Best NFP Method for Postpartum/Breastfeeding

[Teresa1901]

Obviously there’s no easy solution to the postpartum and breastfeeding time when it comes to NFP, but is there one method that you’ve found is easier to use during this time?

We learned sympto-thermal method and, if I’m understanding correctly, you need either dry days or 14 days of basic infertile pattern (BIP) to be considered in infertile phase 1. Any interruptions to the pattern and you need three days in a row return to the exact same BIP and intercourse can resume on the evening of the fourth day. I’ve been reading online about some of the other methods (though info is scarce on some of them) and it seems some other methods like Marquette (and possibly Creighton?) consider the woman infertile as long as the mucus is the less fertile type, but not necessarily exactly the same pattern, as with STM. Marquette, of course, adds the monitor readings in addition to mucus signs.

What method worked best for you during this time?

 

[ShrodingersCat]

Is a breastfeeding based method an option? I’ve never been pregnant but I know there is a set of rules for using breastfeeding as your method for the first 6 months but it requires a lot of discipline around timing of feeds I believe.

Taking charge of your fertility by Tony Weschler lays out the rules.

 

[macstar]

Creighton, hands down. It is based off of mucus observations and doesn’t require four hours of continuous sleep to take a temperature which can be tough with a baby!

FYI fertility can return after the first 56 days of exclusively breastfeeding, so it is possible to conceive while breastfeeding.

 

[pensmama87]

Is a breastfeeding based method an option? I’ve never been pregnant but I know there is a set of rules for using breastfeeding as your method for the first 6 months but it requires a lot of discipline around timing of feeds I believe.

Taking charge of your fertility by Tony Weschler lays out the rules.

I was going to mention that. I don’t think I’d call it discipline, exactly, because you feed baby on demand, not a schedule, and avoid bottle use and pacifiers. It’s called the lactational amenhorrea method or LAM.

There’s another version called ecological breastfeeding, which is different than exclusive breastfeeding, but these methods don’t always work for everyone. I tend to think that all women probably have a kind of set point at which their cycles return, and behavior or environmental factors may influence that some, but no guarantees.

We’ve never had a super serious need to avoid, and as far as I can tell I’ve never been fertile before my first postpartum cycle. It’s always been at least 15 months for me, and after three children I’m fairly confident that’s just how I roll. So we actually don’t chart before that first cycle. I generally have a good idea it’s coming because there will be a big CM change. But if I was relying on mucus all the time it would be constant abstaining, because it’s constant and I don’t dry up. Dealing with that for a year plus would be…very aggravating.

 

[macstar]

Creighton is also excellent for women who have continuous mucus, even while breastfeeding. They can still determine their days of fertility and infertility (speaking from personal experience).

 

[LittleWay92]

I haven’t gone through this personally, but I do know of many babies I’ve seen born from mothers who tried the breastfeeding method.

 

[ShrodingersCat]

I haven’t gone through this personally, but I do know of many babies I’ve seen born from mothers who tried the breastfeeding method.

According to TCOYF, LAM (thanks pensmama) has a 2% failure rate. I suspect though, that that is a ‘perfect use’ statistic. Perhaps it’s more difficult to perfectly obey the LAM rules in the chaos of new parenthood?

 

[bitterhope]

According to TCOYF, LAM (thanks pensmama) has a 2% failure rate. I suspect though, that that is a ‘perfect use’ statistic. Perhaps it’s more difficult to perfectly obey the LAM rules in the chaos of new parenthood?

That 2% failure rate is somewhat deceptive. There are requirements to fit into in order for LAM to “work” for you and there isn’t much you can do to make your body cooperate if it’s programmed differently. One of the big ones is you must be without ANY bleeding before the six month mark. If your period starts up before that timeframe, you are not a candidate to use LAM or EBF. There are many of us whose period reappears way before that 6 month mark while exclusively nursing. Many of us who have tandem nursed still have a return of our cycle. We aren’t counted in that 2% failure rate because we aren’t considered candidates to begin with. And no one can really know whether or not they will be a candidate until they are 6 months nursing with no cycle.

My cycle always returns at 6 weeks post partum so I’m not surprised when it comes anymore. A friend from church has seen a return of cycles earlier and earlier with each baby, and LAM is no longer an option for her, even though in the past it worked well for her. She says she went from 18 months without a return of her period, to now only 4 months (she has 7 children). I do keep hoping for a surprise and one day make it 8+ weeks post partum. Not holding my breathe though.

 

[ShrodingersCat]

That 2% failure rate is somewhat deceptive. There are requirements to fit into in order for LAM to “work” for you and there isn’t much you can do to make your body cooperate if it’s programmed differently. One of the big ones is you must be without ANY bleeding before the six month mark. If your period starts up before that timeframe, you are not a candidate to use LAM or EBF. There are many of us whose period reappears way before that 6 month mark while exclusively nursing. Many of us who have tandem nursed still have a return of our cycle. We aren’t counted in that 2% failure rate because we aren’t considered candidates to begin with. And no one can really know whether or not they will be a candidate until they are 6 months nursing with no cycle.

My cycle always returns at 6 weeks post partum so I’m not surprised when it comes anymore. A friend from church has seen a return of cycles earlier and earlier with each baby, and LAM is no longer an option for her, even though in the past it worked well for her. She says she went from 18 months without a return of her period, to now only 4 months (she has 7 children). I do keep hoping for a surprise and one day make it 8+ weeks post partum. Not holding my breathe though.

I have no experience with it so I defer to your experience. Though I did see in TCOYF that (for her set of rules), any bleeding before day 56 PP is not considered menstrual bleeding and can be ignored. I also don’t know that she has any rules for using LAM beyond 6 months PP so I got the impression that the 2% failure rate was only for women prior to the 6 month mark. I could have misread it though. And I acknowledge it’s not very useful if you want to breastfeed for longer.

 

[tuffsmurf]

That 2% failure rate is somewhat deceptive. There are requirements to fit into in order for LAM to “work” for you and there isn’t much you can do to make your body cooperate if it’s programmed differently. One of the big ones is you must be without ANY bleeding before the six month mark. If your period starts up before that timeframe, you are not a candidate to use LAM or EBF. There are many of us whose period reappears way before that 6 month mark while exclusively nursing. Many of us who have tandem nursed still have a return of our cycle. We aren’t counted in that 2% failure rate because we aren’t considered candidates to begin with. And no one can really know whether or not they will be a candidate until they are 6 months nursing with no cycle.

My cycle always returns at 6 weeks post partum so I’m not surprised when it comes anymore. A friend from church has seen a return of cycles earlier and earlier with each baby, and LAM is no longer an option for her, even though in the past it worked well for her. She says she went from 18 months without a return of her period, to now only 4 months (she has 7 children). I do keep hoping for a surprise and one day make it 8+ weeks post partum. Not holding my breathe though.

For ecological breastfeeding, the failure rate is considered 1 % during the first six months and 6 % after six months. Both of these numbers refer to the period where the mother remains without periods, but no matter when her periods return, the chances of pregnancy before the first bleeding is 1 % or 6 % (depending on the child’s age). The levels of estrogen and progesterone only gradually increases as the prolactin levels decreases, which means that most women will have their first period post-partum before their first ovulation, if they follow the standards for ecological breastfeeding.

 

[bitterhope]

I have no experience with it so I defer to your experience. Though I did see in TCOYF that (for her set of rules), any bleeding before day 56 PP is not considered menstrual bleeding and can be ignored. I also don’t know that she has any rules for using LAM beyond 6 months PP so I got the impression that the 2% failure rate was only for women prior to the 6 month mark. I could have misread it though. And I acknowledge it’s not very useful if you want to breastfeed for longer.

Here is the problem and I hope you can follow what I’m saying. My period returns at 6 weeks (approx 42 days). Ovulation follows in about 2 weeks (14 days more). 42+14=56. So, when I assume to still be infertile according to the rules of LAM, I’m actually ovulating. I really wish the methods would say that once post partum bleeding stops, any return of bleeding should be assumed to be a return of your period, and therefore LAM and EBF are no longer options for you.

 

[tuffsmurf]

Here is the problem and I hope you can follow what I’m saying. My period returns at 6 weeks (approx 42 days). Ovulation follows in about 2 weeks (14 days more). 42+14=56. So, when I assume to still be infertile according to the rules of LAM, I’m actually ovulating. I really wish the methods would say that once post partum bleeding stops, any return of bleeding should be assumed to be a return of your period, and therefore LAM and EBF are no longer options for you.

The chances of having the first period during the first 56 days if you are practicing EBF are so slim that they go in under the 1%. The “failure” rate is as low as with any fertility awareness method.

 

[bitterhope]

For ecological breastfeeding, the failure rate is considered 1 % during the first six months and 6 % after six months. Both of these numbers refer to the period where the mother remains without periods, but no matter when her periods return, the chances of pregnancy before the first bleeding is 1 % or 6 % (depending on the child’s age). The levels of estrogen and progesterone only gradually increases as the prolactin levels decreases, which means that most women will have their first period post-partum before their first ovulation, if they follow the standards for ecological breastfeeding.

This is what I mean. It is only considered for women BEFORE her period returns. Those of us (and it is not a small handful of people) who cycle soon after birth are automatically counted out of the mix. Most advocates of breastfeeding and most advocates for NFP do not mention that there is a good size portion of women who cannot use either of those methods. They use the “no cycles” as a selling point to get women to breast feed, even if it isn’t going to be used as NFP.

And yes, MOST women who ovulate during breastfeeding have a warning cycle first, but many don’t. The ones that get pregnant before the 6 month mark are still not counted in the 1% or 2% of LAM or EBF failures because we weren’t candidates for either methods to begin with. Our cycles had begun and bleeding would have occurred if we hadn’t of gotten pregnant to begin with.

Talk to an OB or midwife and see how many babies they have delivered in their career whose mother hadn’t had a period before they got pregnant. There is a reason that midwives and OBs do not recommend LAM or EBF for pregnancy spacing/avoidance.

 

[ShrodingersCat]

Here is the problem and I hope you can follow what I’m saying. My period returns at 6 weeks (approx 42 days). Ovulation follows in about 2 weeks (14 days more). 42+14=56. So, when I assume to still be infertile according to the rules of LAM, I’m actually ovulating. I really wish the methods would say that once post partum bleeding stops, any return of bleeding should be assumed to be a return of your period, and therefore LAM and EBF are no longer options for you.

I understand what you are saying now.

 

[ShrodingersCat]

And yes, MOST women who ovulate during breastfeeding have a warning cycle first, but many don’t. The ones that get pregnant before the 6 month mark are still not counted in the 1% or 2% of LAM or EBF failures because we weren’t candidates for either methods to begin with. Our cycles had begun and bleeding would have occurred if we hadn’t of gotten pregnant to begin with

See this is the part I don’t understand… why are you not considered a candidate for a method that only applies up to 6 months PP? As far as I previously understood the only think you have to do to qualify is have delivered a baby less than 6 months ago and exclusively breastfeed it the entire time.

ETA: I’m talking about LAM, I don’t know the EBF rules.

 

[bitterhope]

The chances of having the first period during the first 56 days if you are practicing EBF are so slim that they go in under the 1%. The “failure” rate is as low as with any fertility awareness method.

This is untrue. If your period return you are no longer considered a candidate for the method and therefore you are discounted from the group being measured.

And unfortunately, even on CAF, those of us that neither method works for, are blamed for the methods not working for us. There is an awful lot of people that found out the hard way that we are “failures” but uncounted since we allowed ourselves not to become candidates by starting our cycle early.

Edited to add:

The Kippleys let us know here on CAF in a couple of past threads that we are to blame for EBF not working for us. It seems even making sure each box is checked off in the rules does not matter. If your period comes back or you get pregnant, you didn’t fit into their group and it’s your fault for your body not cooperating. You MUST have done Something wrong or else it WOULD be working for you.

 

[bitterhope]

See this is the part I don’t understand… why are you not considered a candidate for a method that only applies up to 6 months PP? As far as I previously understood the only think you have to do to qualify is have delivered a baby less than 6 months ago and exclusively breastfeed it the entire time.

ETA: I’m talking about LAM, I don’t know the EBF rules.

In order to be considered a candidate for LAM, you must remain cycle free for 6 months. If your cycle returns before the 6 month mark, you are not considered a candidate. LAM is not considered effective after 6 months at all.

 

[bitterhope]

waba.org.my/resources/lam/

This is a link to the rules of LAM.

From the link:

"Who can use LAM?

A woman can use LAM if:

1. her menstrual period has not returned since delivery (Bleeding or spotting during the first 56 days is not considered menstrual bleeding.) AND
2. she is breastfeeding her baby on demand, both day and night and not feeding other foods or liquids regularly (Occasional tastes of foods or other liquids are permitted, but they should never replace a feeding at the breast.) AND
3. her baby is less than six months old.

When all three of these conditions exist, she has less than a two percent chance of becoming pregnant. However, the woman is encouraged to begin using a complementary family planning method when any of the three conditions changes, or whenever she chooses."

 

[tuffsmurf]

This is what I mean. It is only considered for women BEFORE her period returns. Those of us (and it is not a small handful of people) who cycle soon after birth are automatically counted out of the mix. Most advocates of breastfeeding and most advocates for NFP do not mention that there is a good size portion of women who cannot use either of those methods. They use the “no cycles” as a selling point to get women to breast feed, even if it isn’t going to be used as NFP.

And yes, MOST women who ovulate during breastfeeding have a warning cycle first, but many don’t. The ones that get pregnant before the 6 month mark are still not counted in the 1% or 2% of LAM or EBF failures because we weren’t candidates for either methods to begin with. Our cycles had begun and bleeding would have occurred if we hadn’t of gotten pregnant to begin with.

Talk to an OB or midwife and see how many babies they have delivered in their career whose mother hadn’t had a period before they got pregnant. There is a reason that midwives and OBs do not recommend LAM or EBF for pregnancy spacing/avoidance.

Everyone who uses EBF are counted UNTIL they get their first period. An example: if a woman would get her first period when her child is 4,5 months, she has 1 % chance of getting pregnant up until then, but not after. After you’ve had your first period you cannot use the method, no matter how old the child is. Of course not everyone can use EBF, but if you follow all the standards, you only have 1 % chance of getting pregnant before your period returns, even if it returns before 6 months.

 

[ShrodingersCat]

In order to be considered a candidate for LAM, you must remain cycle free for 6 months. If your cycle returns before the 6 month mark, you are not considered a candidate. LAM is not considered effective after 6 months at all.

OK so I think we are getting wires crossed. What I mean is, if they say bleeding before day 56 is OK, then if you have no bleeding on day 57 you must still be a candidate. If bleeding starts on day 65 you technically are a candidate for the method, but the method is warning you that you may be fertile and if you don’t want to abstain indefinitely you need a new method. It’s like how every woman is a candidate for regular NFP but it might result in some women abstaining indefinitely if they have constant EWCM or something (crude example).

So my point is, you can’t be discounted if you have your period on day 45 say: since the rules say you are safe if there is bleeding prior to day 56, then if your period ends on day 50 and your next one starts on day 72, you must still be considered a candidate until day 72. You could of course be pregnant by this time and hence never get that 2nd period, but I don’t understand how this wouldn’t put you in the 2% failure rate bracket.

I am very sorry if I’m coming across as argumentative. I really want to understand this so I can apply it to myself and anyone who asks my advice in future