“My period hasn’t returned” – everything you need to know about lactational amenorrhea

One of the questions our teachers often receive from new mums who have attended their classes is when a new mum should expect her first period after the birth of her baby. Unfortunately, this isn’t a question with a straight answer! Everyone really is different, and while some women report having their period as early as 5 or 6 weeks after birth, others may not see it coming back for a couple of years!

So let’s dig a little deeper into this topic, and we’ll explain what happens to a new mum’s body after birth.

When not breastfeeding…

Women who do not breastfeed report their period returning anything between 5 weeks and 3 months after birth. While it is possible that if a woman’s period returns this early after giving birth, she may not actually be fertile for the first few cycles, this is definitely not true for everyone! In fact, if a woman’s period returns 5 weeks after the birth of her baby, there is a possibility that she may be ovulating and be fertile 2 weeks before that, so effectively only 3 weeks after giving birth. It’s always worth remembering that because you do not know when your period will return (but you’ll be ovulating approximately 2 weeks before the first day of your period) you may want to use contraception in case you are fertile. Unless you’re planning another baby very soon, of course!

When breastfeeding…

If you are exclusively breastfeeding your baby day and night and continue to do so for quite a while, your period may return a little later. According to studies carried out by La Leche League, the average time for the return of the menstrual period for mums who exclusively breastfeed is 14.6 months.

Why does your period stop when you’re breastfeeding though? It’s because the hormone required for milk-making (called prolactin), suppresses the release of the hormones that trigger ovulation. In the early days and weeks, when you’re feeding your baby on-demand, you’re very likely to be feeding every few hours, and the amount of prolactin in your body will be high. But this may not be the case if you’re not breastfeeding your baby exclusively.

When you start to feed your baby a little less, because you’re either feeding them a combination of breast milk and formula, or because your baby is a little older (6 months+, for example) and also weaning onto solid foods or sleeping for longer stretches at night, your period may return, even if you haven’t fully stopped breastfeeding. This is because when you start to breastfeed less frequently, the amount of prolactin in your body reduces, and the hormones that cause eggs to mature and Mum to become fertile again, can start being released. When this happens really is down to each individual mum and how their body responds to her baby’s feeding patterns. So it’s perfectly normal to still be breastfeeding but have your period regularly at the same time.

Using breastfeeding as a method of contraception (LAM)

Some women rely on the absence of a period as a way to determine that they’re not ovulating and therefore cannot fall pregnant. This is called ‘lactational amenorrhea method’, or LAM. However, you should know that if you’re not planning another pregnancy very soon, LAM can only be reliable as a method of contraception (with a reliability rate of approximately 98%) if a series of conditions are met.

• Your baby is under 6 months of age;
• Your baby is exclusively breastfeeding;
• Your baby is still breastfeeding regularly at night (every 4-6 hours);
• You are still breastfeeding your baby very regularly during the day (every 3-4 hours);
• You haven’t had your first period yet.

When these conditions are no longer met, it is possible that the amount of prolactin in your body may reduce, and ovulation may resume (even though you’re still breastfeeding).

As we stated earlier, because you will not be able to know when your period returns, but you may be ovulating 2 weeks before the first day of your first period, the only way for you to know for sure whether you’re ovulating or not would be to take daily ovulation tests.

When your period returns…

If you’re not ready for another pregnancy, you may consider another (or other) family planning method(s) once your period has returned. You should consider the onset of your first period since giving birth as a sign that you are ovulating, and you may, therefore, fall pregnant if having intercourse.

Please do bear in mind that the amount of time it takes for the transition to full fertility varies from woman to woman, but as a rule of thumb, it is believed that the earlier your period returns, the more gradual the return to full fertility will be. Having said that, there are women who fall pregnant in the first 2 or 3 months after giving birth, so this isn’t true for everyone.

You may also find that at first, your period isn’t as regular as it used to be – this is because it may take a few months for your body to return to a regular pattern. And for some women, this may not happen until they have fully weaned their babies from the breast.

So this is it from us. Over to you now…

What was your experience like? When did your period return after you had your baby? Was this different with each baby? Do you have any experiences or advice you’d like to share?