The return of the ovaries to normal function varies greatly depending on whether the puerperal woman is breastfeeding or not.
The amenorrhea (absence of menstruation) and anovulation (absence of ovulation) process of breastfeeding mothers is longer than that of non-breastfeeding mothers.
In non-breastfeeding mothers, ovulation occurs as early as 27 days after birth. In most women, the menstrual cycle begins approximately 12 weeks after birth, and the average first menstrual period is 7-9 weeks.
In breastfeeding mothers, the return of menstrual periods varies greatly depending on many factors, such as how often and how much the baby is breastfed and whether or not supplementary formula is used.
In breastfeeding mothers, the return of the ovaries to normal function is due to the high levels of the hormone prolactin, which causes milk secretion from the breasts. In 3 out of 4 breastfeeding mothers, the normal menstrual cycle returns around 36 weeks after birth.
From the last months of pregnancy, the level of the prolactin hormone in the blood increases and milk production begins in the breast tissue. The prolactin hormone is secreted from the pituitary gland located just below the brain in the skull. With the birth, both tissue stimuli and the baby's sucking movements on the nipple ensure that the hormone called oxytocin is secreted into the blood, allowing the milk accumulated in the milk ducts to come out. Regular breastfeeding of the baby ensures the continuation of this process and increases the level of the prolactin hormone in the blood, which is necessary for milk production. The high level of this prolactin hormone in the blood puts an end to ovulation activity that could lead to a new pregnancy. Sexual desire decreases, and vaginal (reservoir) dryness develops. The main purpose of all this development is to protect the growing new generation. Therefore, it can be said that breastfeeding protects against pregnancy. Breastfeeding can be 99% successful in preventing pregnancy. In order to achieve this success rate, certain conditions must be met. The mother should not use supplementary food or water to feed the baby, breastfeeding intervals should not exceed 4 hours during the day and 6 hours at night, and menstrual bleeding should not have started after the end of postpartum bleeding.
After the first 6 months, the success rate drops significantly. In order to keep the success rate high in the future, some criteria have been determined. When these are met, the success rate after the first 6 months until the first menstrual period is reported as 94%. The average time to start menstruation is reported as 14 months. The birth control method that meets these criteria is called the "Ecological Breastfeeding" method. The determined criteria are as follows;
There should be no vaginal bleeding except for the first 56 days after birth.
Breastfeeding should be the baby's sole source of nutrition for the first 6 months.
A pump should not be used, and even water should not be given.
Pacifiers should not be used.
Breastfeeding should be preferred to calm the baby.
Breastfeeding should be as frequent and long as possible. Breastfeeding should not be done at scheduled intervals. The baby should be given the breast whenever he/she wants it.
The baby should sleep with the mother at night. However, since studies have shown that "sudden infant death syndrome" increases with sleeping in the same bed, the necessary precautions should be taken or the baby should be put to sleep in a separate bed next to the bed.
The mother should be allowed to sleep with the baby at intervals during the day. It has been shown that the tactile closeness of the mother and the baby increases the amount of the hormone prolactin.
The mother should be primarily involved in baby care. A caregiver taking care of the baby for long periods of time can cause the mother to distance herself from the baby.
It should not be forgotten that even if all these are met, there is at least a 6% failure rate. In cases where the frequency of breastfeeding decreases, such as individual sensitivity, starting work, nipple cracks, and baby illnesses, the contraceptive effect of breastfeeding may disappear. For this reason, you may need different contraceptive methods.
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