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Wednesday, October 16, 2013

Taking Charge of Our Fertility

Fertility Awareness After a Baby
So.  It's not easy--charting postpartum.  We researched the Lactational Amenorrhea Method (LAM).  When breastfeeding exclusively, this method is 98% effective for 0-6 months postpartum.  After 6 months, it decreases to 94% effectiveness.  Now at about 7 months, we are not using it anymore.  We are feeding Pax table food (barely) and using Fertility Awareness.

Note about exclusive breastfeeding.  This means you are feeding your baby on demand, that means when your baby cries for food, you are breastfeeding.  It means no pacifiers.  When your baby needs pacified, you are breastfeeding.  And it means no pumping.  Oxytocin is more responsive to baby's natural tugs, than the pump.  So a guideline for exclusive breastfeeding is [nursing no fewer than every 4 hours in the day and 6 hours at night].  But if you are following the guideline, but still giving pacifiers, or pumping, or not feeding on demand, LAM may not be effective for birth control.  Here's how it works.

Prolactin (a nursing hormone) is metabolized and excreted at a quick rate, that is it gets out of your system very quickly.  Every time you nurse, your prolactin levels rise starkly.  Then after 2 hours, the levels drop drastically.  After 4-6 hours, you are just like a non-nursing mom, prolactin-wise.  This is why you cannot just depend on nursing this infrequently and just counting on LAM to keep your periods away.  So, speaking of your periods.  

If you get your period before 6 weeks is up, it is very unlikely that this is a period.  It is just a final squeeze your uterus gives to return to its previous size.  After 6 weeks ovulation is a process that is returning.  That doesn't mean you are either ovulating or not.  Prolactin somehow works in an inhibitory fashion with estrogen.  Estrogen grows your follicles and the bigger they get the more signal goes to your brain to grow your follicles.  This is a positive feedback system between your ovaries and anterior pituitary gland until ovulation occurs.  However, it is possible while the process is returning that you release a smaller (less mature) egg, or that you start breakthrough bleeding without ovulating at all.  In these cases, it seems that your cycles have returned completely, when in fact, they are only partially returning--in the process.  

Next, I'll talk about fertility awareness after 6 months.  My little one just woke up.

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