Breastfeeding, Contraception, And Folic acid

Find out more about the lactational amenorrhoea method of contraception and how breastfeeding can potentially be a form of natural contraception in our guest post from Shine, which also outlines the importance of taking folic acid while breastfeeding and the benefits for mums and babies.

Pregnacare is proud to support Shine, the charity dedicated to providing specialist information, advice and support for spina bifida, anencephaly, hydrocephalus, and related conditions across England, Wales and Northern Ireland.

The Benefits of Folic Acid While Breastfeeding

Folate levels are depleted by pregnancy, and breastfeeding uses more of your folate to make milk. In the first six months of life, breastfeeding provides babies with a complete form of nutrition and helps build their immune system. If you’re breastfeeding it’s important to take folic acid to replenish your folate stores for the health of you and your nursing baby, but also just in case of another pregnancy.

To protect the health of mothers and their future babies, the World Health Organisation recommend that you leave at least two years between the birth of one child and the next pregnancy.

However, sometimes pregnancies do happen unexpectedly, especially as your fertility and periods aren’t always easy to keep track of after having a baby.

Is Breastfeeding a Natural Contraceptive?

Exclusive breastfeeding can act as a form of natural contraception known as the lactational amenorrhoea method (LAM). When the criteria are met perfectly LAM is considered 98% effective, meaning there’s still a 2% risk of pregnancy in the best-case scenario.

Taking folic acid, just in case, can help protect against neural tube defects (NTDs) such as anencephaly or spina bifida, even when a pregnancy is unexpected or unplanned.

Folic acid supplements, should ideally be taken at least three months before and for the first three months of pregnancy protect to babies against NTDs. Supplemental folic acid intake increases maternal folate status. Low maternal folate status is a risk factor in the development of neural tube defects in the developing foetus. Most will need 400 µg of folic acid per day, but some are recommended to have a prescription for a higher, 5 mg, daily dose to give the optimal protection against NTDs. Visit www.folicforlife.com for more information.

The Lactational Amenorrhoea Method of Contraception

Prolactin is a hormone that is produced towards the end of pregnancy and in the postpartum period. It drives breastmilk production in the body and suppresses ovulation (and so also stops periods). Prolactin levels are raised every time the baby latches and feeds, the level then falls 3-4 hours later. Babies need to suckle regularly to maintain your milk supply and for the prolactin level to be high enough to prevent ovulation.

LAM is considered 98% effective (2% risk of pregnancy) as long as ALL these criteria are met, if they are not you will need an alternative form of contraception: 

• Baby must be under 6 months old
• You must be exclusively breastfeeding from the breast, day and night
• Your periods have not returned (even light spotting counts). Bleeding or spotting are indicators of fertility but not requirements for it. Ovulation occurs before your first period, so it is possible to become pregnant again without your periods resuming.

The following conditions are thought to make LAM less effective. You should continue to breastfeed your baby but consider an alternative form of contraception:

• If you express rather than feed from the breast for any feeds
• If you introduce any supplementary feeds (expressed milk, formula, juice, solids)
• If you start breastfeeding less often, especially if there are long intervals between feeds – day or night
• If you breastfeed for less total time in 24 hours
• If baby sleeps through the night or you stop night feeds
• If you baby uses a dummy
• If you or your baby are stressed or ill
• The age of the baby – fertility returns over time even with breastfeeding

If you have any concerns that you will not meet all of the LAM criteria, or just for peace of mind, consider using an alternative form of contraception.

Pregnacare Pregnancy & Breastfeeding Supplements

Supplements containing folic acid should ideally be taken throughout your breastfeeding journey and/or at any time you’re sexually active and there’s a chance of pregnancy, even a small one.

Pregnacare supplements provide the recommended 400µg level of folic acid, as part of expert, comprehensive vitamin and mineral formulations. For more information on the Pregnacare range supplements for before, during or after pregnancy, including during breastfeeding, click here. 

Pregnacare is a proud supporting partner of Shine. Shine is a leading UK charity providing specialist advice and support from before birth and throughout the life of anyone living with spina bifida, hydrocephalus or related conditions, as well as to parents, families, carers and professional care staff. Shine enables people to get the best out of life. Find out more about Shine at https://www.shinecharity.org.uk/

The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health professional regarding any medical condition. While every care is taken to ensure the accuracy of the information presented in the blog and to describe best generally accepted current practices we cannot accept any liability for errors or omissions or for any consequences from application of the information given