Estimated reading time: 5 minutes
Updated April 2016
Photo: courtesy Lena Ostroff
Ecological breastfeeding plays a part in child spacing and the transitions from pregnant woman to lactating mother to fertile woman are special.
My youngest turns one tomorrow. As for most mums, it’s a bittersweet realization that my baby is growing up fast. It seems like only yesterday I cradled his tiny newborn body against my chest and let him feed as long as he wanted—which was often for hours. We’re still breastfeeding. It’s our continuum, our bond. It feels very natural to continue breastfeeding and I shall until he outgrows his infant needs and I outgrow my motherly need to keep nurturing him with my milk. It’s a gentle transition. Day by day he grows more independent, less reliant on me for food and I don’t freak out quite as much when dad offers him popcorn. On top of all the health and bonding benefits breastfeeding has for mother and baby, it’s a perfect, natural form of family planning.
It’s been great not having to worry about getting pregnant or faff around with condoms or pills. After nine months of amenorrhea while pregnant, it’s been an extra year without periods. So no complaints about that either. Now, it’s almost fun guessing when my first postpartum menstruation will arrive. I have a feeling it will be soon, as my bodily juices are starting to change. It’s empowering because I’m learning to understand and follow the rhythms of my body. These transitions from pregnant woman to lactating mother to fertile woman are very special and we should honor them.
I also fully breastfed my first child—the initial seven months exclusively, on demand—and my menses returned after a year. He was two years old when he weaned gradually and naturally during my next pregnancy. It was the ideal family planning and spacing between children for us.
On top of all the health and bonding benefits breastfeeding has for mother and baby, it’s a perfect, natural form of family planning.
Ecological breastfeeding as family planning
Breastfeeding according to the criteria for the Lactational Amenorrhea Method (LAM) is considered as natural family planning that is 98% to 99.5% effective [i]. The criteria stipulate that breastfeeding must be exclusive, ideally as frequently as every four hours during the day and every six hours at night. Feeding formula, solids and expressing milk reduce the effectiveness of this method of birth control [ii]. For LAM to be reliable, the infant should be younger than six months old and the mother not have had a period after 56 days postpartum.
I have an aunt who has four daughters. The last two are spaced less than a year apart. The story goes that her husband—incidentally a medical doctor—told her she couldn’t get pregnant while breastfeeding. But she did. For years in our family this has been a bit of a running gag or the “don’t believe the myth” example. My aunt got pregnant while nursing a young baby because she wasn’t breastfeeding frequently enough for LAM to be a reliable form of contraception and she was topping up with formula.
There is a more rigorous form of LAM called Ecological Breastfeeding, which has been shown to be 99% effective [iii] in preventing pregnancy in the first six months postpartum. After six months and before the woman’s first menstruation the “failure” rate is 6%. Ecological Breastfeeding criteria stipulate that breastfeeding must be the only source of nutrition (no formula, solids, pumping milk or even water) and the baby should not use any kind of pacifier or finger, in order to encourage as much suckling at the breast as possible. In fact, suckling at the breast has been shown to play a decisive role for this natural approach to family planning. The more a baby suckles the higher the contraceptive effect [iv].
Separating the baby from its mother decreases the effectiveness of Ecological Breastfeeding; this includes putting the baby in a pram or bouncy chair. According to the criteria, baby wearing is encouraged because it provides constant physical contact and easy access to the breast. The closer a woman follows the standards of Ecological Breastfeeding the later her period should return. The average is 14 months after childbirth, with some women reporting their first postpartum menses as late as 42 months.
Tribal women and our prehistoric ancestors didn’t have any of the high tech birth control methods we have today. It’s very likely they used a form of LAM—whether it was intentional or intuitive—to space their children. As anthropologist Jean Liedloff observed in the jungles of South America, babies were carried in arms (or slings) and nursed in response to their body signals [v]. This is very much in line with Ecological Breastfeeding criteria. Modern day Mayans in Guatemala similarly carry their babies everywhere with them, even to work in the fields. They nurse them proudly and openly at all times, as is documented beautifully in the work of Bill Muirhead.
A further interesting and little publicized fact: scientific analysis of some of the oldest human fossils ever found on the planet has shown that breast milk was the principal form of food for the first three to four years of life [vi]. One could assume that these mothers—over a million years ago—breastfed their babies full term because it was the healthiest, most practical option and a pleasant side-effect was temporary infertility.
i. Hatcher, R, Trussel J, Stewart F, et al. Contraceptive Technology, 18th edition. New York: Ardent Media, 2000.
ii. Zinaman, NJ, Hughes, V. et al. Acute prolactin and oxytocin responses and milk yield to infant suckling and artificial methods of expression in lactating women Pediatrics 1992; 89 (3): 437–40.
iii. Kippley, S. and Kippley, J. The relation between breastfeeding and amenorrhea. Journal of Obstetric, Gynecologic, and Neonatal Nursing (1972); 1(4): 15–21.
iv. Contraceptive Effect of Breast Feeding J. Trop. Pediatr. (1982); 28 (1):1.
v. Liedloff, J. The Continuum Concept. London, UK: Penguin Books Ltd, 1989.
vi. 7 Bermúdez de Castro, José María, director Centro Nacional de Investigación sobre Evolución Humana (CENIEH) in an interview with EFE, October, 11 (2009).
Claudia Spahr was born in Yorkshire to Swiss parents and now lives in Spain with her husband and two children. She is the author of Right Time Baby. The Complete Guide to Later Motherhood (Hay House UK, 2011). Claudia is a journalist and speaker on women’s health, fertility, motherhood, and stress management.