Monday, October 19, 2009

Inquisition Monday: Toddler Nursing and Fertility

The Fun Carter Family asked, "How long do you plan on nursing Margaret? Do you find that you get a lot of "odd" looks because you're still nursing?"

At the moment, I plan on nursing Margaret as long as she likes. I'm not easily "touched out" at this point, so I don't have any objections to continuing to nurse. I do feel more "touched out" around the time I ovulate because of hormones or when I'm very tired in the evenings, but that happens only a couple of times a month, but 95% of the time, it's working for both me and Margaret. If it's not broken, don't fix it, right?

As for odd looks, I don't actually get many. Or any. I think most people I interact with read my blog, know of it, or at least know my opinions on breastfeeding. I think my lack of odd looks is due to the fact that everyone knows this is important to me and I'm not going to be menaced into weaning by odd looks or even a verbal confrontation or anything less than Margaret no longer needing it. The only times people have asked me about it were simple curiosity. For example, a couple of months ago a lady at church asked me if I was still nursing Margaret, but I think it was because she hadn't seen me doing it in a while.

Seth and Brittney asked, "I have been wondering since you posted on it about how your breastfeeding interferes with your getting pregnant. I know this is more of a women's health question but can you explain that more? What makes it difficult when you are nursing the way you are--baby with access to the breast at night, etc.-- to get pregnant?"

In general, it's because of the hormone prolactin. Every time you nurse and your nipple is stimulated, prolactin is released. It's responsible for your milk supply, but also keeps your eggs from maturing and being released. This is why frequency and duration of breastfeeding have a great affect on fertility.

But what about people like me- I've had regular periods for over a year and have been consistently ovulating for over half a year (before that I wasn't taking my temps, so I can't be sure, though I found some notes the other day that indicate I was having fertile mucous from the very first cycle). My prolactin isn't doing its "don't ovulate" job.

Currently, I'm in what kellymom considers to be the 2nd phase of returning fertility, "Ovulation without luteal competence." What this means is that the time between my ovulation and my period is too short for a fertilized egg to implant and give the "Hey you're pregnant" signal. My body goes into period mode too soon, so even if I do have a fertilized egg, I never know. I could be having a miscarriage every month and not know it. From what I've read, luteal phase isn't related to prolactin, but progesterone- and I don't seem to have enough.

Lack of progesterone is actually good for my ability to make milk. From what I picked out of this lengthy, technically-dense article, progesterone and prolactin fight for the same receptors on the aveolar cells, meaning more progesterone can mean less prolactin- and less supply. This is why the progesterone-only "mini-pill" birth control can have an affect on supply, especially if supply hasn't been established prior to starting the pills. It doesn't have the same great affect as estrogen, but it has some.

Highlights from the kellymom page I linked to above:

The amount of time that it takes for the transition to full fertility varies from woman to woman. In general, the earlier that your menses return, the more gradual the return to full fertility.

Many moms can conceive without deliberately changing their toddler's nursing patterns. There is no "magic" threshold of breastfeeding that will allow you to conceive -- every mother is different. Some moms need to stretch out nursing frequency and/or shorten nursing sessions to make it easier to conceive -- babies naturally do this themselves as they get older, so one of your options is simply to wait a bit.

Changes that are more abrupt tend to bring fertility back faster (e.g., cutting out one nursing session abruptly, rather than gradually decreasing nursing time at that session) --even if you continue to breastfeed a great deal-- this is why many mothers experience the return of fertility when their child sleeps through the night or starts solid foods. If you decide to make changes to your nursing pattern, the time of day that you make the change (e.g., cutting out or shortening a nighttime nursing session as opposed to a daytime nursing session) should not make that much of a difference. Current research indicates that nursing frequency and total amount of time at the breast per 24 hours are the most important factors, rather than the time of day that the suckling occurs.

I think that for many moms night weaning is easier than day weaning, so it gets suggested a lot. Also it's an easy time to go without nursing for a few hours. I have heard of moms day weaning and nursing only for naps and night time in order to get their fertility back.

Am I going to do anything to lengthen my luteal phase like trying Vitex? Not right now. It's been quite a journey from nightmares of Margaret weaning a year ago to getting used to the idea that "if you have periods, you should assume that you are fertile" and thinking I might get pregnant any day. Going from using 3-4 pregnancy tests a month to giving up on that and just waiting has been a bit of a let down. Then I look at Margaret and see how small she still is and how much she needs needs the breast. I don't know when my full fertility will return, but right now it's just not supposed to happen for whatever reason.

6 comments:

  1. I think it also helps with "looks" that where we live has one of the highest rates of nursing toddlers in the country. I'll see if I can dig up the study I read.

    Although anecdotal, I was surprised to find that in my previous neighborhood, four of my neighbors were nursing or had nursed their toddlers/preschoolers.

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  2. It took us a while to get pregnant while I was nursing our toddler. I had to decrease feeding times. I still continued to nurse until I was 3 months pregnant, but it definately made getting pregnant harder, which was unexpected. Good luck to you.

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  3. I pretty much told everyone I know that I wanted to nurse Michael for at least two years, and then I blog about it, too, so I rarely get asked about it. I'm sad that the only place I've seen a nursing toddler is at some sort of parenting/breastfeeding group, and once at church in the mothers room, but never in the general public.

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  4. Both topics are very interesting to me. I'm planning to nurse my 8 month old son until he's about 2 years old, but I have no firm plans to wean him on a specific date -- I'm hoping it will be a gradual process agreeable to us both. I am bracing myself for the judgment from friends and family. I'm sure some of them will be shocked when I continue nursing past one year, so I'm trying to stock up on info to respond to the judgy questions/comments. I'm sure I know some moms who nursed past a year, but I can't name anyone specifically off the top of my head.

    As for fertility, the women in my family have never had any issues and my cycles have always been VERY regular (I've charted in the past), so I always assumed that I would have no trouble getting pregnant when I was ready. I was actually charting to avoid when I got pregnant, and I still don't really know what I got wrong (hubby and I say that the pregnancy was "meant to be" because biologically speaking it shouldn't have happened!) Before my son was born, I assumed that my period would return sometime 6-12 months after his birth. But at 8 months old, he's still nursing around the clock, about every 4 hours, and I'm still amenorrheal (not complaining). But only recently has it occurred to me that my fertility might come back gradually or be absent/compromised for an extended length of time. Our tentative plan is to TTC late next summer when Nicholas is nearly 18 months old, but who knows if that will happen eaily for us. I doubt I would make any drastic changes to our nursing relationship to try to get pregnant, though.

    I wish you luck in your TTC journey!

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  5. My periods still have not returned after almost 4 months (as I believe yours didn't). I am always worrying whether I'm pregnant too. I'm certainly in no hurry to have another baby but I must admit it feels funny to use contraception when I don't even think I ovulate (I've never charted temps, but I monitor my cervical mucous). So we tend to go without contraception, which means I am always wondering whether we might have accidentally conceived.

    I think there is something lovely and natural about allowing nature to take its course. I'm not going to change the way I nurse my daughter for any reason and I know my fertility will return when my body feels ready to grow and care for another baby.

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  6. Just found your blog. I am an LDS mother still breastfeeding my 12 month old with no plans of stopping soon. My periods came back at around 9 months PP. I am am charting too (you use fertility friend?) and discovered that my LP was on the short side too. I decided to try 50 mg of B6 and it worked wonders the first cycle. It didn't seem to change my milk supply at all, but my LP went from 8-10 days to 14-15 days! You might try it. I hope we both conceive soon! Love your blog!

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