A hand is raised to the back of the class and a woman asks the lactation consultant: “Excuse me, I am breastfeeding my son. She is 17 months old and a few days ago I asked my doctor if it is normal that my period has not yet come. He told me that it was not normal, that this was impossible and to go to the gynecologist as soon as possible ”.
The adviser smiles shyly and asks the same question to the rest of the women who accompany the first: “And what do you think? It is normal?”. Immediately the voices of women who breastfeed their children begin to sound giving figures, like those who auction for a valuable item: “I have been two years”, “I have been 32 months”, “I have been without rule for more than three years”, “Well me…”.
This happened a few years ago, when I obtained the title of lactation consultant and my wife had been breastfeeding my first child for more than a year and a half, equivalent to the year and a half (without adding pregnancy) that she had not menstruated. The doctor said that this was something abnormal, however in that room full of women the majority gave dizzying figures, which came to say that when breastfeeding makes you spend years without menstruation, there is nothing to worry about .
Why many doctors do not know this happens
Many doctors, pediatricians and gynecologists, and many ordinary people are unaware of this phenomenon for the same reason that they are unaware of many things about breastfeeding: a few decades ago most women stopped breastfeeding before six months and most babies started to eat things at three months .
This meant that menstruation came earlier and few women suffered amenorrhea (lack of menstruation) lasting years.
The cause of the lack of menstruation is prolactin
However, despite the fact that many people do not know that this can happen and that it is normal, the explanation is very simple and the culprit is prolactin .
Prolactin is one of the hormones involved in the cycle of creating breast milk. The moment the placenta is expelled in labor, prolactin levels begin to rise to “make” milk. As the days go by and as the baby sucks, the prolactin levels go up and remain high while there is suction. The more suction, the more prolactin is secreted and consequently the more milk a mother produces.
As nature is not stupid (it has many failures, but also many successes), prolactin has a double mission: in addition to providing the baby with its long-awaited white liquid that emanates from the mother , it also inhibits the secretion of hormones related to fertility .
This means that while prolactin is high, the chances of ovulating are very low and that many women do not have their periods until after a long time of breastfeeding.
I say that nature is not stupid because while it is breastfeeding the body interprets that you are taking care of a baby or a small child and that, therefore, you are not yet in a position to take care of another newborn . For this reason it will delay ovulation while you are breastfeeding.
“But, breastfeeding, my period came to me”
Sometimes this equation is not true. There are women who must have a pump-based menstrual cycle and there is no prolactin to break it down, and after three or four months they tell you that, while breastfeeding, their period has come. Sometimes they are bleeding without ovulation that is not considered menstruation, but sometimes it is the period and it is here to stay.
When your period is more likely to arrive
It is possible that the first months or years, when a child breastfeeds the most, the period does not arrive, but that it does appear in the second or third year if he breastfeeds less.
To put them in writing and define them a little, I will tell you what are the two circumstances that make it more likely that the rule will arrive:
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That the baby is more than six months : at the moment in which babies begin to take new foods they also begin to suckle a little less.
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That there are periods of more than six hours without breastfeeding : if they eat more and more and in some feedings they forget to ask for breast, if at night they start to sleep waking up less often, if they suddenly fall asleep without the help of the breast of Mom and / or if mom has started to work and spends several hours away from home, periods of between 4 and 6 hours may appear without the baby breastfeeding and this makes the body begin to think that the child is more autonomous (it is true ) and that it might be a good idea to get back into the condition of having more babies.
Can we use breastfeeding as a contraceptive?
Well, if the aforementioned conditions are met but vice versa (exclusive breastfeeding with the baby under six months and that there are no periods of more than 4-6 hours without taking a feed) the chances of pregnancy in the first trimester are almost nil. Between 3 and 6 months of the baby’s life, the reliability of this method, which is called LAM (lactation and amenorrhea method), is 98-99% and after 6 months I would no longer risk it .
The first period comes 14 days after the first ovulation, but a woman does not know that she has ovulated until 14 days later, when the blood appears. It may happen that the first ovum after childbirth is fertilized and that the woman continues without having her period for a few more months because she is pregnant . If you are looking for a baby or it does not matter if it arrives, it is a curious anecdote to explain (“I have had no period since I got pregnant with my first child, and I’ve been breastfeeding the second for months”), but if it is not the intention it can be an unexpected surprise.
In Babies and more | The reappearance of the period after childbirth, Yes you can get pregnant while breastfeeding, Contraceptive methods while breastfeeding
