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Infant feeding

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Original poster

Breastfeeding as contraception : quick poll

53 replies

LittleManktiesMum · 27/04/2010 18:44

Hi all

Haven't posted on here for a while as been busy studying. Was wondering if any of you lovely ladies would be able to help me with a research project I'm currently undertaking?

For those of you who have had a baby in the last year or so and have breastfed your baby, were you informed by your midwife/health visitor/GP of the form of contraception which is brought about by breastfeeding - this is known as the lactational amenorrhea method. This may have been discussed as part of the post-natal discharge or your 6 week check.

Just really want an idea at this stage whether or not this was mentioned/discussed with you and if so, by whom and at what stage. (Please note that the results from this will form part of my research project, which is for study purposes only, and all responses will remain anonymous).

Many thanks,

LittleManktiesMum x

OP posts:
Original poster
LittleManktiesMum · 30/04/2010 09:19

Thanks for the advice cory.

Indeed my starting point with this project is the reasons why the method is not promoted by health professionals, reasons which are many & wide-ranging. However, my research will also consider the limitations of LAM and I have a number of case studies who have successfully (or otherwise) used this method. In addition I will be considering alternative methods of contraception whilst breastfeeding with their benefits/associated risks/limitations. Fair enough though if LAM is not particularly successful/effective but it is the fact that it is not widely promoted/discussed with women that bothers me - how can a women make an informed choice if she is not told all the options.

x

OP posts:
Original poster
LittleManktiesMum · 30/04/2010 09:49

As an aside and in response to your suggestion that the spacing provided by BF is only relevant to hunter-gatherer societies where maternal food intake was restricted, a Australian study of 101 well-nourished women backs up these statistics:

www.ncbi.nlm.nih.gov/pubmed/1672186?ordinalpos=1&itool=EntrezSystem2.PEntrez.P ubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&l ogdbfrom=pubmed

LAM is 98% effective if certain criteria are met (no return of menses, fully or nearly fully breastfeeding & baby under 6 months old). Anecdotal evidence (from friends/forums) is undoubtedly very persuasive but is not necessarily reliable and is open to interpretation (although of course so are all studies).

x

OP posts:
PacificDogwood · 30/04/2010 10:35

Hear, hear, cory, v good points.

FWIW, I conceived DS2 1 week after I had stopped BFing DS1 aged 5 months - admittedly at that point he was mixfed.

Like any other method of contraception it has a failure rate and when considering it every individual woman has to consider what margin of error she is comfortable living with. Afterall conception after sterilisation/vasectomy is not unheard of...

BTW, I am a GP and I do mention it at 6 week checked. Sadly at that point hardly anybody is still (exclusively or at all) BFing anymore here.

Original poster
LittleManktiesMum · 30/04/2010 13:46

I completely agree re failure rates and every individual women having to consider what margin of error she is comfortable with living with, but what bothers me is that many Trusts do not promote/discuss this method at all - thus how can a women make an informed choice re contraceptive choice unless she is aware of all the options. LAM for some women can be a very effective method if they are prepared to take the risk that they may conceive another child earlier than planned. Other than abstaining from SI no form of contraception will be 100% effective. It seems to me that natural family planning of any kind appears somehow 'irresponsible' and that its 'simply not worth taking the risk'.

Like other such things with the decline in breastfeeding (of which there are many contributory factors) LAM is deemed by some health professionals not to be worth discussing. Some leaflets which discuss post-natal contraception given to women do not even mention it. Is it not the case that if more women knew about LAM, it may actually extend BF rates or am I simply being too idealistic?

OP posts:
hobnob57 · 30/04/2010 13:53

Haven't read any replies but wanted to answer OP.

LAM was discussed with me as a form of contraception not to be relied upon by my midwife (I think) when discussing BF at an antenatal appointment and similarly by HV and GP after birth and at 6 week check. Basically, well done for BF but you need contraception, ovulation can happen if you miss a feed, etc. I missed loads of feeds with DD1 and took 9 months to get a period...

slushy06 · 30/04/2010 17:53

I have bf two children I was 18 with ds and 22 with dd both times I was warned that bf was not a effective contraception and before I was discharged on ds I had to sit down and confirm what method I planned to use and was even given a appointment at local family planning. On dd the mw repeatedly told me that I was more fertile for the nxt 6weeks than I ever would be and that if my dd went so much as 4 hours without a feed I would be able to catch she said if I didn't want to be counting feed times to use a alternative.

cory · 30/04/2010 19:06

Neither of these references works, LittleMankties, but I do think a study of 101 women seems rather a small sample. Which is the usual objection to anecdotal evidence, too: that the sample will be too small.

Original poster
LittleManktiesMum · 30/04/2010 19:54

Unfortunately cory this seems the very nature of this sort of research - limited samples. This is something I intend to refer to in my project. I certainly intend to highlight the varied reasons why many women do not use the method and its limitations, and do appreciate your advice. (I chose LAM because it appears it is not promoted by health professions, despite the statistics, (Myles Midwifery, 14th ed.) and I wanted to look into the reasons why).

OP posts:
cory · 30/04/2010 19:59

As long as you make your premises clear and document accurately, it should be really interesting.

gumblossom · 01/05/2010 00:13

My GP prescribed the mini-pill for me at 10 week check-up. I told him I was fully BF on demand and he suggested I could rely on it for contraception til my baby was 6 months, as long as I kept feeding on demand.
My son is 20 months now and still no post-partum menstruation here.I BF on demand still, and he probably has 4 -6 feeds a day. Actually I would like my fertility to return so I could have another!

HighFibreDiet · 01/05/2010 01:31

gumblossom it took me a long time to conceive when still breastfeeding my ds2: I had a few periods starting when he was about 18 months but I bought some 'ovulation predictor' dipsticks and don't think that I was actually ovulating until he was nearly 3 years old. Ds3 was born about a week before ds2 turned 4.

No healthcare professional (doctor, HV, midwife) ever spoke to me about LAM but I knew about it because of being a La Leche League member and because I had bought myself Toni Weschler's book 'Take Control of Your Fertility'.

In contrast to my experience, I know people who were exclusively breastfeeding but whose periods returned within a few months. I know these are anecdotal but it really seems that hormone levels can vary quite significantly from woman to woman even if they appear to be breastfeeding the same amount.

StealthPolarBear · 01/05/2010 08:22

No- although at my booking in appt the MW asked about my last periods, and I explained I'd only had a couple, very far apart as I was still bf my DS.

At my 6 week check GP asked had I had a period yet, when I said no he asked if I was bf. That was the closest anyone came to it

PacificDogwood · 01/05/2010 10:58

Just as a PS:

You can of course conceive before you have a period as you ovulate 14 days before you start bleeding...

Sounds like an interesting project, OP

whittywan · 01/05/2010 12:00

Answering in cory's suggested format:

a) yes but not because any hcp discussed LAM with me. I am a medic myself and heard about it as a part of teaching of contraception (studied in South Africa though -not here)

b) no

c) I am a medic, and therefore slightly sceptical (the Australian study was hardly a large cohort) that said DS is 20 weeks, ebf on demand, no return of menses and we are using only condoms as back up.

Original poster
LittleManktiesMum · 01/05/2010 18:52

Thanks again to those of you who have recently responded and that I've not thanked thus far. I really do appreciate you taking the time to share your views/comments.

OP posts:
littlepinkpear · 01/05/2010 21:23

a) had you heard about the lactation method when you had your baby?

Yes

b) did you use it?

No, but for the following reasons

c) if you did not use it, what influenced your decision?

Totally mixed messages from the healthcare professionals who dealt with me after the birth. Within hours of my c-section I was asked by a MW what my chosen method of contraception was going to be. Responded EBF and she laughed. Asked me if I would like the implant before I left the hospital . Appeared back at my bed with 2 huge paper bags of condoms. Every single member of staff who asked me questions on the ward asked me about contraception.

Every health visitor asked me about using condoms / the mini pill even though I was EBF when at home.

In the end I gave up, took a pill prescription at my 6 week check and they stopped asking me. I never took it.

This was all in complete contradiction with the NHS leaflet on contraception I was given in the ward saying that EBF and no periods was the most effective method of contraception.

Nobody I dealt with regarded breast feeding as a serious method of contraception. They all seemed to have a story of someone who had fallen pregnant this way and wanted to push other methods.

Despite me getting pregnant on the pill in the first place!

Debs75 · 01/05/2010 21:29

My dr told me that for the first 4 weeks if I was totally bf then there was no way I would get pregnant. And I didn't as was no way in any mood for sex in the first 4 weeks.

By time my 6 week check came I was on the pill

OrganicHairbrush · 01/05/2010 21:40

The "contraception chat" at my 6-week check went as follows

GP: So, what are we doing about contraception then?
OrganicHairbrush: Well, DD's still in bed with us...
GP: And what does that achieve?
MrOrganicHairbrush: Do you need her to spell it out?
GP: Right, but are you using any recognised method of contraception?
OrganicHairbrush: Um, I'm breastfeeding exclusively, no real plans to stop.
GP: That won't work. Trust me. I've seen enough women here. And we wouldn't want to get pregnant again, would we now?
MrOrganicHairbrush: Speak for yourself

(Actually I made the last line up. But I could see the speach bubble hovering above his head...)

TakeLovingChances · 02/05/2010 21:40

No HCP ever mentioned bf as a contraceptive, or even mentioned contraceptives at all, in fact I had to make a point of asking my doctor for the mini pill.

kitcat1977 · 05/05/2010 21:23

I raised the question with CMW who advised me the method was 98% effective iff EBM with no more than 6 hours between feeds.

GP also agreed that EBM was the way to go for me, particularly as I'm not overly bothered about having a small gap between children as conception was a problem first time round. GP also advised that the latter might sort itself out after the birth of DD.

Caro1302 · 05/05/2010 23:27

It wasn't mentioned to me, even though I was ebf. I knew a bit about it anyway and did use it for the first 6 months. We're at 9 months now and still no sign of a periodbu DD is on solids now so i wouldn't chance it these days.

finefatmama · 07/05/2010 00:02

Didn't even have a period between the 2 pregnancies. Was given the pill as usual and told to take it on the 1st day of my period. After waitng a while, I insisted on the coil, was sent to do a mandatory scan before gettng it fitted and was told "oh, you're 10 weeks along Mrs.." apparently one night is really all it takes

bronze · 07/05/2010 00:19

No they didn't mention it but I think it was already known DH had had the snip by that point.

Belgrano · 28/06/2010 20:58

LittleManktiesMum, I found this by searching for other people on MN who were doing a midwifery degree while juggling small DCs. I see that you did start your studying after all. I am in the position you were in back in 2008 and dithering about whether I can make this work without impacting on my DC's too much while they are so young. Any advice or encouragement would be SO gratefully received!!!
Thank you

edemame · 29/06/2010 23:29

Wont be relying on it though it's not been brought up yet by the gp or midwife. My mother in law was an 'oops baby' as her mother had been told breastfeeding could stop you from getting pregnant... as soon as nanny in law was able to have a little fun again there was mum. Guess we should all thank the midwife since we love mum and half the family wouldnt have come around without her.