You certainly have a God-given right to know the spacing effectiveness of breastfeeding, and you also need to know the differences between the different forms of breastfeeding.
Cultural breastfeeding has almost no effect on the return of fertility. In other words, fertility returns almost as fast as it does with bottlefeeding. That’s because Westernized cultural breastfeeding generally entails nursing according to a schedule, regularly using pacifiers and bottles, leaving the baby in the care of others, and trying to get the baby to sleep through the night as soon as possible. All of these practices reduce the frequency and the amount of nursing, the length of nursing sessions, and generally the months of breastfeeding. This form of breastfeeding certainly provides some benefits to baby and mother alike, but it should not be expected to delay the return of fertility.
Exclusive breastfeeding is also called the Lactational Amenorrhea Method (LAM).
This form of breastfeeding can have a very high spacing effectiveness for the first six months postpartum if three Standards are followed.
- The baby is exclusively breastfed. The baby receives only his mother’s milk directly from her breasts for his nourishment. He does not receive any other food or liquid. His mother’s milk is his only food and liquid. Exclusive really does mean exclusive.
- The mother has no menstrual bleeding after the first 8 weeks postpartum.
- The baby must be younger than 6 months of age. Thus the LAM applies only for six months.
Research has shown that the LAM has a 98% spacing effectiveness during the first 6 months. During the first 8 weeks postpartum, any bleeding may be ignored as a sign of fertility according to the LAM research.
A problem with LAM is that only about half the mothers doing exclusive breastfeeding will experience natural infertility for six months. That is, they will have a period before six months. That’s because many mothers doing LAM do not nurse frequently enough.
Ecological breastfeeding (EBF) means breastfeeding according to the Seven Standards of ecological breastfeeding as follows:
- Breastfeed exclusively for the first six months of life as in LAM above.
- Pacify or comfort your baby at your breasts.
- Don’t use bottles and don’t use pacifiers.
- Sleep with your baby for night feedings.
- Sleep with your baby for a daily-nap feeding.
- Nurse frequently day and night and avoid schedules.
- Avoid any practice that restricts nursing or separates you from your baby.
Mothers who care for their babies according to the Seven Standards will experience, as a group, an average of 14 to 15 months of breastfeeding amenorrhea (no periods).
The return of menses with EBF follows a normal distribution curve. In our two studies—
• 7% had a first period before 6 months,
• 56% were without menstruation at 12 months,
• 34% were still in amenorrhea at 18 months.
• The average duration of amenorrhea was 14.5 months.
Research by Doctors Remfry (1895) and Prem (1971) showed that only 6% of nursing mothers actually became pregnant before they had their first period, and those studies occurred before women had learned to identify the return of fertility from the presence of cervical mucus and/or changes in the cervix.
Besides the natural baby spacing benefit, the other great blessing of ecological breastfeeding is that its frequent suckling maintains the milk supply and thus maximizes the many health benefits of breastfeeding for both mother and baby. For a list of the 21 benefits to babies and 8 benefits to mothers, see pages 103-104 of Natural Family Planning: The Complete Approach. And the full list of benefits grows every year.
Because of both the spacing benefits and the health benefits, we think it is highly appropriate to refer to ecological breastfeeding as God’s own plan for spacing and baby care. It is difficult to understand why anyone who is interested in the welfare of babies and mothers is not making every reasonable effort to promote and teach ecological breastfeeding.
JFK, September 22, 2013
Next week: Minimum standards