Among popular beliefs passed down through generations for many decades, and firmly ingrained in the minds of many women, is that breastfeeding is a natural and guaranteed method of contraception. This information has been handed down from grandmothers to daughters, insisting that breastfeeding alone is sufficient to prevent pregnancy.
However, a group of doctors confirms that while breastfeeding can indeed prevent pregnancy, it is not 100% guaranteed. Its effectiveness depends on the duration of breastfeeding, the frequency of feeding, how much the baby relies on breastfeeding, along with some medical subtleties unknown to many breastfeeding mothers.
In this interview, Dr. Nihal Al-Amrousi, Professor of Obstetrics and Gynecology, explains: When is breastfeeding an effective contraceptive method? When can it unexpectedly lead to pregnancy? And what are the conditions for its effectiveness?
Pregnancy After Childbirth!
Many mothers are surprised by pregnancy shortly after delivery, without realizing it. According to popular beliefs—shared by mothers and grandmothers—breastfeeding alone is sufficient to prevent pregnancy, and that delayed menstruation means ovulation has not yet resumed. In reality, they overlook the fact that pregnancy during breastfeeding is possible, and even common, especially if medical conditions are not strictly followed.
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How Does Breastfeeding Prevent Pregnancy Medically?
When a mother breastfeeds, her body secretes a hormone called prolactin, responsible for milk production. This hormone directly inhibits the release of the egg from the ovary (ovulation), which is the first step toward pregnancy.
The theoretical rule is: as long as ovulation does not occur, a woman cannot become pregnant. Doctors call this the "lactational amenorrhea method" (LAM) — a natural contraceptive method linked to breastfeeding. This means that because the woman is breastfeeding, she does not have menstruation, so the chance of pregnancy is low.
Conditions to Avoid Pregnancy
For breastfeeding to effectively prevent pregnancy, precise conditions must be met. If these are not strictly applied, pregnancy can still occur, sometimes as early as the first sexual intercourse after childbirth.
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The mother must exclusively breastfeed her baby, meaning breast milk is the only source of nourishment—no formula, water, or complementary foods.
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Breastfeeding must be frequent: every 3 to 4 hours during the day, and at least once at night.
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The mother must not have resumed menstruation after childbirth, because menstruation means ovulation has returned, making pregnancy highly likely.
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The baby’s age must be less than six months; after this period, the contraceptive effect of breastfeeding diminishes, and milk alone loses its ability to delay pregnancy.
Summary of Breastfeeding Conditions That Prevent Pregnancy:
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Exclusive and regular breastfeeding from the breast.
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No return of menstruation.
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Baby is younger than six months.
Under these conditions, the chance of pregnancy is very low — some studies estimate less than 2%.
Mothers should also understand scientifically that ovulation occurs before menstruation, something many do not realize. This means ovulation may start silently before the first period returns, which is why many pregnancies happen during breastfeeding even without menstruation.
Why Does Pregnancy Occur Despite Breastfeeding?
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Some mothers produce less milk, leading to early introduction of formula, reducing breastfeeding frequency and thus prolactin secretion. This allows ovulation and menstruation to resume.
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Sleeping long hours at night without breastfeeding weakens the hormone effect that inhibits ovulation, increasing the chance of pregnancy unknowingly.
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Each woman’s body reacts differently: some do not menstruate during breastfeeding for up to a year, while others may resume menstruation after two or three months even with breastfeeding.
Thus, breastfeeding is not a guaranteed contraceptive method for all, and relying solely on it as contraception is risky.
What Are the Safe Contraceptive Methods During Breastfeeding?
It is important for breastfeeding women to find a safe, suitable contraceptive method compatible with their health status. Several options are safe to use during breastfeeding, such as:
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Progestin-only contraceptive pills (which do not reduce milk production).
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Avoid combined contraceptive pills (which contain estrogen and progestin) during breastfeeding, as they may reduce milk supply.
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The intrauterine device (IUD) is one of the safest and most effective long-term methods and can be inserted 1.5 to 2 months after delivery.
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Consulting a gynecologist postpartum to choose the best contraceptive method according to the mother’s preference for spacing pregnancies and her health condition.
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