Tuesday, August 11, 2009

Less Breastfeeding = More Babies

There were some wonderful posts last week in honour of La Leche League's World Breastfeeding Week. The topic of this year's World Breastfeeding Week was "Prepared for Life" and lots of bloggers (including Cartside of Mummy Do That!, Edenwild and the Breastfeeding Carnival bloggers) wrote about the importance of breastfeeding in developing countries.

Here is another spin on why breastfeeding is so valuable to mothers in the third world. Breastfeeding suppresses a mother's fertility so that she is less likely to conceive another child soon after she has given birth. The high levels of prolactin in her blood caused by frequent feeding prevents conception by suppressing ovulation and making an embryo less likely to successfully implant in the uterus if an ovum does manage to get fertilised. Fertility returns slowly, and though lactation amenorrhea (cessation of periods whilst breastfeeding) lasts for over a year for some mothers, others will become fertile much more quickly.

The old wives' tale that you can't get pregnant while breastfeeding is not a myth - the "lactation amenorrhea method" (LAM) is even recognised as a method of birth control here in the West. If you a feeding on demand through the day and night AND breastfeeding exclusively AND not giving your baby a dummy or any other nipple substitute AND your baby is less than six months old then LAM is comparable in effectiveness to other birth control methods. But we all know someone who did get pregnant when they were breastfeeding - I know someone who was expecting their second child two months after delivering the first.

Luckily in the West we have good nutrition and healthcare and we can generally support two close-together babies. But in less developed countries with less plentiful food supplies, an extra mouth to feed can put a considerable strain on a family. Customs of carrying babies and breastfeeding them frequently have in the past prevented women getting pregnant too soon after having a baby, but in countries where bottle feeding has been encouraged, inter-birth intervals have been seen to decline. Meredith Small writes in Our Babies, Ourselves that the rate of pregnancy in Kenya has increased in direct correlation with the increase in formula feeding. Women in Kenya average eight babies in the lifetime, compared to only four in the more traditional !Kung San of Botswana. In fact Small even quotes another anthroplogist, R.V. Short, who went as far as to say: "The changing history of breastfeeding is the history of human population explosion."


Lisa - edenwild said...

That last quote is rather powerful. Yes, I know LOTS of women who got pregnant while using breastfeeding as birth control. But you are right, it has to be pretty much continuous feeding or else fertility can return.

I was just talking to a mom today who thought she wanted four children, but after having three closely spaced, she says her body is worn out.

Personally, I think a "natural" birthing interval would be healthiest--which is more like 3-4 years.

Earthenwitch said...

Yes, I really liked the idea of LAM, though I never trusted it exclusively. Did make me think a lot about how little I knew about the way my body works, though, as did my entire pregnancy; I don't think Modern Woman is half as well-acquainted with the mechanisms of being female as she perhaps should be, and THAT, in my view, is the history of the population expansion more than any other factor - we don't know what makes us tick, physically, and generally, modern approaches to contraception, birth and menstruation are doing little to remedy this. (In my not-so-humble view. ;))

Cave Mother said...

Edenwild - I think you might be right with the 3-4 year spacing. I would obviously love any child whenever it came along, but I think you are probably treating your body AND the children best by leaving at least a couple of years between them.

Earthenwitch - that's an interestinng point of view. This may be TMI, but I have always observed my monthly rhythms and only actually used birth control for the week when I was most likely to become pregnant. And it worked perfectly well, so that when I wanted to be pregnant, that happened quickly too. It's not rocket science, just simple biology. I guess it's not encouraged because it's too easy to make a mistake.

sunnymama said...

Great post! I only have one child but am committed to at least a 3-4 year spacing should I be fortunate enough to have another.

I left you an award at my blog. No need to pass it on unless you want to but I just wanted you to know that I think your blog is great :)

Lisa - edenwild said...

I like what Earthenwitch wrote. I have been pretty clueless about my fertility cycle all these years, and now since I can't risk pregnancy I've opted for an IUD. But if we paid attention to our cycles and exercised restraint when we are fertile but not ready to be pregnant, I think it would be a very good thing.

Jessica said...

Ditto, ditto, and ditto. I always knew when I was fertile (it's REALLY obvious for me, but maybe it isn't for others?? dunno) so it wasn't hard to avoid pregnancy.

Re: LAM, I've never met a woman who did all the things required to reach that level of fertility suspension who still got pregnant. Maybe for some women missing a day of nursing or not nursing continuously is all it takes for their body to kick back into to fertility mode.

I'd have to say the invention of formula is the downfall of all sorts of beautiful miracles (if I may be so bold as to say).

flowers said...

Great conversation. I didn't start to ovulate and bleed until my children were 20 months old. I bf on demand without any pacifiers etc until they started eating by their own desire and hands.

I think a lack of consciousness about our cycles and fertility mixed on top of our low bfing rates (and even if ppl are bfing many are scheduling and supplementing).

Time and time again I come to the realization that nature just works when you leave it alone and it works even better when you bring mindful consciousness to it.

Great post and love that last quote definitely gives you something to think about.

AzĂșcar said...

People are shocked when I tell them I didn't have a return of my period until my oldest was 17 months, and my younger child 14.

Look, that's how LAM works; when you keep nursing, and even delay solids (I'm into baby-led weaning) nursing on demand, all kinds of marvelous things happen.

And I was working with both babies (had one reverse-cycler.)

Becks said...

I breastfed on demand, started introducing solids very, very slowly, no bottles, lots and lots of feeds, and my periods returned at 23 months. I conceived again after two cycles. Baby was born two months before her brothers third birthday. So I'm hoping the pattern follows suit this time around. Although I'm thinking that if I was in a third world country, and this apparently being my natural fertility pattern, that even with three years between babies I could still give birth to as many as ten babies between the age of 16 and 45, the normal childbearing age. Not sure how following a natural fertility pattern and full term breastfeeding would reduce the number of pregnancies down to four as if the mother first conceived at age 16-18, she could potentially have birthed number four at around the age of 27? And therefore could have a possible period of up to 15 years of fertility?
Although maybe I'm not thinking this through properly, late nights and early mornings not conducive to intelligent thinking ;)