Results and Thoughts on the Survey: Breastfeeding vs. Return of Menstrual Cycle

At long (long) last, time to analyze this survey on Breastfeeding vs. Return of Menstural Cycle that just blew me out of the water with all of the responses it received!

So… what is the relationship between breastfeeding and the post-partum return of fertility?

I thought that the answer would become more clear, but although I feel like there are some definite trends and general aspects of the relationship between the two, overall my answer would have to be “Well, it really depends…”. How’s that for clear as mud?

I did manage to confirm something that I already thought, which is that I have a pretty crunchy readership- over 75% breastfed for more than 12 months, and over 36% breastfed for 18 months or longer! Mamas, you rock!

Let’s dig in and see what the survey said:

I'm going to apologize now that these charts are not as clear as I would like them to be-- I couldn't increase the size any more without cutting off the chart!

This is one of the results that blew me away. Those fuzzy numbers say that over 39% of moms were still nursing at night when their cycle returned! Additionally, less than 40% were feeding baby any sort of solids, only 15% offering a pacifier, and 6% offering supplemental bottles.

What that means is that significantly more than half of breastfeeding moms see the return of their fertility while they are NOT offering bottles, NOT using a pacifier, NOT feeding solids, and CONTINUING to nurse through the night!

The next part of the survey asked moms when their cycle returned, in comparison with how long they breastfed in total. You can see that there is definitely a significant holding-off factor that more extended breastfeeding offers. For those moms who continued to breastfeed past the 6 mth mark, another 7.5% of them managed to stave off the return of their fertility.

BUT, for the great majority (over 80%) that didn’t seem to make a difference.

In fact, if you look also at the two charts below, which are for moms who breastfed for 12-18 or 18+ months, most moms still get their cycle back by the time their baby is 6 months old. A whopping 72%, according to my oh-so-scientific survey!

Extended breastfeeding does make a difference, obviously, as a much greater percentage of these moms who breastfed for 12 months or longer saw their cycle hold off for much longer. As many as 10-15% of moms did not regain fertility until after baby was 1 year old.

When I look at these results, I have to extrapolate the fact that perhaps we North American women (brace yourself for the broad, sweeping generalization…) are NOT practicing the kind of ecological breastfeeding that naturally prolongs the return of fertility.

What exactly constitutes “ecological breastfeeding” anyways?

Glad you asked! I did a bit of research and found these 7 basic tenets of ecological breastfeeding, as put forward by Sheila Kippley, author of Breastfeeding and Natural Child Spacing

7 Standard of Ecological Breastfeeding

From an article on the La Leche League International site, by Sheila Kippley

  1. Breastfeed exclusively for the first six months.
  2. Pacify Your Baby at Your Breasts
  3. Don’t Use Bottles and Pacifiers
  4. Sleep with Your Baby for Night Feedings
  5. Sleep with Your Baby for a Daily-Nap Feeding
  6. Breastfeed Frequently Day and Night and Avoid Schedules
  7. Avoid Any Practice that Restricts Nursing or Separates You from Your Baby

Anyone want to do a quick run-through of the standards and see how your breastfeeding practices matched up, according to when your cycle returned?

For me personally, with my first I was only practicing #1, 6, and 7 completely when my cycle returned at 12 months (though fertility didn’t return until 15 mths). She was in our room for night nursings as well (#4) until she was 6 mths and night-weaned at 11 mths. With my second, I was practiced #1, 2, 3, 6 and 7. He also slept near me until 6 months. He was 18 mths old and still getting one early morning (3-5am) feed when I caught the first egg and conceived my third.

Currently, I’m nursing my 12 mth old frequently, but just night-weaned (naturally- I didn’t force it) about a week and a half ago. I’ve practiced #1, 2, 4 and 6 with her, but have had times when I’ve had to pump and use bottles for her while I was away. She also slept near us until about 11 mths old, as I continued to night feed. My cycle is just showing signs of returning.

That’s just my story, though. As I said earlier in this post, my true answer as to the relationship between fertility and breastfeeding is that there are definitely some practices that seem to have a fairly consistent effect on the return of fertility. And there also seem to be a whole lot of women for whom there isn’t a lot of rhyme or reason, but their bodies just seem to work in a particular rhythm of fertility no matter what.

Image by tedsblog

Here are a sampling of the interesting additional comments from moms who took the survey:

  • My cycle returned as soon as I started offering my baby solid food–even though it was just rice cereal. Offering food means the weaning process has started, no matter how little you offer or how long you breastfeed at the same time (in my case, 20 months). My body just seemed to know that it wasn’t the “one and only” any more, and lo, my period came back.
  • I have breast fed all 7 of my kids. With each of them, my cycle returned around 7 months. With each child, they had somewhat different habits.
  • Both I and another breastfeeding mom I know found that the return of our cycles took longer with each successive child. So I had the longest break from my cycle after my third child was born.
  • For me, my cycle returns withing a month of baby night-weaning.
  • I always breastfeed on demand around the clock and my cycle always returns around 3 -4 months postpartum!!
  • I was actually tandem nursing my 15 month old and my newborn and my cycle returned at week 5 post-partum. It return the same time with my first baby as well.
  • My period returns when I quit nursing.
  • My cycle hasn’t come back with any of my 5 children until i was down to about 2 nursings a day….just my experience….I’ll be interested in your finds.
  • I have had three babies and it was different every time. My first nursed until she was four, and my cycle came back when she was 14 months old. With my second, I was tandem nursing a LOT, and was shocked to discover I was pregnant again when he was only seven months old. With my third, I was again tandem nursing and my cycle returned when she was nineteen months old. At that point, I was just two months shy of having gone four entire years with no period.
  • My baby is exactly 18 months old (to the day). I’m still breastfeeding – several times during the day and also at night. My menstrual cycle has not yet returned.
  • I transitioned my son to a crib when he was almost 1yo. Previously we had been co-sleeping. As a result he nursed less at night – though he was still not STTN. A few weeks later and my cycle returned.
  • From my own research and the info I’ve received from fellow NFPers (from our ministry site www.sweeterthanhoney.org), a HUGE reason for an earlier than expected return to fertility is due to baby sleeping through the night. A woman could be breastfeeding exclusively (no pacifiers, no solids) for an entire year but have a early return to fertility (when baby is 9 mo old, for example) because baby began sleeping through the night at 8 mo. I’ve advised young moms who want to delay fertility to co-sleep or wake up the baby to nurse in the night.
  • I was breastfeeding TWINS full time when my cycle returned after only 3 months. :-)
  • I found with all three of my kids that my menstrual cycle returned when I completely cut out nighttime feedings (so baby would go about 8 hours without a feed during the night)- for my first two this was around 6 months, and the third it was around 9 months.
  • I have birthed four babies at home. We have nursed on demand (rarely more than two hours apart even as they approached one years old), co-slept, practiced babywearing, etc. Our babies do suck their thumbs, but we’ve never encouraged it over breastfeeding, and they have all nursed a LOT during the night. With my first three pregnancies, my cycle returned at 2 mo. After my first, I got pregnant when he was six months, then we waited until our second baby was one to conceive. We got pregnant for the fourth time when our third was five months old. Just sharing all of this info, because it is something I’m so greatly interested in. I struggle to come to terms with the fact the my body is allowing me to become pregnant when my babies still need my milk. Couldn’t be happier with our four little ones, so a mixed blessing :)

It’s a whole lot of food for thought. I’ve come to the conclusion that perhaps there is no conclusive answer.

I’m quite certain that trends in the North American diet, environmental toxins, etc. play a role in our hormones and fertility. I also think that (as a general rule) most of us don’t practice true ecological breastfeeding, as it is practiced in many other cultures.

After all this, what do you think about the issue now? How do you think that breastfeeding practices and individual differences between women account for the timing of the return to fertility?

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About Stephanie Langford

Stephanie Langford has a passion for sharing ideas and information for homemakers who want to make healthy changes in their homes, and carefully steward all that they've been given. She has written three books geared to helping families live more naturally and eat real, whole foods, without being overwhelmed, without going broke and with simple meal planning. She is the creator of Keeper of the Home.

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Comments

  1. I just ran into your article. I am a mother of 6 children and a true believer of nursing. I’ve nursed all my children until 12 months except 1 that I got pregnant with while still nursing. I also extent solids until they seem to need it (6 months oldish). My cycle doesn’t return EVER until my children are 10 months or so. I know that I still ovulate though (thus the pregnancy while nursing and no cycle). I am glad to see that your research shows we are not all generalized. Though it may work sometimes to count on nursing all the time to keep unfertile, it’s not logical. It only take a few weeks of a baby not eating as much (sickness etc) to get your body back on it’s regular schedule which seems risky if you want to wait a little to have a baby. I am also a VERY good milk producer— enough for twins, you would think that would wear your body down, but I can tell I still ovulate without a cycle.

  2. Hi Stephanie- I’m fairly new to your blog and just stumbled upon this article. I have three girls and my youngest is 6 months. My 6 month old is the first I’ve been able to successfully breastfeed and I have thoroughly enjoyed the bond that she and I have had. I still have not seen the return of my cycle. I’m hoping to postpone my fertility as long as possible. My baby does use a pacifier and I do not co-sleep (expect for occasional naps), but I feed her on demand day and night. I just introduced solids, but she does not seem to like anything I give her. I guess time will tell. Is it just me or do most people think women are crazy when they don’t take the pill to prevent pregnancy? My mother had breast cancer… I chose to never take the pill again when I found out it would increase my risks even more. What are your thoughts on safe prevention of pregnancy?

  3. I’m a midwife, homebirth only :) but I do not practice “ecological nursing” because I think I’d go nuts :) I love the stability that “scheduling” brings to our lives, and the predictability of our days, and the more stable baby that [I] think I get…but I’m also a huge proponent of extended nursing, delaying solids as long as baby will let you, and baby-led weaning. My 2 weaned babies did not night-wean until I pushed it at a year old. I nursed 22 and 19 mo respectively…and weaned due to discomfort during a subsequent pregnancy–usually the last hold-out nursing at 3 mo pregnant or so.

    I’ll not suggest that it isn’t unbalanced bodies which lead to early fertility return. But I strongly suggest we look toward Genesis for the reason that there is so little rhyme or reason to the timing of the return, while there do remain some trends. Most translations of the curse by God onto womankind from the choice to SIN and disobey God speak of “increase of conception”. If that is an accurate rendering of the curse, then it explains why we get pregnant 6wks after birth, or 6mo, or before 3 yrs, etc–before it is “healthly” for our bodies to handle, over and over and over.
    As profitable as I find it to treat God’s temple with respect, and seek to be good stewards of the resources God has given this world, I don’t believe we will find perfect health, or ever achieve a “perfect” diet. Or at least our bodies will not respond perfectly to that perfect diet–or the nutrients won’t be all available to the growing foods…or something!! Makes me LONG for the return of our King, and a NEW EARTH!!!!

    • @Ruth, Amen, Ruth! I absolutely agree! I’ve been studying health and nutrition now for over 8 years, and the longer I study, the more that I realize nothing is perfect, and that as you say, sin affects our bodies in countless ways. I can easily say with you, “Come, Lord Jesus!”. :)

  4. With my firstborn, I nursed round-the-clock and he didn’t start sleeping through the night until 8 months, and I think my cycle returned at around 6 months. 2nd baby started sleeping through the night at 4 weeks (I didn’t force it at all, she just liked to sleep), and my cycle returned around 4 months. 3rd baby also started sleeping through the night at 4 weeks, and my cycle returned just 2 weeks after that! As much as I enjoy a break from good old Aunt Flo, I enjoy sleep even more, so for me, having my babies sleep through the night is worth it.

  5. I wanted to add that I do practice the ecological breastfeeding, never been away from my child for more than three hours, and never more than an hour for at least a year. Pretty much did everything described, didn’t go outside much at all (so that disproves artificial light theory, I guess unless you are inside with no outside light coming in at all…) and it has been 19 months and still no cycle.. though I’m almost positive I ovulated a few days ago because he has been sleeping longer than 6 hours at night, he does still nurse a lot in the morning, but he will go longer than 6 now and I definitely feel my cycle returning. So i will say that it must be true that if you don’t go longer than 4 and longer than 6 at night you can be successful with a good diet… not being overweight.. all of that because obviously people have nursed on demand and got their periods back. Who knows why!!!!

  6. I haven’t read all of the other comments, but wanted to add my $.02 as a board certified lactation consultant. The lactation literature says that any time the baby is going more than 4 hours during the day or 6 hours at night, the chances of mother returning to fertility go way up. I personally find that if a mom really wants long term suppression of menses, she needs to avoid going more than 4 hours between nursing sessions both day and night. Personally, I breastfed all three of my boys (no formula ever, late intro of solids) and with each boy my period came back about a month before their 1st birthday and coincided with much longer sleep stretches at night.

  7. Herbwifemama says:

    There is documented connection between cycles and light. Maybe we have too much artificial light.

  8. I’ve breastfed our three children and so far, my cycle hasn’t returned until I’ve either completely stopped nursing, or cut down to just once a day. I nursed the first one until 12 mos., the second one until 19 mos. and our third until 15 mos. My last child I had on a fairly consistent schedule too. Interesting results:)

  9. Very interesting…this is something that frustrates me (because let’s admit it…we all want a break, right?). We nurse on demand, around the clock, all night long, only use pacifiers in the car (and all my kids have only taken one maybe 5 times total…ever), never give bottles, nap together (we co-sleep anyway), etc…

    With my first daughter I got my period back at 4 months PP (though was anovulatory until 10 months PP). I did not stop nursing her during my next pregnancy, and after my 2nd daughter, while tandem nursing, got my cycles back (fairly certain I ovulated that first one) at 7 months. And THEN…the kicker…after my son was born this March, I’m still nursing all THREE of them and got my first anovulatory cycle at around 3.5 months, have had 2 more since then and don’t have a CLUE what my body is doing. Definitely frustrates me knowing my friends can go a year+ with no cycle just nursing (or even NOT nursing) 1 baby and I can’t even get to 4 months nursing 3!!

  10. Hi! I found your blog so interesting. I was looking for a blog like this about 5 years ago. :) I have five children! We co-sleep to two and a half years. We follow all your rules and I weaned three of my children so far after the two and half year mark. But my periods came back differently with each child. My oldest came to me sleeping five hour stretches during the night-I had no idea that all babies weren’t wired this way. :) My period did return at eight weeks. I conceived my second @ four months postpartum. I tandem nursed them. My second born nursed non-stop, and never slept more than 2 hours, through three years old. I had my period return into the fourteenth month postpartum. After the return I weaned my first born. And within three months conceived baby three. Baby three was very sick at birth and was unable to nurse at first. She had formula for two weeks. Then I gradually breastfed her. My second born kept me in supply while we were building up for this . . . the transfer was hard work but I was able to complete nurse her before she was a month old. Before this child we never even owned a bottle!! When my third child was six months old I weaned my second child and began solids with child three. Surprise I got my period around 12 months postpartum. We were pregnant about six months later. My fourth was born healthy. When she was 3 months old she went on a nurse strike for three days. The following month I weaned my third born. When my fourth was 8 months old I found out I was four months pregnant!!!
    The question for God is did the nurse strike cause me to get pregnant or did the baby strike because I was pregnant!?!? Currently my fifth baby is two weeks old, I am still nursing my fourth child as well as the baby.

  11. Wow! I didn’t know how fortunate I was! I’ve never practiced what you term “ecological” breastfeeding. I’ve always started solids at four months, put my newborns in a crib in their own room from the first week, and tried to get nighttime feedings down to only once per night after four months. I eliminated the last nighttime feeding at 10-11 months. I’ve never carried my babies in anything other than my arms, although I did avoid bottles and pacifiers just due to personal preference. I breastfed my second child for 20 months and my period returned at nine months. I breastfed my third child for 14 months, and my period didn’t return until then. I was amazed to realize that some women actually WAKE their SLEEPING children to nurse them to try to hold off a return to fertility. Of course, maybe I’d resort to that too, if I wasn’t on the mini-pill!

  12. With my first, I did everything listed for the ecological breastfeeding at the time that my cycle returned–at 6 weeks postpartum! Some of those things I stopped AFTER the return of my cycle (like offering pumped bottle, paci, etc), but at the time that it returned, I was doing all of those things. Now with my second daughter, I’m still doing all of those things, and at 8 weeks postpartum, my cycle is returning! I’m convinced that yes, that can make a difference for a majority of people, but for some (unfortunate) mamas, it will return no matter what you do.

    Question is, though… am I actually fertile, or just having a menstrual period? I have read other sources that say that a woman can have a period without ovulating when she is breastfeeding. That would be an interesting experiment for me… if I had the spare cash to go out an buy a bunch of ovulation testers. LOL

  13. With my first daughter, my cycles returned 6 weeks post-partum. With my second daughter, my cycles held off almost 2 1/2 years (28 months!!!). That is quite a difference!!!

    I’ll tell you what I think effected it. Both my babies nursed day and night (my first daughter nursed till she was 2 3/4), were exclusively breastfeed for 6 months, slept by me at night. But my first daughter was an efficient eater- she nursed for 5 minutes got full and was done. For comfort she liked her nuk. Now my second baby, I was nursing two (my newborn and toddler) for the first 9 months, so I think that extra nursing from the two of them helped hold off my cycle. Plus, my second one didn’t take a nuk and would nurse for 1/2 hour at a time and get two or three helpings of milk. Plus, with my second one we laid down and took a nap together every afternoon, plus she slept by me at night and nursed through out the night. I guess I think it just depends how much sucking a baby does that suppresses the menstraul cycle. Efficient, quick eaters probably won’t keep your cycles suppressed, where as nursing two babies or slow nursers that will nurse for long periods of time will help keep the cycles back, at least that was my experience.

    One thing that I must say was really nice about not having my cycle back with my second daughter is that she never got fussy the whole week I was having my cycle, as my milk supply didn’t drop or taste funny. My first daughter was fussy every week for my cycle week and my milk quantity definitely dropped during that week every month. Plus from what I read probably tasted saltier or different.

  14. I found this very interesting and quite encouraging…to find out I’m not the only one that had her cycle return very early despite following all the principles you mentioned. I’m a new mom and still nursing my eight-month-old so I don’t have a lot of different experiences to go off of yet, but with this little guy, my cycles returned seven weeks postpartum despite nursing on demand, pacifying at the breast, co-sleeping, babywearing, etc. I cried (YAY for postpartum hormones!) and wondered if something was wrong since all of my friends didn’t have their cycles return until their babies were weaned or at least over six months old. So, it’s nice to find out that there are many other women out there that had a similar experience to mine.

    And in regards to the comments made about the possible correlation to body build and the return of cycles, I was VERY slender before getting pregnant and now am just slender ( :)), but that didn’t seem to make a difference in my cycles returning so early.

  15. I think you’re right…there’s no conclusive answer. :) God made each mama’s body unique, her baby (and his/her nursing habits) unique, and family situations unique. I’m sure environmental factors play a role too.

    Everyone told me when my baby started sleeping through the night that I could expect my cycles back. All three of my babies have slept through the night between 6-8 weeks (We are a schedule family…don’t tell my crunchy friends! ;)). And I haven’t seen a period with any of them before 6-8 months! I think solid food may have been the biggest factor in bringing my period back, but I couldn’t even say that with 100% certainty.

  16. I didn’t read all the comments so I apologize if this was already mentioned, but return of menstruation doesn’t equal fertility. I always got my period back quickly (around 4-7 months) despite ecological breastfeeding, but I wasn’t fertile until several months later. Women who are practicing ecological breastfeeding can have anovulatory cycles (cycles without ovulation).

    • @carrie, Yes, you’re totally right about anovulatory cycles occuring.

      I focused on talking about the return of cycles in general, though, because not every woman knows her fertility signs and whether her cycles are actually fertile are not, so this was a bit of an easier way to approach it.

  17. I’ll share something interesting from a friend who would have her cycles come back after 3 months and her milk supply dry up with each baby. However, after making the switch to raw milk, she was able to breastfeed 9 months or longer!! (Baby #10 is now 4 wks old!!!)

  18. With my first, he self-weaned at 14 months and I started my period at 15 months. He was in his own crib at 6 weeks, had a pacifier, slept through the night, took a bottle (as I worked full-time back then), and started solids at 4mo.

    My second is 5 months, EBFing, sometimes sleeping through the night, in her crib since 2 mo and no sign of flo. :)

  19. I breastfed both of my littles: the first till he was 15 months and the second till she was 17 months. I started trying to get pregnant when my first was 14 months and didn’t have periods. I had to use ovulation predictors to try to get pregnant. So I never had a period in between. With my second child, my period returned at 7 months and continued every other month. I did put my children on a schedule, but I didn’t give them solids till 5 months, and didn’t use any bottles or pacifiers. They ate every 3 hours like clockwork till they were about 5 months, nightweaned, and then ate every 3 hrs in the day they were fully weaned. I was shocked when my period came back so quickly after my first child. Amazing to hear how different we all are.

  20. I think that those who follow the principles of “true ecological breastfeeding” (strange term in itself, biological seems more appropriate) and have longer delay of menstruation should just consider themselves lucky. I have nursed five children, some for over two years, but none less than one year, and my period has ALWAYS come back before six months. How long I breastfeed my babies does not have any effect on the return of menstruation, so I think it is strange to use that as a corollary in this survey. I have never heard of “ecological breastfeeding” using that language, but I have always done every one of the things on that list because it works best for me. The data is interesting as a reference–I’ve always been frustrated that my period returns so quickly, and have wondered if I were the only one with such bad luck. My sister breastfeeds very similarly, and her period has never come back before she get pregnant again over a year later. I’m always so jealous! I think we’re all just different.

  21. Mama Brown says:

    My first had the need to suck a lot, but he would refuse to nurse if he wasnt hungry. It was an issue that I found within a few days of him being born! If he wasnt hungry, he just refused to let me be a “Human Pacifier”. So, after much frustration, I gave him a pacifier, and it was a lifesaver! (he was 2 days old when I first gave it to him) he nursed 18 months, we coslept til around 7-8 months. no solid foods were started til 11 months, He never drank from a bottle or cup (even when I was so sick with a high fever my milk dried up… he refused to eat or drink anything a whole day!! my milk returned when my fever went down the next day)
    My periods came back at 6 months.
    with my second. he ate and ate a lot. he ate about every 1-2 hours, and sometimes more. he also took a pacifier, But it was only when he was done eating.
    My periods came back at 6 months, I started solids for him at 7 months.. he was one VERY hungry boy! He nursed 15 months. I gave him a bottle once when he was 2 months old. he was so hungry he couldnt nurse right. he was nursing every 1/2 hour for a few days.. I was tired and frustrated and so was he. ONE 4 oz bottle made him settle down enough to nurse properly and he was fine and went back to his normal nursing routine. He is a baby that REFUSED to cosleep. He would scream until I put him into his own bed, there he slept just fine! He also refused to be swaddled, wrapped or worn. He is still the same way at 6 – he likes his own space.
    My third nursed a lot! Mostly because he would nurse and throw up everything he just ate A LOT. (we later found out he is allergic to milk) He never took a bottle, he never took a pacifier. He DID suck his thumb. he didnt cosleep due to his need to sleep upright (or he would puke) I wore him as much as he would let me. He nursed 14 months. my my periods came back at 6 months.
    With my 4th, she coslept, I practiced babywearing, nursed on demand, the works. My period back once at 4 months, then not again til 7 months. She never took a bottle, and hated pacifiers. She was and still is a thumb sucker. She nursed 15 months.
    All my kids weaned themselves, I never encouraged it at all, it was totally up to them!