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Extended Breastfeeding May Not Be Smart For Older Moms Who Want Another Baby

I sit in my office with a woman before me – a mother to a toddler who is still breastfeeding.

She and her husband are trying for baby number two, month after month with no luck. She’s only nursing a couple of times per day plus when her little one is sick or hurt or can’t sleep.

This scenario plays over and over again in my office. With women asking…

“Do I need to stop breastfeeding to get pregnant?”

The answer is not completely clear.

Before I explain, let me say, I am a huge breastfeeding advocate.

It’s my opinion that mother’s milk is the best food for babies and nursing should be encouraged for as long as it is serving both child and mother.

That said, I believe that sometimes extended breastfeeding may inhibit fertility.

How Breastfeeding Normally Acts as Birth Control

In most mothers, the temporary birth control that breastfeeding provides is thought to be caused by the effect of the baby suckling. This built-in pregnancy prevention helps to keeps babies spaced at a healthy distance apart for the benefit of both mother and her children.

The constant nipple stimulation during the first several months postpartum limits the release of lutenizing hormone (LH), which then suppresses ovulation. Without the release of an egg from the ovaries, pregnancy cannot occur. When a baby starts solids (or formula) the mom’s period soon returns, and ovulation typically follows.  (source)

Another contributing factor to delayed postpartum fertility is prolactin, the hormone responsible for telling the body to make milk.  Elevated levels of prolactin can prevent ovulation and/or prevent the body from releasing enough progesterone, the hormone that makes it possible for an fertilized egg to implant in the uterus. As the baby nurses less, prolactin levels fall, and fertility is soon restored. (source)

Can extended breastfeeding inhibit pregnancy?

Since toddlers don’t nurse as often and newborns and younger babies, it’s unlikely that the frequency of suckling will prevent conception.

It is possible, however, that elevated prolactin can get in the way of making a new baby, since prolactin may also be elevated in those who feel rundown, or are experiencing thyroid issues, adrenal fatigue, too much stress, not enough sleep, or poor nutrition. (source)

Since the demands of motherhood often trigger some of the above symptoms, women who are trying for baby #2 (or #3 or more) should consider having prolactin tested if they are having difficulty conceiving this time around.

Why Age Matters…

I despise the term “advanced maternal age”. I see young, vibrant women every day who technically have this diagnosis, and frankly it seems harsh and ridiculous.

Unfortunately, though, age is an undeniable factor when it comes to fertility, and while getting older does not preclude you from having baby, a woman’s fertility actually peaks in her late 20′s. (source) Luckily, there are measures women can take to conserve fertility.

From a Chinese Medicine perspective, each of us is born with a certain reproductive capacity and overall vitality. This is referred to as Jing or Essence. I like to think of Jing as our trust fund of vital energy that was bestowed on us at birth.  Ideally, we aren’t supposed to touch it, but throughout our lives our Jing is tapped for various reasons and naturally wanes over time.

Women cash in some of this reproductive capacity with each child that we bear. When we over-work, mismanage stress, and eat nutrient-deficient diets, the depletion of Jing may present as depression, anxiety, adrenal fatigue, thyroid imbalance or other health issues.

While breastfeeding can be a profound bonding experience, it can place nutritional and emotional demands a mother’s body that may contribute to overall depletion – especially in older moms.

For women who want to have another child, it’s especially important to conserve your reproductive energy – eat well, sleep well, and manage stress. In addition to good maternal care, proper spacing between siblings also goes a long way to preventing unnecessary Jing deficiency.

Ultimately, mama knows best.

Is nursing depleting you?

If so, you may want to consider weaning your little one (and adding some extra self-care) before trying to conceive again.

Did you have challenges getting pregnant when you were nursing?

Please share your experiences in the comments below,

and if you’ve found this post interesting or helpful, please pass it on!

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Comments

  1. Megan Alton says:

    Do you have any suggestions for how to wean a toddler in a gentle way?

    • France says:

      I, too, would love some weaning suggestions. My little one just turned 2 and is nowhere near ready to wean and even though I’m not either, I know I have to for my health’s sake.

    • Emily says:

      I think it depends on what works best for your family. What worked for me may not work for you. That said, I will definitely write a post on this soon presenting some great suggestions.

    • Hey Megan and France! I would like to heartily recommend “The Nursing Mother’s Guide to Weaning” by Kathleen Huggins. I was feeling ambivalent about continuing to breastfeed my then almost-2-year-old when I literally stumbled across this book at a used book store. I read the whole appropriate section (which has the woman who WANTS/WANTED to nurse in mind) after nursing my son to bed and immediately took action (like that night). Turns out (for us, and for many) that abrupt weaning (I hate the term, but it just means non-gradual) would cause the least crying and the least anxiety for my son and I both. Kind of like how potty training is usually better when done more quickly, weaning seems to be a similar animal. Quicker is often gentler. It’s more clear. My ambivalence from month 17-23 was actually making my son nurse MORE…it was a love/hate thing. I put Grapefruit Seed Extract (GSE) on my nipples that night and said “the Nanas must taste bad because you’re such a big boy now.” He asked for them for 4 days and then stopped asking. We blamed the Nanas and their horrid taste (this is what many tribal cultures do). Anyway…since you asked, there’s my 2 cents!!!! :)

      Emily – love this post. I am 35 and just conceived my 2nd child. I wasn’t fertile until I literally stopped BFing my then 2 year old. My menses had returned at 19 mos, but I really hit a moon rhythm at 24 mos. I am in the boat of wanting to conceive as many as possible before I’m 40…so I will definitely be weaning at 18 mos with the next one and trying to conceive right away! Thanks for the clear and lovely post. :) Andrea

  2. Ashley says:

    This is so interesting to me! I had zero issues getting pregnant the first time around, and my cycle returned when my baby was about 10 months old. When my son was 16 months (and still nursing) we decided to try for another baby (I’m 32). As with the first time, I immediately got pregnant, but ended up miscarrying very early on- my period (the miscarriage) was barely even a week late, almost like implantation never even really occurred…? In the back of my mind, I wondered if nursing played into the miscarriage.

    • Sam says:

      Ashley, I’m sorry to read about your miscarriage. Out of my own curiosity I too wondered if breastfeeding while pregnant can cause complications. Kori below commented that she carried a baby to full term while breastfeeding, even against her practitioners advice. I’m curious to the science behind it all. Thank you for sharing your story.

    • Emily says:

      Hi Ashley – Thanks for sharing. Typically a miscarriage that early on is considered a ‘chemical pregnancy’. Chemical pregnancies are thought to be nature’s way of eliminating a pregnancy that wouldn’t result in a baby. This is quite normal and happens more often that one might think.

      Could it have to do with nursing? Maybe, maybe not. Breastfeeding is just one piece to consider when trying to conceive. I would say that if you continue to experience chemical pregnancies or have any of the health issues discussed in the post, you many want to consider waiting to get pregnant until you are done nursing. Wishing you the best!

  3. Kori says:

    I’m so interested in this article – just saw your website through the “riding the wave” picture on FB!

    I was 39 when I got pregnant with my first-born, a little boy. When we thought about trying for a second child, around little boy’s 16 month mark, I did have one chemical pregnancy (only showed positive for a few days, then negative). Then, a couple of months later, I did get pregnant with my second-born, a little girl. The nurse practitioner I saw at my OB’s office told me to wean my son. I remember leaving that appointment feeling distraught and angry and completely upset. Because I was over 40, it made no difference that I had already had one healthy child, that I was and am healthy and fit, she just said “wean now.” I didn’t agree, so did more research. I checked in with every La Leche League article I could find, checked Kelly Mom’s website, checked random things, checked in with a Doula, read books on nursing while pregnant… and ultimately, I decided I would not wean my little boy. Our little girl went full term, without any issues! I think each mother has to consider her own endurance, her own health level, and disregard this “oh-mi-gosh-you’re-over-40-time-to-freak” issue. My little boy was my 39th birthday gift. My little girl was my 42nd. I tandem nursed both children until the little boy was almost four. She is still nursing now at 3.5. :)

    • Emily says:

      Hi Kori – Welcome, and thanks for sharing your experience here. I agree that each mama is different, and I wish that health care providers on a whole were more compassionate in their bedside manner, remembering that their patients are individuals not just a clinical case. Extending breastfeeding is certainly just one component to consider with fertility in ‘older’ moms, and many women will go on the conceive multiple children while nursing. I hope that this post presents this clearly. :)

  4. Frances says:

    I have a 12 month old. I m ready to have another one. We have been trying and so far no luck. It has been about 4 months. I am still not having regular periods (they ate usually about 2 months apart), I have only had 3 so far. I am really torn with wanting to continue nursing bit also feeling like it is stopping ovulation. We had no trouble at all getting pregnant before. Also, I started opk last month and got a positive test but then no pregnancy and still on period. That was on the 17th of January. Can anyone give any advice?

    • Emily says:

      Hi Frances – It’s difficult to really advise you without getting to know more about your situation. Some things to consider though – At 1 year, many babies are still nursing quite a bit. It is possible that breastfeeding may be preventing adequate progesterone for implantation to occur, despite the fact that you are ovulating. . Also spacing babies at least 2 years apart is known to be best for fertility and the health of your and your children. Wishing you best!

  5. Sam says:

    Great write up! I was just discussing with my husband last night the science behind breastfeeding and all the hormones it releases & suppresses. I was wondering out loud that if children should ideally be breastfeeding for several years, does that mean that siblings ideally should be at least 3 years apart?

    My 19 month is still breastfeeding (morning & night and if she’s not feeling well, more) & so far my plan is to continue doing this until she’s done. Any suggestions on if I should wean & if so, how?

    Thanks for sharing!

  6. Susie says:

    My period didn’t return until 25 months, and I am THRILLED that it stayed away that long. My son still nurses quite a bit – 6-8 times a day and twice at night – so I’m sure that’s why my fertility stayed at bay for so long (although speaking to other moms who nurse on demand, two years really isn’t uncommonly long). Even though I am ovulating again, my luteal phase is only 8 days long and preventing anything from sticking.

    It’s a beautiful thing, isn’t it, that your body knows when your baby still needs you and becomes fertile again after those needs diminish. I’ve been very grateful for that.

  7. Monique says:

    Today I have been breastfeeding for 8 years! I am 41. My first son was born when I was 33. When he was a year we tried to conceive but suffered 3 miscarriages. I really thought it was the breastfeeding. I chose not to wean though. I read about Vitex, Chasteberry I think it’s called and I found some at GNC and took the recommended dosage to regulate my cycles. Online research and miscarriage while nursing boards on ivillage led me to believe that I had a luteal phase defect from breastfeeding. It worked and I fell pregnant with my second son and carried him to term! I was 35 and also nursed throughout the entire pregnancy. I tandem nursed both boys and imagine my surprise when baby boy #3 was conceived a year later while tandem nursing and without vitex! I tandem nursed both boys throughout the whole pregnacy! By the time baby boy 3 was born, baby boy 1 was gently nudged to wean (he was stubborn lol). I was 37 and happily nursed both boys and again surprise, fell pregnant with my youngest boy a year later while tandem nursing! This time I tandem nursed throughout the pregnancy until two months before birth and gently weaned both boys and had a two month break ((sleep, recharged, relaxed)) Baby boy number 4, born when I was 39. I am 41 now and he will be 2 in May and is still nursing. No plans for any more :)
    I am sure that in my situation the Vitex helped my luteal phase defect caused by my breastfeeding! I think as the extended breastfeeding continued my body just got used to breastfeeding and regulated itself.
    Of course I am not a dr so who knows ;p just my experience! Also, maybe while reading and pouring over the Internet I convinced myself that it would work but seriously it worked after the first month of taking it!!
    Monique :)

  8. Silvia says:

    Hi
    I’m a mum to a 2year old girl whom I had at the age of 37. She is breastfeeding regularly, day & night, although she does eat all the foods at this stage & age. We are both to continue this actualy whole family including my husband Jacques is quite supportive. We weren’t really trying for another baby yet – but it looks like I had no trouble with that – I’m 2 months pregnant now, aged 39 something. It feels to me that the right nutritious diet & lifestyle has generally much more influence on reproductive health then breastfeeding (which is not exclusive – it means the child eats other foods as well). I’m definitely not forcing my firstborn to wean :)
    All the best!

  9. Simone says:

    Hi,
    I guess I am very fortunate with my situation…I had my first baby at 38, and exclusively breastfed her for 12 months, then started to introduce solids very slowly at 13 months…my cycle returned within 3 months of giving birth, I fell pregnant 3 months after that, but unfortunately miscarried, ; then fell pregnant again when my first born was 12 months old, had my second daughter at 40, and tandem fed for 3 years…Extended breastfeeding certainly didnt seem to affect my fertility, even though I was an older mum,but I am not sure whether it has affected my overall health and well being now…I weaned my second daughter at 3 1/2 years old, a few months ago, and still feel so exhausted all the time…I think having children later in life definitely places a toll on your body, that you maybe wouldnt experience if you had children in your 20′s, early 30′s…certainly dont have any regrets though, and feel priveleged and blessed, I was able to breastfeed my 2 daughters to 4 1/2 and 3 1/2 years of age.

  10. Lee Skidmore Shields says:

    Hi. Just want to share my testimony. I am 42, breastfeeding an 8 month old, and 6 weeks pregnant. I consider myself healthy, but by all means could be healthier. I try to eat organic, whole foods, but also don’t have a problem indulging in things I shouldn’t eat. No fast food though! I believe in balance. I do not exercise. I have 5 kids, and run a business so I just don’t make the time. I would say my level of stress is probably the most detrimental to my health. I don’t take vitamins or supplements (unless I am breastfeeding, or pregnant). I probably should. I am truly astounded I am pregnant and consider it a miracle! I believe God wants me to be a testimonial for other women in their 40′s not to give up or be afraid. Thank you for the opportunity to share this blessed news! Lee

  11. Mama Lee says:

    I have not found breastfeeding to stop me from conceiving; not even round the clock, on demand BF. So there is hope for anybody out there who doesn’t want to wean to TTC. I am very convicted about NOT weaning to TTC because I don’t feel for me it is right to take away from my child in the here & now, to potentially have another, even if it means not having another at all. I know many others feel differently though ;).

  12. Missy Lee says:

    So happy to find this great site! I’m nursing my 22-month old about 3-4 times daily and am trying to conceive. I have had two chemical pregnancies and had blood tests done with each, showing that my progesterone levels were VERY low (around 4). The tests were performed a few days after my missed period. I have wondered if the low progesterone could be (1) due to nursing and (2) preventing implantation. However, my luteal phase is 14 days and my cycles occur every 28 days like clockwork, so I figured that since I was so “normal,” my hormones must be as well (?). My menses resumed when my son was 15 months and my first chemical pregnancy was at 16 months, with the second now at 22 months. Any advice on whether weaning would actually help in this particular case, since I KNOW I have low progesterone? I’m fine with weaning if nursing is “more than likely” the reason I keep having chemical pregnancies (no one, of course, could say with 100% certainty, especially at my “advanced maternal age” of 39), but all the info out there is so confusing. It irks me that most reproductive health professionals treat weaning so cavalierly, as if it’s no big whoop and/or that I should even be glad to have an “out.” I’m glad to see that other women treasure nursing! Thank you in advance for any insight.

    • Emily says:

      Hi Missy – Thanks for your comment. It’s difficult to say for sure without knowing more about your case, but it’s certainly possible. I’d try working with an acupuncturist/herbalist specializing in fertility support to see if you can get your hormones in balance whether or not you choose to wean.

  13. Katie says:

    When the youngest of my four children was 13 I had my fifth child at age 43. Menses returned almost immediately, but I breastfed exclusively for almost a year and did not become pregnant, so I think I was not ovulating. When my baby was 19 months old I had a very early miscarriage. I have not been pregnant since. She is now 2-1/2 and I am 46 and I am still breastfeeding but only twice a day when my baby takes a nap and goes to bed. Until recently she breastfed more often. About the time she cut down to this schedule my cycles and from being every 28 days on the dot to bring too frequent. That was 2 months ago. They went from 28 days to about 2 weeks and now are about 3 weeks. Are my hormones just adjusting to all the recent changes so that I can conceive again or am I beginning menopause? I would very much like another baby. I am generally very healthy and would like my current little one too have a sibling her own age. But she still wants to nurse very much, just not often, and I don’t feel right about weaning her when she’s not ready if I can’t conceive again anyway.

    Any thoughts?
    Thank you,
    Katie

    • Emily says:

      Hi Katie – Thanks for your comment. Whether or not you can conceive again is a question that is difficult to answer. Every woman’s personal ‘fertility window’ will close in it’s own time, but this usually occurs sometime in our 40′s. Keep in mind that this is not a function of poor health, but the body’s natural flow as we grow older. Menopause may be a long way off or around the corner.

  14. Ingrid says:

    Hmm. I had my son when I was 42. I wanted another child, but I did not have a period again for two years. Perhaps this was because I was breastfeeding him this whole time. I did get pregnant again at 45 but then I freaked a little and my feeling was just that I was too old to go through it all again. I guess once you have had a child, you realise what is involved with all those sleepless nights and all that attention that is needed. I miscarried after just a few weeks. So perhaps if I had known this about breastfeeding and conception, I would have stopped breastfeeding earlier.But maybe not ? It is sad to stop breastfeeding before you are ready too, especially if you are thinking that maybe you may only be lucky enough to have one child. It’s hard to imagine how different life would be if I had two children.

  15. Cheryce says:

    Hi Emily,

    I stumbled across this post while trying to look up if nursing would cause my progesterone levels to be low.  My husband and I got pregnant on the first try with our son, when I was 30.  We had decided we wanted our children to be about 2 years apart and began trying last April with no success.  I finally went to a fertility specialist in December, which was only costing me $25 a visit at the time.  Ultra sound showed everything was good except the fact that she couldn’t see one of my ovaries–it looked like it was behind my intestines, which she said was probably a result of having a c-section.  I wasn’t told this at the time, but just learned, yesterday, after reviewing my day 3 FSH and estradiol results with a nurse, that my progestrone levels in Dec indicated I didn’t ovulate that cycle.  My FSH and estradiol for my current cycle is normal, though.

    I am still nursing, but very little.  My 25 mo. old usually nurses for a little bit when I get home from work, when he is going to bed, and sometimes during the night if he wakes.  Other than that, he doesn’t nurse as we are apart for about 13 to 16 hours a day.  Could this still be the cause of my low progesterone?  

    My co-pay for infertility services went from $25 to 50% of the cost in January, so I can no longer afford to continue them.  It would cost $75 just to see the doctor.  It is very difficult for me not to stress about this or be upset.  My husband and I have a family bible study we attend every Tuesday and the past 2 weeks have been difficult for me because we found out that 2 of the women are pregnant and another that is about 3mo. along just returned back after being gone for a couple months.  So the topic of babies is ever present and it takes every grain of my being to smile and not break down into tears.  I am fighting tears just writing this.  

    On top of that, I am the sole supporter for a family for 3 1/2.  So when the day is over and I get home from work, I don’t have the energy to even try to ween my LO, even though it seems that is what I need to do.  I have read things from others talking about progesterone creams and supplements, but I don’t know anything about that and don’t know that I want to risk taking something without discussing it with a doctor first.

    Any thoughts on my situation?

  16. Katy says:

    Hi, I think part of the point of this article should not just be focused on whether you can conceive while breastfeeding another child. What you should really worry about is whether it is safe for the fetus to develop in a situation where the mother’s available nutrients are being depleted by the other breastfeeding child. I was told that it is completely safe to breastfeed while pregnant. Three years later my second child has developmental problems. If I could do things again there is no way I would breastfeed while pregnant. I was just too old, too tired, and much later found out that I had low iron and a thyroid problem, which is a risk for older women. So if you are going to breastfeed while pregnant better get lots of rest, get your iron, b12, checked, get your thyroid checked, or just don’t risk it. That is coming from someone who risked it and really really wishes she didn’t. Also look at some of the studies coming out, one shows an 8% dip in the IQ of the second born child who gestated while the first child was breastfeeding. Check it out, do you research.

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