Rus Articles Journal

``Safe`` period. Whether contraception is necessary to the feeding mother?

Exist rather popular belief that during feeding by a breast the woman cannot become pregnant. So really happens not always. In this article we will talk about those cases when breastfeeding can really serve as a contraception method.

the physiology has some

the Postnatal period one of important stages of life of the woman. At this time in its organism there is a restoration of all changes caused by pregnancy in genitals endocrine, nervous, is warm - vascular and other systems. The risk of approach of pregnancy increases by 6 months after the delivery irrespective of, the woman nurses or not. On 7 - 8 - y to week restoration of a mucous membrane of a uterus comes to an end. In 6 weeks after the delivery at 15% which are not feeding and at 5% of the nursing women the ovulation - an ovum exit from an ovary is noted. Out of pregnancy the ovulation occurs in the middle of each menstrual cycle.

the Ovum which ripened in an ovary leaves in an abdominal cavity then gets into a uterine tube. There it can meet a spermatozoon - in this case there will be a fertilization. That is the ovulation is one of highlights which defines a possibility of conception in this menstrual cycle.

During pregnancy and several months after the delivery ovulations do not occur. The earliest ovulation is registered on 4 - y to week after the delivery. Thus, to 3 - mu to month after the delivery the woman is potentially capable to become pregnant. By this time production of the hormones providing cyclic changes in the woman`s organism during a menstrual cycle is restored.

during pregnancy production of Prolactinum (it is developed by gland located in a brain) - one of the hormones participating in blocking of maturing of an ovum in ovaries increases. Prolactinum provides preparation of mammary glands for a lactation. By the end of pregnancy, with approach of childbirth, oxytocin hormone level increases. Both of these hormones - Prolactinum and oxytocin - provide a lactation (from armor. lacto “I feed with milk“) - formation of milk in mammary glands and its periodic removal. The mechanism of a straight line and feedback between intensity and duration of sucking of a breast and production of Prolactinum and oxytocin turns on. On the one hand, a large amount of Prolactinum provides formation of a lactation, and with another - maintenance of a lactation promotes preservation of high level of Prolactinum. As a result of it at the women nursing the child on demand conditions to suppression of an ovulation, lengthening of the period of restoration of periods are created. The period of breastfeeding and lack of periods call laktatsionny amenorey.

with

As MLA “works“?

the Method of a Laktatsionny Amenorea (MLA) is a natural method of the prevention of pregnancy since for protection from pregnancy use breastfeeding.

Breastfeeding is provided to

with laktatsionny reflexes which are regulated by the highest departments of the central nervous system. The complex of pacifiers - an areola (an okolososkovy circle) is supplied with a large number of nervous receptors which sensitivity increases in process of increase in term of pregnancy and reaches a maximum in the first days after the delivery. The irritation of these receptors when sucking starts the reflex mechanisms leading to development of oxytocin and Prolactinum - the hormones regulating a lactation.

the Reflex of production of milk (Prolactinum reflex) is connected by

with production of hormone of Prolactinum when sucking a breast, and Prolactinum, in turn, stimulates production of milk in a mammary gland. The longer the child sucks a breast, the milk is produced more. Production of Prolactinum has a certain daily rhythm. Its highest level is registered at night, in 2 - 3 hours after falling asleep, the lowest - from 10 to 14 o`clock in the afternoon. Therefore, feeding by a breast has to happen, at least, each 4 hours during the day and each 6 hours at night. Prolactinum suppresses activity of ovaries, constraining an ovulation therefore breastfeeding and protects at night from new pregnancy in 98% of cases in the afternoon. Thanks to Prolactinum reflex the mammary gland develops enough milk for successful breastfeeding.

Not less necessary for satisfaction of the child is oxytocin reflex, or a reflex of release of milk. In the course of sucking in response to irritation of a nipple in a back share of a hypophysis hormone oxytocin is produced, forcing milk to be emitted outside. Oxytocin is called “love hormone“: mother is happy when milk well follows and her child is satisfied. Thoughts of the child full of love, a type of the child strengthen a reflex, and the stress, pain, nervousness suppress oxytocin reflex. Breast milk contains substances (inhibitors) which reduce its development. If breast milk when sucking or at decantation is removed from mammary glands - these substances are removed too, and then the mammary gland produces more milk. Therefore if the child temporarily does not suck a breast, milk needs to be decanted that its development did not stop. Depletion of a mammary gland is the strongest stimulator of its work.

laktatsionny reflexes provide to

In the early postnatal period formation of a normal lactation therefore for the subsequent successful feeding by a breast it is desirable to carry out the first applying in the first hour after the birth when reflexes of the child and sensitivity of a complex of pacifiers - an areola are highest.

Only full only breastfeeding reduces probability of pregnancy in the first 6 months after the delivery.

The more intensively feeding by a breast (frequent, upon the demand of the child, applying to a breast to 10 times, feeding as in the afternoon, and in the night from night breaks no more than 6 hours, feeding by both mammary glands), the longer the period of inability to fertilization and the less often arises pregnancy before emergence of periods.

When MLA ceases to work with

?

Though with a high frequency of feeding only a breast ability to fertilization after menstrual bleeding is still significantly suppressed by

, emergence of periods remains the most reliable sign of restoration of ability to fertilization.

in process of increase in number of the months which passed after the delivery the risk of an ovulation before renewal of periods gradually increases. After six months use only of a method of a laktatsionny amenorea as contraceptive is inadmissible. The six-months boundary was chosen also because by this time mothers recommend to lure the child. It begin to separate from a breast that leads to increase in intervals between feedings, so - to increase in risk of approach of new pregnancy.

of MLA as the method of contraception differs in the fact that it is possible to speak about its reliability only at observance of a number of conditions: lack of periods, is exclusive breastfeeding, the age of the child is less than 6 months. Perl`s index (number of the unplanned pregnancies which arose at 100 women using this method within a year) in this case is equal to 2. For comparison: when using condoms it is equal to 14. Even when using a hormonal preparation, purely progestinovy “pass - saw“, recommended in the postnatal period, Perl`s index is equal to 5. If after application of MLA for 6 months after the delivery at the woman remains amenoreya and she continues to nurse before each prikarmlivaniye, then an opportunity to prolong MLA till 9 - 12 months is created. Perl`s index in these cases makes 3 - 6.

method Shortcomings

with
  1. In a case when any of three necessary conditions of use of MLA is not carried out (there is a renewal of periods, feeding by a breast irregular or the child is more senior than 6 months), it is necessary to pass to other ways of contraception which are not influencing a lactation and development of the child in due time.
  2. Time of action of protection is limited to
  3. till 6 months.
  4. does not have
  5. protection against infections, sexually transmitted.
  6. Reliability of a method depends on observance of rules of breastfeeding. Today changed socially - the biological status of the woman, her role increased in society, policy, business. The principles only of breastfeeding are not always suitable if mother works or studies.

When can renew sex life?

after the delivery should limit to

Within the first 6 - 8 weeks sex life as at this time there is a restoration of an organism of the woman after the delivery. In a uterus - in the field of the platform to which the placenta was attached there is an extensive wound surface, from a genital tract so-called lokhiya are allocated. The uterus neck, a body of a uterus are reduced gradually, not at once get the prenatal sizes. Right after childbirth the neck of a uterus remains rather short, the channel of a neck conducting in a uterus cavity - is open. All these conditions are the contributing factor for infection of a uterus in the postnatal period. Therefore after postnatal allocations (it occurs just in 6 - 8 weeks) will stop, it is necessary to address the doctor. Only after survey it is possible to get permission to renewal of sex life.

of Advantage of a method

  1. Application of MLA is controlled by the woman, this method cannot be carried to typically medical procedure, he does not demand medical supervision.
  2. of MLA is the effective method of contraception applied after the delivery which not only improves feeding by a breast, but also provides timely transition to the lactation period to use of other contraceptive means.
  3. the Method favorably affects on health of mother and child. The children receiving exclusively breast milk are ill in the childhood less often, and in an adult state are less subject to chronic diseases, cancer, blood diseases.
  4. At mother the risk of postnatal inflammatory diseases of a uterus decreases, the lactation is a prophylactic of a breast cancer.

So as we see, a method of a laktatsionny amenorea can be used as a contraceptive only with 1 - go on 6 - y month of the postnatal period, at careful observance of rules of breastfeeding “on demand“. In other cases use of other methods of contraception is necessary.