Breastfeeding Is Not a Guaranteed Contraceptive, Experts Warn Mothers

The postpartum period, a transformative phase marked by physical recovery and maternal adjustment, is often overshadowed by a barrage of conflicting advice that can sow confusion and anxiety among new mothers. 

From rigid pregnancy spacing timelines to misconceptions about breastfeeding and fertility, expectant and new mothers face a gauntlet of unsolicited opinions. Obstetrician-gynaecologist Dr. Stella Njenga emphasises the need for evidence-based decision-making, urging women to prioritize medical guidance over prevailing myths. A prevalent belief dictates that mothers should adhere to a strict two-year interval before conceiving again. 

While spacing pregnancies offers undeniable advantages, Dr. Njenga cautions against a one-size-fits-all approach. She underscores the importance of allowing the body adequate time to recover from the physiological demands of pregnancy. Pregnancy depletes essential nutrient reserves and affects physical structures, necessitating a period of recuperation to restore iron, calcium, and vitamin levels before embarking on another pregnancy.

Dr. Njenga warns against rushing into a subsequent pregnancy within six months of childbirth, citing potential complications such as miscarriage, preterm labour, and low birth weight. The decision, she emphasizes, should factor in individual mental and emotional readiness, as well as the mode of delivery—vaginal or Caesarean. Ultimately, pregnancy spacing should be a personal choice guided by medical advice, rather than arbitrary societal norms.

Breastfeeding during pregnancy is another area rife with misinformation. Dispelling the misconception that nursing harms the unborn baby or dries up breast milk, Dr. Njenga asserts that breastfeeding is generally safe during low-risk pregnancies. While nipple stimulation does trigger the release of oxytocin, a hormone involved in labor induction, the quantity released during breastfeeding is insufficient to cause premature contractions unless the pregnancy is already high-risk or near term.

For mothers who continue breastfeeding while pregnant, prioritising nutrition is paramount. Both pregnancy and breastfeeding demand increased caloric intake, necessitating a balanced diet to meet the needs of both the mother and the growing baby. The body adjusts the composition of breast milk to suit the nursing infant, even during pregnancy. However, certain medical conditions, such as carrying twins or a history of premature labour, may warrant a different approach. In such cases, consulting a healthcare provider is advised to determine whether continuing breastfeeding is advisable.

A common misconception holds that breastfeeding acts as a reliable natural contraceptive. While exclusive breastfeeding can delay ovulation, Dr. Njenga cautions that it is not a guaranteed method of birth control. She cites numerous cases of women becoming pregnant shortly after childbirth, unaware that ovulation can occur even before the return of their first postpartum period.

The Lactational Amenorrhea Method (LAM) offers an estimated 80 percent effectiveness rate when three strict conditions are met: the baby is under six months old, the mother is exclusively breastfeeding, and her menstrual cycle has not resumed. Given its limitations, doctors recommend exploring alternative contraceptive options that align with one’s lifestyle and breastfeeding status. Methods such as intrauterine devices (IUDs), contraceptive implants, and oral pills provide more reliable protection against unintended pregnancies.

The return of the menstrual cycle postpartum is often unpredictable. While some women resume their periods within four to eight weeks after childbirth, others experience significant delays, particularly those who exclusively breastfeed. Dr. Njenga explains that the hormonal changes induced by nursing often suppress menstruation, making its reappearance highly individualised.

The nature of postpartum periods can also differ from pre-pregnancy cycles, with some women experiencing heavier flows and others experiencing irregular patterns. Factors such as bottle-feeding versus breastfeeding influence the timing of menstruation, with formula-fed babies often leading to an earlier restoration of the mother’s cycle. Rather than relying on anecdotal advice, Dr. Njenga urges mothers to prioritize postnatal check-ups for personalized medical guidance to navigate these changes with confidence.