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 a 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 as 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 on 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.