Learning the Lactational Amenorrhea Method
Learning the Lactational Amenorrhea Method
In my last post, The Rules of FAM for Contraception, we went through the 4 main rules under typical menstruating circumstances. But many people want to start FAM after they've had a baby and while they are currently breastfeeding. The purpose of this post will be to explain the modified rules for contraception - otherwise known as the Lactational Amenorrhea Method.
It's possible to get pregnant while breastfeeding, especially if you are not charting your cervical fluid. Because ovulation occurs before your first menstruation after giving birth, it's possible to release an egg before you've gotten your menstrual cycle back.
The most important factors to how soon your menstrual cycle returns while breastfeeding are the frequency and intensity of breastfeeding. These factors include:
The length of time you nurse - how many months you nurse after birth
Frequency of feeds per day - the more frequently the baby suckles, the less likely ovulation will return. It is the frequency, more than the duration, that has the greatest impact on your returning fertility. For example, nursing for 2 minutes every 20 minutes is more likely to suppress ovulation than nursing for 6 minutes once every hour.
Intensity of nursing - when you start to introduce solids, bottles etc. Exclusive breastfeeding is when you nurse day and night, and whenever your baby needs to, for the first six months. You do not give them bottles, solids, or a pacifier. Partially breastfeeding is when you breastfeed according to a schedule set by the mother, and when the baby is introduced to pumped milk, and/or formula.
Every time a baby suckles the breast, the mother's body releases oxytocin and prolactin. These two hormones inhibit the ovulatory hormones including luteinizing hormone which releases the egg.
There's only a 2% chance of ovulation if you meet all three criteria of the Lactational Amenorrhea Method.
These are the criteria:
Your menses have not returned
You are fully or nearly fully breastfeeding
Your baby is less than 6 months old
If you are not able to sustain constant togetherness with your baby (for real-life reasons such as having to go back to work for example), you will not be able to solely rely on breastfeeding as an effective form of contraception, and should resume observing normal charting rules.
Some things that make using the LAM easier are carrying your baby on a sling or snuggly for easy breast access, keeping a crib by the bed or sleeping with your baby. Every parent must find the balance that is right for them.
Good news is that those who choose to breastfeed will still have some warning signs that ovulation is returning in the form of cervical fluid. These patches of cervical fluid will often be longer than in the usual menstrual cycle, and you may have several patches of them before your body actually ovulates. Eventually, your cycles will begin to normalize after the first 1-3 cycles postpartum.
When to Resume Observing Your Fertility Signs
This depends on whether you are not breastfeeding, partially breastfeeding, or exclusively breastfeeding.
If you are not breastfeeding:
Begin checking your cervical fluid after your lochia (blood-tinged secretions from your healing uterus) diminishes, about ~5 weeks after childbirth.
You can start taking your temperatures again ~3 weeks after giving birth
You can check your cervical position 4-6 weeks after giving birth
If you are partially breastfeeding:
Begin checking your cervical fluid after your lochia (blood-tinged secretions from your healing uterus) diminishes, about ~5 weeks after childbirth.
You can start taking your temperatures when you notice any wet cervical fluid, when you have a patch of bleeding, nurse less frequently, or introduce solid foods.
You can check your cervical position 4-6 weeks after childbirth
If you are exclusively breastfeeding:
Begin checking your cervical fluid after your lochia (blood-tinged secretions from your healing uterus) diminishes, about ~5 weeks after childbirth.
You can start taking your temperatures when you notice any wet cervical fluid, when you have a patch of bleeding, nurse less frequently, or introduce solid foods.
You can check your cervical position 4-6 weeks after childbirth