EBF as contraception?

[FoodieMum3]

I was reading that EBF a baby younger than 6 months (as long as several conditions are met) is as effective as taking the pill.

Any thoughts/experiences?

Have you heard of the Billings Method? It might be an idea for you to look into it. I've used it successfully for 7 years not only to avoid pregnancy but to conceive.

To not get pregnant while BF I believe you need to be feeding on demand but that needs to be at least every 4/5 hours day and night. No dummies, no food, no water, no expressed milk. On top of that it's best to still monitor mucus discharge. That's the indicator of whether you're fertile rather than periods returning.

I think it might depend where you live in the country but there are people who teach the biology behind it to help you understand and feel confident in the process especially as it feels bizarre nowadays to do anything other than take hormones.

My two are 12 months apart...

It is a myth that BFing can't be used as contraception, just as it is a myth that any amount of BFing can be a contraceptive.

NO contraceptive is full proof, so pregnancies can happen with any method.

The Lactational Amenorrhea Method is actually pretty reliable IF

• periods have not returned
• BFing is on demand, with NO gaps of greater than 3 hours, night or day
• no extra food or fluid
• baby is less than 6 months

If ALL those criteria are met, the effectiveness is 98% with typical use.

Compare that to

condoms: 85% (I never understand why people think that condoms are that reliable!)
the pill: 92%

kellymom.com/bf/normal/fertility/

We used the LAM last time quite happily and it worked for us.

Dino That's the only time I've seen condoms down as 85% (I've worked in FP which is obviously pro, and had anti-condom stuff due to religious reasons, even they don't have them down as 85%!). What's your source please?

See the link I posted just underneath it. It is data from Planned Parenthood. Condoms are 98% with perfect use and 85% with typical use.

Similar data from the CDC, which puts the risk of pregnancy with typical use failure rate of condoms at 18%!

www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm

This table from Hatcher (one of the big names in contraception, practitioners have proably used his textbooks) puts 'typical use' condom failure at 18%.

"Perfect" use gives a much lower failure rate; and some "typical" use failures will be spotted so emergency contraception can be used; and of course barrier methods are the only ones which offer any protection against disease.

Like any other method of contraception, it has its failures, but the reputable sources of information generally give it a 98-99.5% success rate (eg NHS choices website).

You do need to feed your baby nothing but breast milk and never go longer than 4 hours in the day and 6 hours at night between feeds.

Personally, I found having a tiny baby was a pretty effective method of contraception in itself.

I wanted to err on the side of caution so I asked my GP for contraception at my 6 week check this week. He told me that I don't need it as I'm EBFing, and didn't prescribe me anything. So if I get up the duff, I'm fully blaming my GP!

My mum exclusively breast fed my older sister - when my sister was 3 months old my mum was pregnant with me

I'm EBF but there's no way I'd take the risk

My gran EBFed all 14 of her children. At one point she had 4 under 2.

Just sayin'.

I was ebfing 3 mo dc2 round the chuffing clock and used a condom and dc3 was due on dc2's birthday

Actually it worked out brilliantly for us. But I think it would have been very tough to deal with my first tiny baby and learn about being a mother and cope with early pg as well. I really wouldn't rely on bfing as a contraceptive.

Had a Mirena fitted asap after dc3 was born.

Wow! I'm surprised to see that in the Food of Love, because I thought it was a very good book with sound info in it. Now I'm intrigued! Was there a source listed?

It sounds iffy to me because how does your body magically know six months has passed. Nature doesn't work to a timetable like that. "More likely" would be more acceptable to me I suppose.

The condom thing surprises me but it's US data. I'd love to see UK data and see if it's different. This blog post explains some of the culture around condoms in the US which I don't recognise as being similar to here at all. pervocracy.blogspot.de/2011/08/condom-failure.html

'Typical use' often includes things like inebriation and getting part way through before deciding OK we'll use one... most long term couples (and like it or not most long termers have a sexual routine) have enough of a routine to push this closer to perfect use. Having said that in the UK long-term couples tend to use either hormonal, coil or natural FP methods.

Yes, also culturally condoms are used very differently in the USA and have different connotations/behaviours linked to them (in terms of who/how they are most likely to be used).

To answer some of your questions - no, there was no source in the food of love for those statements, they seem to just come from the author herself. I can't seem to find much information on her.

I'm not sure the Billings method is suitable for me because I have irregular periods so I think it might be dangerous to practice that, in case I ov'd early one month and there were still sperm there waiting to pounce on the egg.

Strange conversation weeks before my baby is due! Lol

UK data is not much different, BertieBotts.

"With perfect use, 2 in every 100 women using condoms will experience an unintended pregnancy each year. With typical use - in which the condom is sometimes not put on or taken off properly - that increases to 12 in every 100."

www.bpas.org/bpasknowledge.php?year=2014&npage=0&page=81&news=624

"My gran EBFed all 14 of her children. At one point she had 4 under 2."

Not many women in the 'old days' fed completely on demand but kept babies to a schedule. Obviously I don't know what Dione's gran did, but the LAM only works with on demand feeding, at least 3 hourly for 6 months. As for the 6 month thing, I'd guess that this is because then weaning would begin. I imagine that the LAM would work for as long as it was the ONLY source of food and fluid for the baby.

12% is quite a difference from 18%. But good to know.

I also thought about the gran who EBF thing - they would have introduced solids much earlier at that time, and it's not EBF once solids have been introduced. You can't really say that somebody EBF in the past unless you're saying "Until XXX age/date" because you can't exclusively breastfeed a child all its life.

No! I'm EBF for 5 months now and have had two periods! Use contraception if you don't want another baby yet.

Is it normal for EBF babies to still be feeding at least 3 hourly for 6 months?

EBF on demand DS2 had moved himself to having longer gaps between feeds long before 6 months.

Foodie, I know it sounds like you're not interested in Billings but I just wanted to clarify that it is entirely about monitoring ovulation and really has much less to do with periods/cycles.

Many women don't realise that no ovulation, about to ovulate and ovulation itself all cause changes to the type, texture and quantity of mucus discharged. Obviously during the ovulation period barrier or no sex is required as it is when women are learning how to monitor and understand their own fertility.

Not only is it a tool to prevent pregnancy but it is often favoured by women with PCOs and similar to help them pinpoint ovulation when trying to get pregnant too due to their irregular cycles.

It's a shame because it's often overlooked as NFP claptrap but really has its roots firmly in physiology and is unique to each woman just as our ovulation, fertility period, cycle length and irregularities are unique to us.

Best wishes for the baby! At least you don't need to think about this for the next couple of weeks.

"Like any other method of contraception, it has its failures, but the reputable sources of information generally give it a 98-99.5% success rate (eg NHS choices website)."

The NHS choices website give that figure for condoms "if used correctly every time" ie that is the 'perfect use' figure.

The CDC gives typical use, and Hatcher both typical and perfect use. There is not much difference between the 'perfect rates' between those sources, and the 'typical rates'.

The 'typical rate' is the more useful one in real life.

I can introduce you to 5 children less than a year younger than their siblings whose parents thought the same as you OP......

I ebf'd and had no period but was pg again in time for my six week check!

I have a prolactin secreting tumour that means I have the same levels as someone who is breastfeeding (prolactin is the hormone responsible for suppressing ovulation and inducing breastmilk). I have never breastfed either of my dc for medical reasons however I have the same levels of prolactin as someone who is exclusively breastfeeding. I ovulate randomly but I do ovulate (as proven by my two children albeit conceived with the help of a drug to slightly reduce the prolactin levels, but still higher than the average person).

The thing is everyone's personal "level" is different and you don't know when you might ovulate. Mine can still be very high (normal level is between 80-300 and mine is 3000 but I usually have a period when I take medication to get it to about 1000).

I always have breastmilk. I still have periods.

It's not worth the risk.

The cdc document on effectiveness of contraception describes it as a "highly effective but temporary" method.

The problem with the clinical document is it doesn't make it clear the protection could vanish at any time. That is the issue. Unlike other methods of NFP and contraception, you may not realise when it 'runs out': it would only be measurable at all when all conditions were being met (unlike other forms) so there's no 'everyday use' in real terms.
You can't exactly never wean your child or force feed them when their stomach is large enough to go without milk every 3 hours: so one day, the efficiency will fade. Unlike "did I take a pill?" or "have I checked my mucus today for the chart? Better not DTD" that fade will not be immediately apparent.

I'm also a bit about a few PP saying 'Would it be a disaster to have another child soon?' - almost in a tone whereby if you had one - especially if you BF and are therefore a superior earth mother, you should just expect to make more and more kids, without seeing it as a problem. Seeing it as a 'problem' means you're too uptight.
Remember we think of FP and safe sex for youngers ... but its majority use worldwide is to help women's health by spreading out their children and preventing massive families. If a woman doesn't want to have another child right away, it's bizarre and offensive to question her judgement on that: HER CHOICE.