that you can be ovulating and become pregnant before you get your
periods back, but what is the absolute soonest you can become pregnant while
nursing exclusively?

DH & I are not big fans of condoms (him) or hormonal methods of birth
control (me) and we tend to use natural family planning, quite effectively,
but this throws a spanner in the works. I want to know how long
breastfeeding will give us a 'get ou

of jail free' card until we're
possibly playing with fire.

There are no 'absolute guarantees' at any time, or with any method of
contraception. You CAN get pregnant while on the pill or using condoms or
having had a tubal.

LAM (Lactational Amenhorrhea Method) is about 98% effective, comparable to the
pill or an IUD. The method requires that:
a. You are less than 6 months post-partum.
b. Baby is bf exclusively on demand. (Which usually implies night feeds, though
the method doesn't specifically say so). Small amounts of solids at around 6
months are not an issue, and don't reduce effectiveness.
c. You have not yet had a period. (No bleeding after 56 days post-partum.)

If all these criteria are met, there is about a 1% chance of conception. (Which
translates to 98% effectiveness, since contraception effectiveness ratings are
based on pregnancies-per-year ... and since LAM can only be used for a maximum
of 6 months, the 1% figure is doubled.

The reason the method works is that, while some women will begin
menstruating/ovulating before 6 months, the numbers are fairly small, and a
large percentage of those first cycles are not fertile. (Either no ovulation
before the bleed, or post-ovulation hormones are not adequate to support a
pregnancy should conception occur.)

After 6 months the odds of pregnancy each cycle increase gradually, as the odds
of menstruation go up, and the odds of a fertile first cycle increase. So,
while some women find that they remain infertile for 9-12 months or more (some
women never menstruate as long as they are bfing), the method is less reliable
at that point, and it's usually best to use another method if you don't want
another pregnancy.

NFP is certainly usable while bfing. Though interrupted sleep makes temps less
reliable, and hormone fluctuations affect cervical mucus. (Though the effect is
usually towards extra caution. Commonly women have what appears to be fertile
mucus while tests show that they are not, in fact, ovulatory. So you would
tend to end up abstaining more often than necessary.)

So ... in summary ... if you are nursing exclusively, LAM is a safe bet for the
first 6 months. After that, you could probably switch back to NFP (of course
you'd want to start charting/monitoring before the 6 month mark, to be sure
that your results mae sense).
If you find that NFP doesn't work for you (or your periods return before 6
months), you might also consider an IUD or a diaphragm if you really don't like
condoms/hormones.


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)