Breastfeeding as an effective birth control

Besides providing a baby with sufficient nutritional requirements, at least in the first six months of life, breastfeeding also provides the mother with a host of health benefits such as speeding up recovery after delivery, reducing stress, reducing risk of cancer of the ovary and breast and birth control.

Exclusive breastfeeding

When you exclusively breast feed your baby for at least four hours during the day and six hours at night, your body will naturally stop ovulating. This means that no pregnancy can happen since you are not producing eggs.

Additionally, no menstruation takes place during this time. Medically, this method is referred to as Lactation Amenorrhea Method (LAM); “lactation” meaning breastfeeding and “amenorrhea” meaning no menstruation.

The science behind it

As published in the USAid Reference Manual for Service Providers on LAM, a breastfeeding baby triggers the mechanical stimulation—also known as the suckling stimuli-- on the mother’s nipples that sends neural signals to the mother’s pituitary gland.

The pituitary gland is responsible for production of hormones that are linked to a couple of body processes, including ovulation.

Increased prolactin hormone production by the pituitary inhibits the secretion of gonadotropin-releasing hormone (GnRH), disrupting the production of the follicle stimulating hormone (FSH) and luteinizing hormone (LH), both of which are directly involved in ovulation.

FSH promotes the maturation of the egg in the ovary while LH promotes the release of a mature egg.

Disruption of these hormones prevents ovulation and in turn ensures no egg can be released for fertilisation.

The three criteria for effective use of LAM

Information from the African Population and Health Research Centre, APHRC, suggests that LAM is becoming an increasingly popular method of family planning.

This is mainly because it is a natural method with no side effects that are normally associated with artificial contraceptives such as “reduced sexual urge” or “decreased milk production”.

A couple can take advantage of this method to provide a timely transition to other methods of birth control after giving birth. A 98 percent effectiveness means that 2 out every 100 women may fall pregnant when using LAM as a method of birth control.

According to analysed results coordinated by Family Health International, the World Health Organisation (WHO) and Georgetown University’s Institute for Reproductive Health, a woman must meet three criteria;

1.    A woman must not have esumed menstruation after delivery since periods indicate the return of ovarian activity. Notably, vaginal bleeding during the first two months after delivery is not considered as menstrual bleeding.

2.    She must be breastfeeding exclusively- breast milk providing all of the baby’s thirst, hunger, nutritional and suckling needs.

3.    She must be in the first six months after giving birth. Above six months, a baby needs complementary feeding to support breast milk. This also means that there are reduced suckling stimuli allowing hormonal mechanisms influencing ovulation to resume.

It is important to understand that breastfeeding is only effective in the first six months after birth.

During this period, a woman is considered to be in temporary post-natal infertility. After the elapse of this period, additional family planning methods should be considered if one needs to prevent unplanned pregnancy.

 The downside to LAM

· LAM is a temporary method; it is only effective for six months post-partum

· It may be inconvenient for some working mothers who resume work after 3 months maternity leave

· It does not provide protection against sexually transmitted infections and HIV

Misconceptions about pregnancy while breastfeeding

According to APHRC, there is an unmet need for family planning accounting for 25% of married women in Kenya and a high prevalence of 43 per cent unintended pregnancies among women of reproductive age of between 15 to 49 years.