Post-pregnancy and childbirth, it takes some time to recover and to resume some normalcy, especially in your cycle. Due to the demand that pregnancy and breastfeeding put on the body, most health agencies (including the World Health Organization) recommend not becoming pregnant again for at least 12 months after giving birth. If youβre not breastfeeding, you could ovulate as early as the first few weeks after giving birth, but what if you are pumping or breastfeeding? Letβs look at what happens when we produce breast milk in relation to ovulation and when you should consider using contraception.Β What hormones are affected when breastfeeding or pumping? Prolactin is the hormone that tells breast tissue to grow and produce milk, so when you're breastfeeding or pumping, youβll have a great amount of this hormone around. When prolactin levels are high, it sends a feedback message to your hypothalamus (a little gland that sits under the brain) to stop gonadotropin-releasing hormone (GnRH). By stopping this signal, the ovaries are prevented from getting the hormones that cause egg development and ovulation. Prolactin spikes in your body during nipple stimulation (pumping) and suckling. Prolactin also follows a circadian rhythmβa sleep-wake cycleβnaturally peaking around the hours of 1 a.m. to 5 a.m., and is at its lowest during the daytime. How to Increase Milk Supply β When you start weaning off breastfeeding or pumping or when there are longer periods between feedings, prolactin levels will go down, which means GnRH comes back online and you can start ovulating again within two to four weeks. Am I ovulating if my period returns? Having a menstrual flow doesnβt mean that you're ovulatingβthis holds true whether youβre breastfeeding or not. You can also ovulate just before the return of your first menstruation postpartum, so itβs possible to become pregnant even before youβve had your first postpartum period. Having a period is not a good indicator of if you are ovulating. Can you ovulate while breastfeeding without a period? Breastfeeding often delays ovulation and a regular period, but it doesnβt fully prevent it, and ovulation while breastfeeding can happen, even without a period. Hormones, feeding frequency, and your body's response all play a role in your cycle. Spotting the signs of returning ovulation (more on that below) while breastfeeding can be helpful, whether youβre planning another pregnancy or hoping to avoid an unexpected one. When does ovulation return after giving birth? Ovulation can return as early as 4 to 6 weeks postpartum, sometimes before your first period. Exclusively breastfeeding often delays ovulation, but combination feeding or extending the time between feeds may cause it to return sooner. Thereβs no hard and fast rule, and everybodyβs experience will be different. Can you get pregnant while youβre breastfeeding? Yes, itβs definitely possible to get pregnant, even if youβre breastfeeding. In the early months of nursing or pumping, the ability to get pregnant is often reduced, thanks to a lack of ovulation caused by the hormone prolactin. Still, this effect is temporary, and ovulation can return even if your menstrual cycle has not yet resumed.Β Can I breastfeed or pump as a method of birth control? Producing breast milk is an unreliable method of birth control and is not recommended if youβre trying to prevent pregnancy. Although the prolactin hormone, in high enough concentrations, can prevent ovulation, there is no guarantee this will happen. Itβs highly recommended to use a barrier form of contraception, like condoms, while breastfeeding. Can You Drink Alcohol While Breastfeeding? βΒ For additional context, in one study of 60 breastfeeding mothers, there was a higher risk of ovulation with infrequent feeds or pumping sessions and with shorter duration of pumping or feeding. In this study, it was reported that for women without a menstrual period during the first six months postpartum, the risk of ovulating was about five to 10 percent with partial breastfeeding, and one to five percent when exclusively breastfeeding. However, if menstruation resumed within those first six months or if breastfeeding continued beyond six months, the risk of ovulation increased, requiring the use of contraception. Why is contraception important during breastfeeding? Pregnancy and breastfeeding both put high demands on the body, especially when it comes to energy and nutrients. When pregnancies are not spaced out by at least 12 months, there are increased health risks, including preterm birth and low birth weight babies. Β Period has not returned Period has returned Exclusively pumping or breastfeeding Lower chance of ovulationβcan be delayed for many months Higher chance of ovulation Combination feeding Lower chance of ovulation (but higher than exclusively pumping/nursing) Higher chance of ovulation Formula feeding Lower chance of ovulation in the first few weeks postpartum, but ovulation likelihood increases quickly High chance of ovulation Weaning or weaned Higher chance of ovulation High chance of ovulation Do ovulation tests work when youβre breastfeeding? Ovulation test strips measure the amount of luteinizing hormone (LH) in your urine. When LH peaks high enough, it causes the test line on the strip to show up and become dark. Ovulation typically occurs about 24 to 36 hours after this LH surge. However, since prolactin suppresses LH, thereβs a good chance you wonβt see that LH surge on your test strips, especially if you havenβt had your period come back yet. In short, ovulation tests are not reliable when youβre nursing, if youβre hoping to use them to predict ovulation to avoid pregnancy. But they can be used to understand the fluctuations in your cycle after childbirth. By testing over time, you may be able to have a better idea of when you are ovulating again. How to Take and Read an Ovulation Test β Can you track ovulation while breastfeeding?Β If you donβt have a menstrual period yet, itβs difficult to track whether youβre ovulating (and, like we mentioned, ovulation tests arenβt always reliable during this period). There are some hormonal symptoms that you might notice, such as breast tenderness, lower abdominal cramping, and changes in resting body temperature, but these could be due to other reasons and donβt exclusively mean youβre ovulating. Bottom line, if youβre hoping not to become pregnant shortly after childbirth (or while nursing) itβs best to use a barrier method of birth control.
