Postpartum Periods, Breastfeeding & Pregnancy

There is a lot of information out there that can feel confusing, so let’s talk about it!

The most important thing to note is that there is a wide variation of what “normal” looks like. Our babies are different, our bodies are different, and how our body responds to hormones is different — this can all affect when/how our postpartum periods occur.

Understanding hormones and their roles

When it comes to producing milk, there are two main hormones involved:

1. Prolactin - the milk-making hormone.

2. Oxytocin - the milk ejection reflex (MER)/letdown hormone.

During breastfeeding when these hormones are higher, the two major hormones needed for ovulation and pregnancy (estrogen and progesterone) are lower.

As feeding frequency decreases, whether because baby is sleeping longer stretches or you’re introducing solids, this causes the milk hormones to decrease and the ovulation/pregnancy hormones to increase.

Can anyone get pregnant breastfeeding?

It’s very important that you know that breastfeeding DOES NOT guarantee that you can’t get pregnant!

Like other contraceptives, breastfeeding is not 100% preventative for all women.

Even if you have not yet had a cycle or period postpartum, you can still technically “catch that first egg” since ovulation occurs before a period occurs.

This is where “how your body responds to certain hormone levels” comes into play— for some women, it would take babe being fully weaned before her cycle returns. For others’, it could be as early as 3 months postpartum and still exclusively BF when her cycle returns. I got pregnant with my second at 9 months postpartum with no period prior (still EBF), just as an example.

The hormone-spectrum threshold varies from woman to woman, and breastfeeding will affect your hormones differently.

Let’s talk about the LAM Method

LAM stands for Lactation Amenorrhea Method, and it can be used to temporarily help prevent pregnancy.

If you’re actively breastfeeding and producing high amounts of breastfeeding hormones, your body will potentially not release any eggs. Although this method can be successful for many, it is not fool proof.

There are 3 criteria that must be met for LAM to be effective:

1. If you are < 6 months postpartum

2. If baby is exclusively breastfed with no more than 4-6 hours between feeds.

3. If your period has not returned.

There is literature indicating that lactation alone is unreliable in preventing conception after the 9th week, so pay attention to your body and discuss this & other methods with your doctor/midwife. They will help guide you in deciding what will be a good fit for you!

What are postpartum periods like?

This is when “normal looks different for everyone” is important to remember.

Some women have noted that the first few postpartum periods are heavier with more cramping and then eventually level out. Some notice changes in the length between cycles, how long periods last, how heavy the bleeding is, etc.

Others have periods and cycles that they feel are relatively the same as before. Periods that are heavier or irregular can happen the first few months after cycles return as hormones may fluctuate and the body is left trying to keep up.

In other words: there is a huge variation, so don’t be alarmed if you experience one thing, and someone else experiences another.

What if I have fully weaned and my period is still not coming back?

Though it can be normal to completely wean and still take a month or two for cycles to return, if you’re concerned, please please let your care team know! Discuss this with your doctor/midwife and maybe ask about getting a thyroid panel and bloodwork done to understand if there are any underlying issues that may be at play.

This is exactly how we found my postpartum hypothyroidism after my first (at 8 months postpartum— yes, the month before I got pregnant unexpectedly with my second!). I was having a well woman exam and my doctor decided to run a thyroid panel since I was experiencing some symptoms and still didn’t have a period yet (even though EBF). Instead of just “blaming postpartum”, he listened. He did a thyroid panel and I was extremely hypothyroid. Started on medication and a month later I was feeling way better and actually conceived our daughter.

I know that’s a lot, but I hope this information helps you understand your body a little more and helps you feel more comfortable navigating your postpartum journey.

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