This is a guest post by Jessica Bruner on using the sympto-thermal method of fertility awareness while breastfeeding. She talks about what worked for her and some of the common concerns breastfeeding moms have about using fertility awareness.
If you’re pregnant or breastfeeding you’ve probably heard that breastfeeding can be used as birth control. You’ve also probably heard that it isn’t effective. So, which is it? Can breastfeeding work as birth control or not? The short answer is yes. Clear as mud? Good.
In reality, breastfeeding can be done in such a way that it delays the return of fertility, meaning you have only a very small chance of pregnancy. You have to follow some rules, and if you don’t follow them because you don’t know what they are then, no, breastfeeding won’t be a very effective form of birth control for you.
Ecological Breastfeeding is the name of a method that uses breastfeeding for birth control. It’s specifically designed to delay return to fertility. For me and my family it worked quite well. I followed the seven rules (which aren’t that hard to learn or follow) and my period didn’t come back until my daughter was 11 months old.
For me, Ecological Breastfeeding was a great choice, and I plan to use it again when I have another child. It isn’t for everyone, though.
It’s best suited for moms who are staying home with their babies because it necessitates 24/7 proximity. This isn’t to say that you can’t ever get a break or leave the house to do anything. It does mean that you have to be the one doing all the feeding, though, at the breast.
Most definitions of exclusive breastfeeding include offering pumped milk from a bottle. That’s not the case with Ecological Breastfeeding. With ecological breastfeeding, every feed is done at the breast – no bottles and no pacifiers. If you decide to use those, the effectiveness drops quite dramatically.
Ecological Breastfeeding works because of close contact between mother and baby and frequent breastfeeding, which maintains high levels of prolactin which suppresses the hormones that trigger ovulation and menstruation.
I hope I’m not painting Ecological Breastfeeding as a painful thing. It really wasn’t – at least not for me. Honestly, I didn’t really want to be away from my baby for more than an hour or two at a time for most of the first year, which was about how long she went between feedings. I use a sling or a wrap to carry her with me when I leave the house, which makes taking the baby with you pretty easy. It was only when I specifically needed a break that I didn’t take her with me. It’s important to realize, though, how Ecological Breastfeeding works. If you want to use breastfeeding for birth control, you have to follow the rules that maximize the delay in fertility.
Officially, Ecological Breastfeeding is 98-99% effective for the first six months. I personally think the expiration date has more to do with the introduction of solid foods than an arbitrary date on the calendar. (There are lots of expiration dates imposed on breastfeeding moms, often at six and twelve months. I’ve examined my breasts for these expiration dates, but can’t find them anywhere.) It is generally assumed that parents introduce solids at six months, which would mean the mother is no longer exclusively breastfeeding, thus reducing the effectiveness of breastfeeding for birth control. We chose to do Baby Led Weaning, and didn’t really start solids until around 8 ½ months.
There was still a significant lag time between starting solids and the return of menstruation for me. During this time I took my temperature sporadically, but it was all over the place (which is normal for breastfeeding before ovulation returns). I mostly relied on cervical fluid and cervical position to tell if I was potentially fertile. Honestly, though, I had very little cervical fluid before my period returned and I believe my first one was an anovulatory bleed. I did return to an ovulatory pattern right away, though.
You may think that it’s too hard to use the symptothermal method for birth control while breastfeeding because it’s too hard to get accurate temperature readings in the morning. It is true that it’s best to take your temperature around the same time each morning and that it should be done after at least three hours of sleep. I don’t find this to be particularly difficult, though. There is occasionally some variation in my temperature taking time. If I’m woken very early and have to get out of bed, I generally don’t even take my temperature those days because it’s going to be much lower than any before. It’s rare for that to happen more than one day at a time, though, so it doesn’t have much effect on the accuracy of my charting. On top of that, temperature is only used to confirm ovulation.
Cervical fluid is the real tell-tale sign of fertility.
The other reason that I don’t find taking my temperature to be that difficult is because I don’t have to get out of bed to breastfeed my daughter. She sleeps snuggled up against me, where she has since she was born. At this point, I’m not really sure how often she nurses at night. I sleep through it and so does she. I realize that bed sharing doesn’t work for every family for a variety of reasons (please see the Resources section for links to learn how to bed share safely if that interests you). I do recommend cosleeping with the baby in the same room in a crib next to your bed, or at least nearby. The best place for a baby to sleep is in the same room as its parents. This reduces the risk of SIDS and facilitates easier breastfeeding.
I don’t find using the symptothermal method while breastfeeding that much different or more difficult than doing it when not breastfeeding. The process is the same – take and record your temperature, observe your cervical fluid, and possibly check your cervix if you want to. Keep track of it in whatever way works best for you (I use an app on my iPhone).
The most challenging time is the limbo zone between relying on breastfeeding and the return of menstruation. Watching your cervical fluid is the most reliable way to monitor your fertility. And, if you’re unsure, you can always use a barrier method.
If taking your temperature is the biggest hurdle to using the symptothermal method, then I would encourage you to look at the Billings Method. It relies only on cervical fluid. One thing that stuck out at me from the Billings Method literature is that it’s the change in the quality of the cervical fluid that heralds the potential for fertility. Many women have a basic infertile pattern that includes some cervical fluid. Watching for a change in the consistency of the cervical fluid will alert you that your body is trying to ovulate.
One thing I’ve found that nobody really warned me about is that breastfeeding can cause odd cycles. Mine weren’t even this odd when I was coming off the pill.
Generally speaking, the preovulatory phase is the most variable, while the luteal phase is fairly stable. When breastfeeding that kind of goes out the window. It is fairly common for breastfeeding mothers to produce lower levels of progesterone. This causes the luteal phase to be shorter than normal and allows for more variation in the length of the luteal phase. This isn’t something to be concerned about, but it is something to be aware of. Things do tend to stabilize over time, but for many women their cycles don’t completely normalize until after weaning. For me, my luteal phase is still shorter than it used to be (11-12 days instead of 13-14), but after nearly a year is more predictable than it used to be. The shortest were in the beginning, and were often around 7 or 8 days. I was a little annoyed at the time having my period come a week earlier than I thought it should. That only lasted for a few cycles, though. The luteal phase slowly and steadily started lengthening to what it is now.
Using the symptothermal method while breastfeeding is pretty easy, especially if you have experience with it prior to becoming pregnant. Even if you’ve never done it before, I think it’s possible to learn while breastfeeding, though it might take a few more cycles to feel confident with it than it would if you weren’t breastfeeding.
Because it is difficult to find very much information about using the symptothermal method while breastfeeding, taking a class would be the quickest way to get a handle on the information as well as giving you an ongoing resource for asking questions if you’re unsure about something. Pretty soon, though, it becomes like second nature and is easier than remembering to take your vitamins.