Waiting for the Right Time: Lactational Amenorrhea

So, when are you going to give your toddler a new baby brother or sister? When do you think you'll try again? Are you planning on having other children?

I know that people mean well when they ask these kinds of questions. I know that they are just excited and want to know more about how we plan to shape our family. However, these questions just aren't relative to our lives right now because I have had no fertile cycles since my son was born almost two years ago. I am in the midst of lactational amernorrhea. This means that I have not had a regular period since October of 2008. So, when am I going to give my toddler a baby brother or sister? Um, sometime after my body decides it's ready to support another child.

Before I started nursing my son, I knew almost nothing about breastfeeding. In fact, I was even a little scared of it because I had never personally known anyone who nursed their children. (Apparently, I had some relatives who did nurse their children, but it was before I knew them or I didn't grow up around them.) My plan when I was pregnant was to try nursing and I hoped it would work, but I didn't really expect it, too. Especially since I didn't really have anyone in my day to day life that knew anything about it. If it worked, I was sure that I'd wean my baby by the time he was a year old.

Then, I became a mother and not just any mother, the mother to my son and all of his needs, emotional and nutritional. In fact, I sometimes think that God might have created my son's cesarean section, colic, reflux, severe food sensitivities, inability to sleep, and head cyst surgery (at the age of ten months), because without that kind of incentive I would never have chosen to research and do the things I do now (like co-sleeping, healthy, organic eating, extended nursing, cloth diapering, even chiropractic care!). These are aspects of our relationship and our lives that I treasure and that I am thankful to my son for leading us to every day! He has made me be a better mother than I might have been to an "easier" child.

And two years later, we're still going strong with no immediate plans to do weaning at any pace other than the one my son is currently setting. Is it weird nursing a toddler? Nope. Not for us. It's a mutually content relationship and I think that our nursing relationship, like our bed sharing relationship, fulfills his need for security and anyone who knows my toddler can attest that he is one independent and secure little guy. He's even dropped quite a few nursings and is sleeping a little better at night, so I know that the inevitable weaning will occur.

Yet, my period has not returned. If someone had told me five or six years ago that extended nursing would keep my monthly cycle at bay for years, I would have said, can I start now? Because, well, periods aren't very much fun. However, I'm finding more and more that I miss mine. I miss what they stand for. Even though I'm not sure our family is ready for a fourth member quite yet, I miss having the option of making that decision. As a woman who is now thirty, I worry about how much time I might have left. I'd like to have two more children, but if my fertility does not return soon and it takes us awhile to conceive a second when it does . .. well, I may have to rethink that plan.

I know that this is the point when many of you are wondering why I do not night wean my almost two year old son and then start weaning during the day. I know that is an option, but at this point, I respect that our son is only asking for what he still psychologically (and even physically) needs. I see it as very similar to my choice last year (when he was almost one) of accepting his night waking and sleep sharing as normal. I decided to trust that when he was ready, he would sleep through the night, and although that has not happened yet, I fully believe that he has come a long way and it will happen when he's ready (like walking, talking, and all of his other milestones). Weaning will be the same. What I'm trying to do is to trust my body as much as I have trusted his. It's a hard thing to put your faith out there and trust, but I think it is necessary in this case. I have placed my trust in my body and God before and I feel like I should again. I could try to take fate into my own hands and force him to wean, and know that my fertility will likely return shortly thereafter, but that would be no guarantee (as every woman who has had to "try" to get pregnant knows, that I would actually get pregnant when I wanted to. What is guaranteed is the child I already have and his needs. It is possible that I might not get pregnant until when our natural nursing relationship would have ended anyway.

Last year, when his sleeping patterns involved waking up seven to eight times a night. I kept a copy of Dr. Sear's The Baby Sleep Book next to my bed and whenever I felt myself doubting, I would pick it up and be assured that my son would sleep eventually. This year, I've replaced that book with Natural Child Spacing by Sheila Kippley. Before reading that book, I had no idea that I was "ecological breastfeeding," I was just nursing my child when he seemed to want and need it. According to that text, my fertility will likely return any time, and will certainly return before he is four, and considering the thoroughness of her research, I believe her. Until then I wait.

Thanks!

Confused About When To Wean? Your Baby Has The Answer.

It has been nearly a full week since the first media buzz about a new study that contradicts the World Health Organization’s recommendations to breastfeed exclusively for at least 6 months. Originally published in the British Medical Journal, a new review basically states that waiting 6 months to introduce solid foods (wean) may leave babies at an increased risk of iron deficiencies, obesity and food allergies. Instead the authors suggest starting the weaning process at 4 months of age. Not surprisingly, the main stream media took it upon themselves to turn this into fear mongering headlines like ‘Breastfeeding for 6 months is too long and could hurt babies’.

The World Health Organization and UNICEF have both released statements backing up their 6 month recommendations, sighting that this one review in the British Medical Journal is contradicted by thousands of other studies and the data used in this review is incomplete. It should also be noted that 3 of the 4 authors received funding from the commercial baby food industry. You can find a summary of this article's many flaws on the Baby Milk Action website.

UK officials have apparently asked that further studies be conducted to review their own official recommendations that babies be exclusively breastfed for 6 months. In the mean time, confusion and fear have won out causing many new parents to question their decision to breastfeed, and when to start the weaning process. I am going to go out on a limb and suggest that is exactly the reaction the baby food industry was hoping for.

Regardless of how this whole scenario plays out, and whether or not the UK changes it’s current recommendation from 6 months to 4 months, here's what I think:

Instead of health professionals adding confusion, stress, and pressure on parents by advising that they mark a date on a calendar to start introducing complementary foods, why not educate parents about the physical and developmental signs that their child is actually ready to eat solid foods? While the recommendation to start the weaning process at 6 months is a nice guideline that loosely fits the average baby, there are some babies who show all signs of readiness before 6 months and still more who don’t show all of the signs until later.

The developmental signs that a baby is ready to start solid foods, and the reasons they are so important are*:

- The ability to sit upright unassisted. A baby who is sitting upright without being propped or supported is better able to chew and swallow foods without choking. Tipping a baby too young to sit up backwards to feed them is a very real and dangerous choking hazard!
- Loss of the thrust reflex. The thrust reflex causes babies to thrust their tongue forward to spit out any foreign objects or substances. This reflex protects a baby’s airway from becoming blocked and is your baby’s way of telling you ‘I am just not ready’. Many parents who start solid foods too early will remark that their baby ‘spits it out and doesn’t seem to like it’ this is a sign to stop, not to try different foods.
- The ability to grasp and bring objects/food to the mouth. With the ability to place objects in his or her own mouth, comes the ability to feed him or her self. Just like a breastfed baby self regulates how much milk to drink at the breast, he should also be able to self regulate how much or little solid foods he eats by feeding himself. Spoon feeding infants before they are ready to self feed can lead to over feeding, and without taking proper care to read baby’s cues and offer solids without decreasing breast milk intake, this over feeding can cause milk supply issues and end nursing relationships before the recommended one to two years.
- An interest in food such as watching and mimicking others eating, and grabbing at food that others have. It should be noted that some very young babies show this behaviour so it is important that this be taken as a sign of readiness only AFTER all other milestones have been reached. Conversely, if your child has hit all of the above milestones but does not show any interest in eating it is better to wait until they start to show interest instead of forcing the issue.

Looking at these developmental signs of readiness, it is laughable to suggest that the average 4 month old would be ready to eat anything other than his or her mother’s milk. But I can see why those who work in the baby food industry wouldn’t want parents to wait for all of these signs. Once your baby is ready, REALLY ready to eat solid foods, there is no need to finely puree and mash all of his or her food or buy jars of liquid fruits and vegetables or feed them powdered cereals mixed with water or milk.**

Once your baby has hit ALL of the developmental milestones needed to start solid foods, he or she will be able to start with finger foods, a practice known as baby led weaning. The basic principle of baby led weaning is to offer pieces of nutritious whole foods for your child to explore and self feed while still receiving most of their nutrition from breast milk or formula. Avocado chunks are a popular first food for baby lead weaning, other popular early foods include whole bananas and steamed vegetable spears. You can learn more about the practice of baby led weaning here.


If you're still not convinced, and are not interested in making your own mashed baby foods, there is certainly nothing wrong with that, but I would still steer clear of commercial baby foods and encourage you to look for mom-preneurs in your area who may deliver home made baby food for a fee, or click here to read a Connected Mom review of organic preservative-free super yummy and flavorful baby food by Ella's Kitchen.

No matter how you choose to introduce solid foods to your baby, the when is still very very important. Anyone who may be swayed by this latest review, and the media blowing it far out of proportion by making bold statements with incomplete information, I encourage you to look further into what the data is actually saying. Think about what the baby food industry has to gain, and what you and your family has to loose in making the decision to introduce solid foods early***. I am not trying to sound alarmist or paranoid, but the baby food industry is not exactly known for their ethics where their bottom line is concerned. If you are concerned about obesity, iron levels or food allergies, please talk to your doctor about it, and know that there are many other less bias studies that show delaying the introduction of solids until your baby is 6 months old is the safest and healthiest choice.

*These signs were gathered and consolidated into the bullet points on my list from the Ask Dr. Sears website and my favorite baby food website Whole Baby Foods.

**Kim, a nutritionist who runs Your Green Baby has written this must read article about baby rice cereals.

** See Dr. Sears on Allergies, Kellymom.com on benefits of delaying solids, Le Leche League Information on unwanted/early weaning