as hormonal birth control.
Getting Pregnant While Breastfeeding
Many experts suggest that women should avoid interpregnancy intervals of less than six months. This is because some research shows that there are elevated risks for mothers and their babies when the interpregnancy interval is too short. However, the decision to get pregnant a second time is intensely personal and should not be made without your partner and doctor.
Women who exclusively breastfeed may not ovulate or have a period for up to six months after giving birth. Even so, it is possible to breastfeed and still get pregnant, especially if your baby is older than six months or you are also using breast pumps or formula. In fact, some women may find that their periods return sooner than six months after giving birth.
If you are still breastfeeding and have decided to try and get pregnant again, you may be wondering how breastfeeding will affect your fertility, and if there is anything you can do to improve your chances of conception. In this section, we’ll go over everything you need to know about getting pregnant while breastfeeding.
Ovulation While Breastfeeding
The release of oxytocin that occurs when a baby latches onto its mother’s nipple can interfere with the new mom’s hormone production. Women usually do not ovulate for at least six weeks after giving birth — but if they are exclusively breastfeeding, they may not ovulate for up to six months due to the role oxytocin plays in postpartum fertility.
Changes like breastfeeding your baby less often than every four hours in the daytime and six hours in the nighttime, feeding your baby formula, or using a breast pump increase the odds that you will ovulate sooner rather than later.
Chances of Getting Pregnant While Breastfeeding
It is possible, but rare to get pregnant while breastfeeding — especially before your menstrual period has returned. If you are exclusively breastfeeding, your chances of getting pregnant in the first six months after giving birth are approximately 2%. You are more likely to get pregnant if you breastfeed less often than every four hours in the daytime and six hours in the nighttime, if you formula-feed in addition to breastfeeding, and if you use a breast pump. It is also more likely that you will get pregnant if your baby is more than six months old.
Tips for TTC While Breastfeeding
Theoretically, you can get pregnant as soon as you are ovulating again. Thus, restoring fertility while breastfeeding means speeding up the return of ovulation. Some ways you can achieve this are:
- Reducing the frequency of breastfeeding (for example, consider night-weaning)
- Give your baby a pacifier to reduce its need to breastfeed
- Alternate breastfeeding with formula-feeding, or use a breast pump
- If your baby is old enough, start introducing solid foods
- Eat an overall healthy diet and maintain a healthy weight to encourage the return of ovulation
Tracking your hormones postpartum can help you identify exactly when you have started ovulating again, so you will know as soon as you are able to get pregnant again that it is time to start trying. Using a digital fertility tracker like Mira can help make this process easier. Mira charts your unique hormone curve so you can identify the hormonal shifts that indicate ovulation with greater accuracy and precision.
When does full fertility return?
If you are ready to start trying to conceive again or think it is time to consider a new birth control method, it is important to understand the transition back to full fertility.
Every woman’s body is different, and the time it takes to return to full fertility varies as well. For some women, their menstrual periods return while their baby is still younger than six months. Other women might not return to regular cycles until much later.
As you begin to wean your child off of breastfeeding, either by supplementing with formula or transitioning to solid foods, you should begin to gradually return to full fertility. Most women see a return of menstruation within four to eight weeks of stopping breastfeeding, but it can take longer. Once your menstrual period returns, your fertility should be back to normal.
Using a fertility tracker such as Mira will allow you to track your hormones to pinpoint ovulation and your return to fertility. The use of a hormone tracker isn’t recommended for the first two weeks after childbirth. During this time, your HCG level remains high and could interfere with the levels of luteinizing hormone (LH), which normally indicate ovulation. After waiting two weeks, you can use the tracker — even without having returned to a regular menstrual cycle and while breastfeeding.
If you are still breastfeeding and considering undergoing fertility treatments to become pregnant again, be sure to discuss it fully with your healthcare provider. Some treatments won’t affect your milk supply or the baby, but others may require you to stop breastfeeding. Your doctor will be able to discuss the specific treatment and its effects for you to make the best decision for your family.
✔️ Medically Reviewed by Dr Roohi Jeelani, MD, FACOG and Lauren Grimm, MA
Dr Roohi Jeelani is Director of Research and Education at Vios Fertility Institute in Chicago, Illinois. Dr Jeelani earned her medical degree from Ross University School of Medicine in Portsmouth, Dominica. She then completed a residency in Obstetrics and Gynecology and a fellowship in Reproductive Endocrinology and Infertility at Wayne State University, Detroit Medical Center, where she was awarded a Women’s Reproductive Health NIH K12 Research Grant. She is board certified in Obstetrics and Gynecology. Dr Jeelani has authored numerous articles and abstracts in peer-reviewed journals, and presented her research at national and international scientific meetings. A Fellow of the American College of Obstetrics and Gynecology, Dr Jeelani is a member of the American Medical Association, the American Society of Reproductive Medicine, and the American Association of Gynecologic Laparoscopists.
Lauren Grimm is Research Coordinator at Vios Fertility Institute in Chicago, Illinois. Lauren earned her bachelor’s degree from Loyola University Chicago, where she also completed her masters in Medical Sciences. Lauren has worked alongside Dr. Jeelani for the last 3 years, authoring a number of abstracts and articles in peer-reviewed journals, and presented her research at national and international scientific conferences. Lauren will be continuing her education this fall at Rush University Medical College in Chicago, IL as an MD candidate.
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