Nursing During Pregnancy: Can I Get Pregnant While Breastfeeding?

Let's talk about breastfeeding and pregnancy! There are several issues at work here, and I'll be talking about a few of them over the course of this week.

The questions I'll be covering are:

Can I Get Pregnant while Breastfeeding?

Is It Safe to Breastfeed while Pregnant?

What are Some Other Concerns about Nursing through Pregnancy?

Can I Continue to Nurse My Older Child after the Baby is Born?

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Today's question: Can I get pregnant while breastfeeding?

The short answer is: Yes! It is certainly possible to get pregnant while you're still nursing. 

Let's break it down, though. 

Breastfeeding is a natural contraceptive, given to us by nature to assist with child spacing to encourage safer and more viable pregnancies and childbirth and to ensure that there would be adequate resources for the existing child before another was born. However, the advent of agriculture, the addition of regular complex carbohydrates to our diets, our ample food supply, and the disruption of natural breastfeeding rhythms in favor of a more "scheduled" life have all weakened breastfeeding's ability to suppress ovulation.

Breastfeeding is as effective (over 99%) as the Pill for contraception provided you meet all of the following criteria:

1. Your baby is under six months old.

2. Your baby breastfeeds at night as well as during the day and sleeps in close proximity to you.

3. You use no artificial nipples (no bottles, no pumping, no pacifiers - all feedings and comforting are at-breast).

4. Your period has not returned.

This means that some women can get pregnant even while breastfeeding and meeting these conditions, just as some women can get pregnant while taking hormonal birth control correctly. However, most women will find exclusive breastfeeding to be very effective as contraception during the first six months. If a new pregnancy is absolutely not an option for you, consider using a backup method as well, such as condoms, hormonal birth control*, or an IUD.

*A note about the Pill: There are several forms of oral hormonal birth control (the Pill). There is evidence that the estrogen in the combination pill may have an effect on milk supply. It is recommended that nursing mothers who wish to use hormonal birth control try the "minipill," which contains only progesterone. The minipill is very effective, but only if used exactly as directed, which means that you must take it at exactly the same time every day. If you don't feel that this is realistic for you, talk with your OB or midwife about other birth control options.

After six months, you cannot rely upon breastfeeding alone for contraception. Some women find they are unable to get pregnant when they are breastfeeding at all, while others begin ovulating as soon as their babies start going longer between feedings, start sleeping through the night, or begin eating solid foods in addition to breastmilk.

Also, remember that you ovulate before you have a period, meaning that it is possible to become pregnant the first time you ovulate after giving birth, even if you haven't had a period yet.

I did not use any birth control after the birth of my third child, and breastfeeding alone prevented the return of my period until my baby was 12 months old. I got pregnant when G was about 16 months old, meaning I had about four periods before conceiving. G was still nursing pretty often, including at least three or four times at night, but he was also eating solid foods. My cycles were very irregular, ranging from 33 days to 57 days, and it was quite nerve-wracking when my period was so unpredictable. I took many, many pregnancy tests during that time! That's just my experience, but I think it's a fairly common one. If you decide to go the "let's let nature take its course route," be aware that you may not know you're pregnant until you finally decide to take a test!

Next: Is It Safe to Breastfeed while Pregnant? >>