UPDATE: Wow, the comments went onto a second page! That's never happened before!
(When you get to the bottom there's a leetle teeny arrow link pointing to the second page.)
Christy P emailed me a link to an article about "ecological breastfeeding" and lactational amenorrhea at Inside Catholic.
Of course, I've read lots of these articles over the years, and had my own stints of lactational amenorrhea, and I've made it out of lactational amenorrhea 3 times without any surprise pregnancies (going on four, I hope). So little of this is new to me.
Except having been out of the loop for a little while, I didn't know that CCL is not, apparently, emphasizing breastfeeding amenorrhea as a spacing method as strongly as they used to. Here is part of a comment from "Steven" who self-identifies as a CCL teacher:
the reason that EBF is not mentioned in the same way in CCL teaching as it was previously… is because EBF is not NFP. While breastfeeding has many benefits for mother, baby and everyone in the family (including Dad!) it is simply not a reliable method of spacing babies.
CCL's focus is on teaching the sympto-thermal method of NFP, which is very reliable if used correctly….there is no way to ensure that EBF will lead to extended post-partum infertility. I agree that it increases the odds, but there are many women who have an early return of fertility who are faithfully applying the seven standards of EBF. …
However, the CCL curriculum still highlights breastfeeding and encourages couples to breastfeed their babies for many of the reasons you highlighted, including the delay of fertility that occurs for some, but not all, women. … I believe that our current policy of focusing on reliable methods of NFP and including the benefits of breastfeeding in our program is the right one.
The author responds:
I do understand how EBF is not the same as NFP. However, if EBF is wholly embraced it can be a reliable form of natural child spacing for many women…
And at this point, I say: I guess that depends on what you mean by "reliable."
I am an NFP user, CCL-trained, who has had 4 children and no surprises (yet), and has never weaned before the age of 3. Lactational amenorrhea has ended for me at 6m, 7m, and 11m postpartum (still going at 8m right now).
Let us take for granted that I am on board with Church teaching and can write purely about practical matters of pregnancy spacing.
At this point I would not use the term "reliable" to describe ecological breastfeeding for spacing. Some women are fortunate (or blessed, or whatever term you want to use) to find that amenorrhea lasts a long time; some are not. Even if that were true for most women — maybe it is — the fact that you can't tell in advance whether you fall into the "most women" category would make it not "reliable" (it would if that "most" was "all but a tiny few" but it is not). There's a significant element of unpredictability there.
Rather contrary to the suggestion that women risk selfishly doing EBF for the fertility suppression at risk of harming their babies, I'd say that EBF is worth doing for the baby's sake, and if you get some spacing out of it, that's just a bonus.
Another thing I want to throw out there: A lot of people seem to be measuring the "reliability" of EBF as a baby-spacing means with "how many months of amenorrhea did I get." I'd say that unless you're happy with lactation being your only spacing mechanism — which is fine for many families, I know — the measure of reliability has a lot more to do with whether you can detect the return of fertility clearly enough that you know when to start abstaining in anticipation of switching to NFP.
If you look at my "how many months" data, it sounds pretty good. I wasn't following the 7 standards the first time (I was in grad school and did a lot of pumping) and I still got 6 months of amenorrhea. Here I am still not cycling at 8m postpartum.
But for us, it has been a significant sacrifice to continue with lactational amenorrhea. I haven't (yet) tried to kick-start the cycles by depriving my baby of time he needs with me, but we've certainly been tempted. And the reason for that is that my pattern of return to fertility has been an early onset of fertility signs which last many, many weeks. And no, before you tell me it is probably a "basic infertile pattern," I can assure you that it is not, not according to any sort of system (CCL, Creighton, or Billings). EWM for months straight. Oh, and, three out of three times, the first ovulation has occurred without a "warning period."
I wouldn't use the term "unreliable" either for EBF — the connotations of the word are too negative. Truth is, it's useful for many couples. Many informed couples are, clearly, willing to rely upon it because of their own very subjective judgment; which is what matters for them. And again, the standards that increase the odds are good for babies and worthy for that reason. But I'm not willing to call it "reliable" under any objective standard. There's just not enough predictability.
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