How To Get Pregnant While Breastfeeding

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By Hilary Flower, author of
Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond, published by La Leche League International

So you're breastfeeding and dreaming of a new baby? Good news! Lots of moms are able to conceive a new baby without having to wean their current nursling. Let's look at seven of the most common questions.

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Do I have to wean in order to get pregnant?

Probably not. It is true that breastfeeding can delay the return of fertility, especially while frequency and duration of breastfeeding sessions remain high. But most women can become fully fertile while still breastfeeding.1

Is there a way to bring my fertility back sooner?

Try tinkering with your breastfeeding pattern. Each pair is different. There is no magic or typical threshold of breastfeeding intensity which predicts the return of fertility. Abrupt changes generally bring back fertility more rapidly and at a higher threshold of breastfeeding frequency than gradual changes.1

Of course, you and your child would have to be ready for a radical change. And bear in mind, your body may be trying to space your children more so as to prolong the special status your current nursling is enjoying!

My menstrual cycle has returned; am I fertile yet?

If you are experiencing regular menstrual cycles, and if you were normally fertile before, chances are you have returned to normal fertility. Long, short, or irregular cycles can be a sign that your cycles are not yet fertile. Sometimes it's just the way your body works; it helps if you have a record of your cycles from before you were breastfeeding.1

How can I tell if I am fertile?

If you wish to know more about your fertility status, you can gain remarkable insights using simple family planning methods. Toni Weschler, MPH, includes a section on charting during breastfeeding in her wonderful guide Taking Charge of Your Fertility.

Can I get pregnant before my first period?

Yes! Some lucky and patient moms manage to "catch the first egg." While you are still amenorrhoeic you can monitor your returning fertility on a family planning chart. Patience is the key, because the amenorrheic period when changes are occurring can involve weeks or months of wet cervical fluid. Weschler's Taking Charge of Your Fertility has great information on this.

I have had problems with infertility in the past; should I wean before treatments?

If you're eager to become pregnant first steps may include charting some cycles or reducing breastfeeding to evaluate your fertility status. If you are not ready to try to conceive, though, you may do well to take precautions since fertility reversals do occur.

Although there is no direct research, there is no obvious reason to believe that fertility treatments would harm the breast milk. To find out the latest on how a particular drug affects breastfeeding, turn to Thomas Hale, MD's Medications and Mothers' Milk. Clinical observations suggest that Clomid (Clomiphene) is compatible with breastfeeding.2 And there is no reason to expect that breastfeeding would affect your fertility treatment because the drugs will control your cycle.3

Is it safe to continue breastfeeding while pregnant?

Breastfeeding is believed to be compatible with healthy pregnancies. Many moms go on to nurse throughout pregnancy and nurse both newborn and toddler together, an arrangement known as tandem nursing. For the latest in research related to breastfeeding and such concerns as preterm labor, miscarriage, and the nutrition of the unborn child, see my book Adventures in Tandem Nursing: Breastfeeding during Pregnancy and Beyond.

REFERENCES

McNeilly, AS, Glasier, AF, Howie PW, Houston MJ, Cook A, Boyle H. Fertility after childbirth: Pregnancy associated with breastfeeding. Clinical Endocrinology (1983) 18:167-173.
Hale, Thomas, MD, personal communication 2002.
McNeilly, Alan, PhD, personal communication, 2002. McNeilly is the world's leading researcher on the return of fertility during lactation.

Breastfeeding and Fertility