The breastfeeding hormone (prolactin) suppresses other hormones involved in the menstrual cycle so prevent ovulation. Most experience at least a few months without a period whilst nursing.
Many women find periods heavier after pregnancy. It usually settles over time as hormone levels balance out.
You may also notice worse PMS symptoms initially which should also improve over time.
If your periods remain heavy and difficult to manage, you should see your GP for basic blood tests and an ultrasound.
Periods after pregnancy loss
If you have unfortunately experienced pregnancy loss at any gestation, you may be wondering what to expect from your cycles, and when it is safe to try again to conceive.
Wait until your bleeding has stopped, and then take a pregnancy test a few weeks after treatment to be sure the miscarriage process has completed. This should be negative. If not then contact your local early pregnancy unit or your doctor.
If all clear, its best to wait until after your next period so its easier to date the future pregnancy and be certain that products from the previous pregnancy have been emptied from the womb.
Most women will ovulate around 2-4 weeks after the uterus is empty following a first trimester miscarriage. For later losses, ovulation may begin again after around 6 weeks. However, it may take several months for your periods to return to their regular cycle and pattern.
Some women wish to conceive as soon as possible. Technically it isn’t dangerous if you conceive before you see your period again so don’t worry if this happens.
You may conceive quicker than you expect after a miscarriage, so it is important to take your time until you and your partner are ready emotionally as well. It is likely that you will feel anxious about miscarriage in your next pregnancy, so take your time and prepare for those challenges. Here is a post on pregnancy after pregnancy loss.
Periods and breastfeeding
Can I get pregnant whilst breastfeeding?
Yes you can! If periods returned and are regular, then it is likely fertility is close to normal.
If trying to conceive and periods haven’t restarted you may wish to consider weaning if right for your family. Abrupt cessation of lactation is likely to cause a quicker return to fertility.
Even if your periods arent regular, you can still conceive so practice regular intercourse with your partner if you would like another baby, and prepare your body for pregnancy.
You can continue breastfeeding and conceive by changing the pattern of feeds (shorter feeds, with more gaps between them by introducing some expressed/ formula bottles between. This is particularly relevant for night feeds).
Most (not all!) women find their periods return between 9-18 months post partum although but we do know that continued breastfeeding will cause spikes in prolactin levels which can be enough to impact on fertility.
Breastfeeding as contraception
Technically breastfeeding can be used as contraception when your baby is under 6 months old.
However, there are lots of reasons this method may be less reliable and can result in unintended pregnancies. Read more about it here.
What influences whether periods restart?
- Frequency of nursing
- The more often baby feeds throughout day and night, the less likely periods are to restart.
- Gaps of longer than 4 hours between breastfeeds or pumping allow prolactin levels to drop so may increase the likelihood of ovulation.
- Introduction of solid foods may reduce amount of milk baby takes & frequency of breastfeeds
- Use of bottles/ dummys (pacifiers) reduce nipple suckling so increase likelihood of ovulation.
Once you see your periods you can track them.
If regular, it is likely you are ovulating again. It may take 6 months to regulate from birth if not nursing, or from when breastfeeding stops.
Breastfeeding and IVF
If you haven’t conceived after 1 year of trying, or 6 months without regular periods, you should see your GP who can check if you are ovulating.
If, after tests and treatment, you are referred for fertility treatment you may be advised to reconsider breastfeeding.
This is a very under-researched area which lacks in firm evidence but the recommendations are because:
- it can decrease the success of an IVF cycle by impacting embryo implantation.
- Some, but not all, medications used in fertility treatment may be harmful to your breastfed child. You should consider the timing of treatment and medications as well as the length of time you intend to nurse for and discuss this with your fertility doctor.
- This link has more information about where to seek advice about medications and IVF.
Ideally you could wean off breastfeeding prior to IVF and frozen embryo transfer but complete cessation may not be necessary if you are just feeding once or twice per day.
It can be very hard emotionally if you feel that you are needing to choose between your future hoped for child and meeting the needs of the child currently in your arms.
As with everything, please do check with your own medical team if you want specific advice tailored to you.
To those trying to conceive I am sending you baby dust and wish you all the best for your journey!