Breastfeeding as birth control - does it work?

We explain how you can use breastfeeding as birth control if you're not quite ready for another addition to your family.

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It's true, in the first few months after you give birth breastfeeding can provide you with a completely natural form of contraception. Think of it as mother nature's way of giving you time to recover between babies!

Using breastfeeding as birth control is known as the Lactational Amenorrhea Method (LAM) and is accepted by the medical profession as a reliable means of suspending your fertility while you care for your new baby. Having said that it's not as straight forward as it may seem, we explain...

How does LAM work?

When you breastfeed a hormone called prolactin is produced by your body, this stimulates the continuous production of milk so that your baby is able to feed. Prolactin also acts as a fertility suppressant, blocking the release of the hormones involved in ovulation. This means that if you breastfeed your baby on demand from birth (feeding every 3-4 hours) sufficient prolactin will produced to suspend your menstrual cycle and prevent you from ovulating and falling pregnant again.

Is it reliable?

When used correctly LAM has a 98-99% rate of reliability, however as with any contraception you do need to meet certain conditions for it to be effective. These are....

Absence of menstruation - LAM will only be effective if menstruation has not yet restarted again after giving birth (spotting or light bleeding in the first 56 days after delivery aren't counted as menstruation). Restarting your periods is a sure sign that you have started ovulating again so you will need to use an additional form of contraception if you don't want to fall pregnant again.

Breastfeeding on demand - For LAM to be a reliable form of contraception you will need to exclusively breastfeed your baby every 3-4 hours throughout the day and night, this is so the levels of prolactin in your body remain high enough to hold off ovulation. For this same reason it is also important that you feed your baby directly without the use of bottles or dummies.

Your baby is under 6 months - Some women use LAM as an effective form of contraception right up until their baby is a year old. However, LAM's reliability in preventing pregnancy is significantly reduced after the 6 month mark as your baby is likely to be sleeping through the night and starting on solids.

If you are able to meet this criteria it's likely that you'll be able to use breastfeeding as birth control successfully. However, if it is really important that you don't fall pregnant it could be worth your while using supplementary forms of contraception just in case.

When it comes to how long you'll be able to use breastfeeding as contraception for there is no definitive answer as it's all down to hormonal reactions in your body. All women experience the restarting of menstruation differently with some able to rely on LAM for 3 months while others use it successfully for up to a year. Regardless, as you will ovulate for the first time roughly two weeks before you experience your first period it does make sense to combine LAM with other natural contraception methods such as charting your cervical mucous and cervical position anyway as this will help you keep an eye on your fertility.

When you resume ovulation, your baby starts to sleep through the night, needs a substantial amount of solids in addition to breastmilk, or you return to work you will need to review your contraceptive needs with your health care provider.

What are the alternatives?

Most forms of contraception can be used whilst breastfeeding and non-invasive options such as condoms or a diaphragm are often popular. Most hormonal interventions such as taking the pill or having a contraceptive implant are also safe to use.

There is only one form of contraception to steer clear of when you're breastfeeding and this is the combined pill as the oestrogen it contains will significantly reduce your ability to produce milk. If you feel the pill is the right option for you you're doctor is likely to prescribe you with a progestin-only (mini) pill as these are a better alternative.

Are you using breastfeeding as contraception? Do you have any advice on LAM for new parents? Why not share your tips on breastfeeding and any other questions or stories you have with other parents on the AskBaby Forums.