Periods during breastfeeding: myths and reality

Restoration of menstrual cycles after childbirth causes various concerns in women who breastfeed. Fortunately, in many cases, mothers' worries are in vain! But still, it will not be superfluous to find out exactly how the menstrual cycle of a woman who has given birth is restored, and how the process of breastfeeding affects this. Important facts, expert conclusions and a lot of useful information below.

Is it normal that the period returned only a few months after childbirth? Can it negatively affect breastfeeding? And vice versa: the child is already 2 years old, but there are still no periods? Does this mean that the next pregnancy while breastfeeding is impossible? Is it normal that for a long time the cycle "walks" and does not return to normal in any way? Let's consider the most common misconceptions in this matter.

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In our article you will find the following information:Why is the cycle not restored immediately after childbirth?What are the discharges after childbirth? When the cycle will resume? What changes in the cycle can await a woman? Is it possible to get pregnant during pregnancy?? Will the taste of milk change when the cycle is restored?

Why is the cycle not restored immediately after childbirth?

During pregnancy, due to changes in the hormonal background, the functioning of all systems of the female body changes significantly. And after childbirth, everything begins to gradually return to its usual state. This also applies to menstrual function. But recovery also requires a certain amount of time. The first period after childbirth is a sign that the woman's body is recovering and returning to normal.

What are the discharges after childbirth?

Discharges that appear 2 hours after childbirth and that can last up to eight weeks are not called monthly because they do not have a cycle. They are called lochia. There is no menstruation during the bad period. Lochia can be normal and pathological. In addition to vaginal discharge, during this period a woman may also have discharge associated with inflammation of the mucous membrane of the vagina and the mucous membrane of the cervix - vaginitis or cervicitis. They may be associated with a bacterial infection, candidiasis, or sexually transmitted infections. What is the difference between a period and a period? Menstruation comes after the end of lohi. Menstruation does not occur in the first 1-2 months after childbirth (during periods). Lochia lasting more than 8 weeks is considered pathological discharge, and patients with such symptoms need further examination. Menstruation also depends on whether a woman is breastfeeding. In women who breastfeed, as a rule, the first menstruation comes no earlier than 6-8 months after childbirth, and in women who use artificial feeding, the first menstrual-like reaction can occur already after the end of the cycle, after 1 month.

When will the cycle resume?

There are no clear norms for the recovery of menstruation, and at the same time, there is no possibility of a new pregnancy. A lot depends on whether the mother breastfeeds the baby or not. And also from the individual characteristics of the body. The appearance of menstruation (if the discharge is really menstrual, and not postpartum complications) three weeks after childbirth and lactational amenorrhea lasting two years are two poles of the same norm. Against the background of breastfeeding, menstruation usually returns 11-18 months after childbirth. But sometimes - after 3 weeks or, as the second extreme - after 2 years. To a large extent, the timing of recovery of cycles depends on the organization of breastfeeding: frequent application of the baby to the breast contributes to maintaining a high level of the hormone prolactin in the blood, which is responsible for suppressing ovulation. Long intervals between feedings, the use of a pacifier and topping up with water limit the child's natural need for frequent sucking, which means that they lead to a faster decrease in the level of prolactin. And on the contrary, intensive breastfeeding in the second year of a child's life increases the probability of a later recovery of menstruation.

The menstrual cycle after normal physiological births without pathological deviations is restored after 6-8 weeks if the woman does not breastfeed. The cycle after childbirth may not change if the woman does not have a hormonal imbalance and is pathologically abnormal.

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What changes can await a woman?

Do not worry if at first the discharge will be significantly less than before pregnancy, and the cycles will be irregular. This is a consequence of the work of the prolactin hormone. Such a situation is also possible, when after several menstruation cycles disappear again for some time. This can happen if, after a period of more infrequent feeding, the breastfed child again accelerates attachment to the breast (for example, during a growth spurt or intensive teething). However, the environmental friendliness of breastfeeding is not the only factor influencing the recovery of cycles. It also depends on genetics and natural changes in a woman's hormonal background depending on age or current lifestyle. Even in the same woman, the timing of menstruation after each subsequent birth may differ. At the same time, women whose lactational amenorrhea lasts long enough can be called lucky, because this contributes to the economy of the ovarian reserve of eggs, and consequently, to the extension of youth.

You should be alerted if the discharge during menstruation has become dark, scanty, the cycle has shortened; an increase in body temperature during menstruation and an unpleasant pungent smell is released; lower abdominal pain; profuse red blood discharge, weakness, dizziness, nausea.

A common situation for the first period after childbirth is increased pain. The cause of pain in the lower abdomen may be a caesarean section. The fact is that during menstruation, the uterus shrinks, including in the area of ​​the scar, which has not yet healed sufficiently. Also, during childbirth, women sometimes rupture, stretch ligaments and muscles, which can cause pain during critical days. Painful menstruation after childbirth can indicate inflammation in the uterine cavity or other diseases. Sometimes this is a signal about adhesions. Therefore, when such symptoms as high temperature, weakness and headache appear, it is necessary to urgently seek medical help.

Is it possible to get pregnant during pregnancy?

Gynecologists do not recommend getting pregnant immediately after giving birth. On average, a woman needs at least 1,5-2 years to fully recover. Therefore, the need for contraception occurs almost immediately — somewhere 2-3 months after childbirth. But in the case of breastfeeding, nature comes to the woman's aid. The absence of menstrual cycles against the background of breastfeeding is indeed the basis of one of the natural methods of family planning — the method of lactational amenorrhea (MLA), the reliability of which is 98%. The method of lactational amenorrhea is considered a natural (biological) method that mankind has used since ancient times. It is based on the natural decrease in fertility after childbirth if a woman has amenorrhea and only breastfeeds. However, it is possible to rely on this method only during the first 6 months and if there is no bleeding after 56 days after childbirth.

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In addition, in order to achieve the declared effectiveness of the method, the woman must observe the following rule: the baby must be exclusively breastfed (they receive only breast milk directly from the breast, the use of pads and pacifiers is excluded), while the intervals between feedings should not exceed 4 hours during the day and 6 hours at night. Therefore, if you are not ready for the appearance of another baby at the moment, you should use the second method of delaying conception.

GV can be a reliable method of contraception if the woman actively puts the child to the breast (after 2-3 hours), especially at night, as prolactin is produced at night (from 2:00 to 7:00).

In 1986, Sheila Kippley developed the so-called concept of "ecological breastfeeding" - a more rigid form of MLA. To achieve high contraceptive effectiveness of MLA, the author recommends adhering to the following rules:

• Breastfeeding should be the only source of food for the child. It is not possible to use ready-made milk mixtures, complementary foods and complementary foods (up to 6 months). Feeding with expressed (using a breast pump) milk is also excluded;
• the child should be soothed only by the breast, without using a pacifier or bottle;
• feedings must be frequent. Generally accepted MLA standards: the interval between feedings should not exceed 4 hours during the day and no more than 6 hours at night. Sheila Kippley recommends more frequent feeding without observing the schedule (at the request of the child);
• the baby must sleep with the mother, at least in the same room, if not in the same bed; a woman should not be away from her child for more than 3 hours a day;
• during short periods of daytime rest, the baby should be close to the mother; a woman should not have menstruation after 56 days after childbirth (bleeding before this period does not matter).

According to studies, with strict observance of the above rules, the rate of contraceptive failures in the period from birth to 6 months is 1% and in the period before the first postpartum menstruation — 6% (Kippley S., Kippley J., 1972). Although the first postpartum cycle is most often anovulatory, subsequent cycles are almost always ovulatory and indicate the restoration of fertility. However, in some women, breastfeeding to some extent reduces fertility even in the presence of ovulation. In most cases, the luteal phase is too short to preserve pregnancy.

Will the taste of milk change when the cycle is restored?

One of the frequent fears of nursing mothers when menstrual cycles are restored is a change in the taste of breast milk, which allegedly can lead to the child's refusal to breastfeed. But firstly, there is no reliable confirmation of this fact, and secondly, minor changes in the taste of milk occur almost constantly depending on the range of products consumed by the mother. These changes are normal for babies and do not lead to rejection of the breast by themselves. As for the influence of menstruation on the amount of milk, sometimes in women there is indeed a tendency to a certain decrease in ego production in the first days of the cycle. However, this is only a short-term phenomenon, and after a couple of days the amount of milk becomes the same. On the basis of this, it is possible to conclude: the resumption of menstruation is never the cause of a large lack of milk. Remember that the necessary conditions for establishing the lactation process are frequent feedings during the day, the presence of night feedings and the correct attachment of the baby to the breast, and the early arrival of the first postpartum menstruation does not affect the success of the process in any way. At the same time, lactation does not decrease, so any woman is able to breastfeed as long as she and the baby want, regardless of the timing of the recovery of menstrual cycles.

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