There are many different issues surrounding lactation and menstruation you might be concerned about; from discharge and missed periods to wondering whether your periods will ever return. After giving birth, your body needs some time to adjust and return to its previous state of being. The period in which lactation suppresses your menstruation and fertility is called lactational amenorrhea. (1)
The Return of Menstruation while Breastfeeding
How long can you go without a period while breastfeeding?
There is no set time to resume menstruation. Every woman is different, but most mothers will resume their monthly cycles just a few months after birth. A mother who is exclusively breastfeeding may benefit from an extended "vacation." ;-) Some mothers enjoy a whole ten or more months of freedom.
Mothers who introduce formula after birth may have a period as soon as 10 weeks postpartum.
The average time that mothers start their periods is six months postpartum, but, If you follow the principles of Ecological Breastfeeding, you can delay your menstrual cycle up to 16 months or longer!
There is a possibility that you have lower levels of Progesterone, and this could also cause you to ovulate sooner, even while sticking to ecological breastfeeding.
Ovulation is highly unlikely before the 10-week mark postpartum. Exclusive breastfeeding promotes the release of the hormone Prolactin, which will keep your body from ovulating. As soon as your baby starts nursing less, skipping feeds or skipping night feedings, your body will slowly become fertile again. Some mothers though, have to wean completely before their period returns.
Bleeding and Discharge after Giving Birth.
Immediately after birth, you will experience some bleeding; this is called lochia; it's a combination of blood, mucus, and tissue from the uterus. It may contain blood clots.
Most mothers bleed for up to a week postpartum. During pregnancy the amount of blood in your body is 50% higher than usual, so your body is prepared for blood loss after birth. The rule of thumb is that if you need to use more than one sanitary pad every four hours, you should contact your doctor. When the bleeding stops, you might notice a pinkish or whitish discharge for a few weeks. This bleeding and discharge can last for up to six weeks postpartum.
Is it okay to use tampons immediately after birth?
During the first six weeks after giving birth, it is essential that a mother steers clear from wearing tampons. Sanitary pads are best, as they are less likely to cause infection.
The first few periods that a mother experiences, usually come back with a bang (more pain and discomfort than you are accustomed to). You might also notice some extra nipple tenderness. During this time, if you are concerned about anything, this would be a good time to have a chat with your doctor or midwife to put your mind at ease.
What’s a normal period during breastfeeding?
Menstruation during breastfeeding can be very unpredictable. There is a broad range of normal including the following.
Mothers who bottle feed their babies will usually start their periods within a two to three months after giving birth.
Having no period while breastfeeding is normal. Mothers who breastfeed may go without their period for weeks, months and even years while breastfeeding.
Some mothers only regain their cycles once they have fully weaned their babies.
Can your period start and stop while breastfeeding? A mother may have irregular periods while breastfeeding and may skip some months. A missed period while breastfeeding is normal.
Moms may have premenstrual symptoms without any bleeding; this may be an indication that your period will be returning soon. It's best to start taking precautions at this stage if you do not want to fall pregnant.
A mother may find that her milk supply drops a little, just before a period starts; this is due to hormonal fluctuations. (discussed more in detail below)
Some babies may drink more or less during a period, as milk might taste a little different. (discussed more in detail below)
Mom may experience some uterine cramping during a period. (discussed more in detail below)
Some mothers may experience a single period before six months postpartum and then do not menstruate again for a couple of months. There is no way of knowing, in this case, whether the mother has become fertile (released an egg and could possibly fall pregnant).
Will Your Milk Turn Sour? Will Your Milk Supply Decrease?
Your milk will carry on to provide your baby with the healthiest form of nutrition until your baby decides to wean.
One thing you might notice is a reduction in milk supply during "that time of the month." This is due to hormonal changes and is natural, and your milk supply should return to normal within a few days. During these low-production-days you can comfort-feed more and if necessary add a few pumping sessions in-between feedings to increase milk supply. A diet high in lactogenic foods is also recommended.
There is a terrible myth that breast milk turns sour when menstrual cycles return, this is not true. When there is less milk in the breasts, your breast milk might taste a little salty. Your baby may pull away from the breast because of this. That's okay, just keep trying; they will eventually take the breast, and your milk supply will return to normal within a few days. Breast massage is a great way to increase milk supply and reduce sodium content in milk.
Blood calcium levels drop mid-cycle until about day three after your period, this drop in calcium causes the decrease in milk production as well as nipple tenderness and cramping.
Taking a daily dose of calcium (1000 - 1500mg) and magnesium (400 - 750mg) especially during the week before and during your period will minimize the drop in milk production, will prevent nipple tenderness and uterine cramping too. The calcium and magnesium should be taken together, as that much calcium should never be taken alone. They can also be taken for one whole month to regulate menstrual cycles. Evening primrose (1 per day) can be taken to relieve nipple tenderness too.
Getting Pregnant while Breastfeeding
Can you fall pregnant while breastfeeding, if your period has returned?
Yes, you should consider yourself fertile once your period has returned.
What about pregnancy before the first sign of ovulation?
If you understand how the menstruation cycle works, you will know that ovulation comes a few days before a period. You may, therefore, become fertile before you see a period.
It is crucial that you look into breastfeeding safe birth control methods once you have had your first period unless you want to conceive.
For those mothers who are wanting to conceive, but who do not want to stop breastfeeding, please read our article on fertility and breastfeeding.
If anything is bothering you, please get hold of a la leche league group in your area. Their services are free.
Many mothers may feel that they want to wean when their periods begin. The longer you breastfeed, the better it is for you and your baby, but this is a personal choice. Please make an informed choice and read up about the benefits of breastfeeding before deciding.
“Hello, my baby is almost 15 months old, and we are still breastfeeding.
My period has been coming pretty regularly since my daughter turned about 5/6 months old, but they were always late.
Last month I had a normal period, but this month I haven't started at all? I am worried about pregnancy because I don't want another baby this soon.
My husband and I do use protection when we "get" to have sex. Is it normal to be this late during breastfeeding?
My daughter still breastfeeds on demand, but she, of course, eats solid foods too. She also nurses throughout the night since she sleeps with me, she nurses most of the night."
Re: Help, irregular periods and breastfeeding!
Yes, it is normal during breastfeeding to have irregular periods.
Your hormones are always changing, according to the time your child spends on the breast. The more you breastfeed, the less likely you are to get a period. But this is not the case with everyone, we all have different hormone levels; a mother may have regular periods, even if she skips feeds regularly, or combination feeds."
by Karen LaRose
"My last period was 25th, November, however around December, 18, last I began having premenstrual symptoms, but I am still waiting for a period.
In addition to waiting in expectation, I am experiencing at times severe cramping in my right side, but this usually lasts for a few minutes and would subside, its also irregular, sometimes a day or two would pass and no cramps at all.
I refused to take a home pregnancy test because I keep getting premenstrual symptoms and believe my period would come at any moment. Both before and after my son was born, I have experienced irregular periods, but once I began to get cramps, it would usually come shortly.
I am concerned about this because I don't know if its normal what I am experiencing, because I am still breastfeeding my 28-month-old."
Re: Cramps while breastfeeding but no period.
"Hi Karen, Any irregularity is normal during breastfeeding, the pains that you are experiencing could be hormone related.
I am breastfeeding my 18-month-old and still skip months in which I also experience some cramps, but no bleeding.
If the pain is severe, it’s best to see your doctor. Those pains can also be an early sign of pregnancy.