When it comes to menstruation
and breastfeeding, just about anything can be considered normal.
Some moms get their periods when the baby is two or three months
old, even if they are exclusively breastfeeding. Other moms may
be partially breastfeeding and not get their cycle back until they
wean. It just depends on the mother and how sensitive she is to
the hormonal influences of breastfeeding. It may also be influenced
by how often the baby is nursing, if the baby is supplemented with
bottles, if the baby takes a pacifier, how long the baby sleeps
at night, and if solids have been introduced.
Once menstruation returns, it may be irregular for
a while as mother continues to breastfeed. There may be some nipple
tenderness associated with the onset of the cycle as well. Once
the cycle returns, mother *is* fertile. She can also be fertile
BEFORE the first cycle. Fertility
is influenced initially by the amount of time baby is at the breast.
Hormonal changes associated with the cycle may bring
about the following temporary conditions: tender nipples, irritability,
unsettled feeling, , or increased moodiness in mother; headaches
(often associated with PMS); a slight dip in milk supply (usually
not a big problem); slight change in taste of mother's milk.
If there is a significant dip in supply, mom can
use the usual methods suggested for boosting
supply. She can also add a calcium/magnesium supplement to her
diet when ovulation occurs and continue it through the first or
second day of her period. If mother just experiences some nipple
tenderness during ovulation or at the onset of her period, the herb
Primrose Oil may be helpful.
While most breastfeeding advocates recommend nursing
mothers avoid hormonal forms of birth
control, there are a few options available that are considered
compatible with breastfeeding.
Most doctors will suggest the breastfeeding mother
use Micronor, commonly called
the "Mini-pill". Micronor is a progestin-only pill. This
means that the problems, particularly reduction in supply associated
with combined pills (containing estrogen) are usually avoided, but
this doesn't hold true for every mother. For this reason most experts
suggest mother wait at least six weeks, or until her milk supply
is well established before beginning any form of hormonal birth
control. Estrogen-containing contraceptives should be avoided till
at least after the 6th month and once the baby is well-established
on solid foods.
Some mothers have considered using an IUD, or Intrauterine
device. The Copper
IUD is non-hormonal and is considered compatible with bf. Mirena
is a plastic device that has a tiny storage system of a hormone
called Levonorgestrel (progestin hormone). This hormone is also
used in contraceptive pills such as Eugynon, Logynon, Microgynon,
Ovran 30, Ovranette and Trinordial. In the Mirena, however, a much
lower dose is released than when you take the Pill (about 1/7th
strength), and it goes directly to the lining of the womb, rather
than through the blood stream where it may lead to the common progesterone-type
side effects. It is not supposed to interfere with milk supply but
moms are urged to wait until they have a well established milk supply
before starting this or any horomonal birth control.
Provera shot has been used because it has no estrogen, but is
not recommended by many breastfeeding advocates because if the mother
DOES have an adverse reaction (drop in milk supply) she cannot just
"stop" this, but must wait for it to work out of her system.
More information on breastfeeding and birth control
Many breastfeeding mothers experience vaginal dryness,
resulting in difficulty "making love". It may be almost
impossible for some mothers if the dryness is extreme. It is important
to understand that vaginal dryness is related to the hormonal influence
of breastfeeding, and it is not a permanent problem. It is, in fact,
part of nature's "birth control".
Taking extra time for foreplay
can be helpful, and being romantic
goes a long way in helping each other through a difficult time
To ease vaginal
dryness, products like Astroglide, Replens, or regular KY-jelly
is fine to use. In extreme cases, a vaginal estrogen cream is used.
A couple of examples include Estrace and Estratab, both of which
have been approved by the American Academy of Pediatrics for use
in breastfeeding mothers. Estrogen therapy has the potential to
lower your milk supply. Although estrogen suppositories don't seem
to affect supply the way oral estrogens do, most experts advise
that lactating women avoid any estrogen until at least the 6th month
postpartum and once the baby is well-established on solids due to
the risk of it lowering milk supply.
is another popular cream, but mothers may want to avoid using it
due to the controversy surrounding it's manufacturing process.