Is it possible to get pregnant while breastfeeding?

Dear Reader, 

Trying to make sense of spotting can certainly be confusing, especially after just having a baby. It is possible to get pregnant while chestfeeding, but it’s also possible for chestfeeding to be used as a short-term method of contraception. However, this method relies on you exclusively and frequently chestfeeding your infant and not menstruating (having periods). Since it’s generally recommended not to get pregnant so soon after your last pregnancy, consider talking with a health care provider about your situation and the best contraception plan for you. 

How soon can you become pregnant after giving birth? 

Although people’s bodies vary, it’s conceivable (no pun intended) that somebody could become pregnant in the first month after giving birth. In order for someone to become pregnant, their ovaries must release an egg into their fallopian tubes, a process known as ovulation. This happens approximately once per month as part of the menstrual cycle. However, for people who are or have recently been pregnant, hormones block ovulation from taking place. While this helps to prevent humans from conceiving again when they’re already pregnant, these same hormones continue to suppress ovulation for a short time, even after someone’s no longer pregnant. On average, this lasts for about six weeks following pregnancy, but it is possible for ovulation to start back up within as few as three weeks.  

How soon after giving birth is it considered safe to become pregnant again? 

Just because it’s possible to conceive soon after giving birth doesn’t mean it’s advisable. Medical experts recommend most people wait at least 18 months after giving birth to become pregnant again. This allows the uterus (and body as a whole) to recover from the physically taxing process of pregnancy before carrying another child. Waiting can also reduce the risks of complications for the baby, which are most probable when conceiving in the first six months after pregnancy. Back-to-back pregnancies tend to run a higher risk of: 

• Congenital disorders 
• Restricted growth 
• Premature water breaking 
• Premature birth 

List adapted from Parents 

Does chestfeeding affect your ability to conceive? 

Chestfeeding can prevent you from getting pregnant under certain circumstances. During chestfeeding, the action of the infant suckling causes hormonal changes in the person chestfeeding which helps them produce milk. Interestingly, these changes interfere with the hormones that control the menstrual cycle. When a child suckles, it can suppress ovulation, and if you don’t ovulate, you can’t become pregnant. This method of contraception is called the lactational amenorrheal method (LAM) and has specific guidelines. The LAM may work for you if you’re: 

• Exclusively chestfeeding: Since the physical suckling is what drives this method, it works if the infant’s sole source of nutrition is attached chestfeeding. Therefore, the LAM isn’t effective if you use a chest pump or feed formula to the infant. 
• Frequently chestfeeding: To achieve continual suckling by the infant, the LAM calls for chestfeeding at least every four hours during the day and at least every six hours overnight. 
• Not menstruating: Once someone’s menstrual cycle starts back up, the LAM can’t prevent conception. However, since your first ovulation after giving birth will take place before your first period does, monitoring menstruation isn’t a perfect system. 

List adapted from Harvard Medical School 

Although spotting can be caused by ovulation, it might be due to other factors, like the hormonal effects of the LAM itself. However, when followed diligently, the LAM can be successful at preventing conception; it’s around 98 percent effective if the guidelines are strictly followed. That said, after approximately six months of age, infants tend to sleep more than the LAM’s chestfeeding schedule allows for and it’s recommended to introduce solid foods into their diets. These factors can reduce the effectiveness of the LAM since they make it harder to follow the strict guidelines. 

What are other ways you can reduce your likelihood of pregnancy post-birth? 

If you’re hoping to reduce your chances of becoming pregnant again too quickly or at all, there are several methods of contraception other than the LAM that you may find more sustainable. If you’re interested in learning more about hormonal and non-hormonal options like pills or intrauterine devices, consider checking out the Birth Control Options - Medication and Long-acting Reversible Contraception fact sheet. You might also find it helpful to compare different methods of contraception side-by-side. Though your menstrual cycle may be inconsistent at the moment, tracking your ovulation could be another useful tool later on to figure out when your chances of pregnancy are highest. In the meantime, checking other physical cues, like body temperature and cervical mucus, might help you stay abreast of when you’re ovulating again. 

It may also be beneficial to meet with a health care provider to discuss options. They can help you find a method that’s best suited for your lifestyle and conception plans. 

Wishing you and your baby health and happiness!