Preparing for Pregnancy While Breastfeeding: Common Concerns and Questions

Preparing for pregnancy during breastfeeding?

Hello, Doctor: I have a one-and-a-half-year-old daughter whom I have been breastfeeding, currently twice a day.
I have been trying to conceive for the past four months.
My menstrual cycle is 30 days and regular.
My last menstrual period started on July 9.
I have a few questions:
1.
On July 24, I experienced lower abdominal cramps for about two days and some breast tenderness.
Could this indicate that I am preparing to ovulate or that I am currently ovulating?
2.
Is it possible to have a menstrual period without ovulation during the breastfeeding period? I have been getting my period every month since my daughter was nine months old.

3.
If I become pregnant while breastfeeding, will I definitely experience nipple pain during breastfeeding?
4.
From July 19 to July 27, we had intercourse every two to three days, and on August 1 and August 3 as well.
I was anxious and took a pregnancy test on the morning of August 3, which was negative.
I have no pregnancy symptoms such as breast tenderness, abdominal discomfort, or excessive sleepiness, only dizziness.
Is there still a possibility that I could be pregnant this month? Thank you for your answers.

Lam, 30~39 year old female. Ask Date: 2019/08/04

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have a one-and-a-half-year-old daughter whom I have been breastfeeding exclusively, and now I am nursing her in the morning and evening.
I have been trying to conceive for the past four months.
My menstrual cycle is 30 days and regular.
My last menstrual period started on July 9.

1.
On July 24, I experienced lower abdominal cramps for about two days and some breast tenderness.
Is this preparing for ovulation or is it ovulation occurring?
Answer: Ovulation is occurring.
2.
Is it possible to have a menstrual period without ovulation during the breastfeeding period? I have been having regular periods since my daughter was nine months old.

Answer: Yes, it is possible.
3.
If I become pregnant while breastfeeding, will my nipples definitely feel painful?
Answer: Not necessarily.
4.
From July 19 to July 27, we had intercourse every two to three days, and on August 1 and August 3 as well.
I was too anxious and took a pregnancy test on the morning of August 3, which was negative.
I have no pregnancy symptoms such as breast tenderness, abdominal discomfort, or excessive sleepiness, only dizziness.
Is there still a possibility of becoming pregnant this month?
Answer: There is a possibility of becoming pregnant in August; test for pregnancy in September.

Reply Date: 2019/08/04

More Info

Preparing for pregnancy while breastfeeding can raise several concerns and questions for new mothers. It’s important to understand how breastfeeding can affect your menstrual cycle, ovulation, and the possibility of conceiving again. Here, I will address your specific questions and provide some additional insights based on medical knowledge.

1. Ovulation Symptoms: The pain you experienced in your lower abdomen around July 24 could indeed be related to ovulation. This is often referred to as "mittelschmerz," which is a German term for "middle pain." It occurs when an ovary releases an egg, and some women experience discomfort or pain during this time. Breast tenderness can also accompany ovulation due to hormonal changes. If your menstrual cycle is regular and you are tracking it, this pain could indicate that you are preparing to ovulate.

2. Menstruation During Breastfeeding: It is possible to have a menstrual cycle while breastfeeding, even if you are not ovulating. This phenomenon is known as "lactational amenorrhea," where the hormonal changes associated with breastfeeding can suppress ovulation. However, some women may experience what seems like a period without actually ovulating. Since you mentioned that your period returned when your daughter was nine months old, it is likely that you are experiencing regular cycles, but it’s essential to note that ovulation may not occur every cycle, especially while breastfeeding.

3. Breastfeeding and Pregnancy: If you become pregnant while breastfeeding, some women report experiencing nipple tenderness or pain during breastfeeding. This can be due to hormonal changes that occur during pregnancy. However, experiences vary widely; some women may not notice any discomfort at all. If you do experience pain, it’s essential to assess your comfort level and consider discussing it with a healthcare provider if it becomes severe.

4. Possibility of Pregnancy: Given that you have been actively trying to conceive and have had unprotected intercourse during your fertile window, there is still a possibility of becoming pregnant. The fact that you tested negative on August 3 does not rule out pregnancy, especially if you tested very early. Pregnancy tests are most accurate when taken after a missed period. If you are experiencing symptoms like dizziness, it could be related to hormonal changes, stress, or other factors. If your period does not arrive as expected, consider retesting in a few days or consulting with a healthcare provider for further evaluation.

Additional Insights:
- Breastfeeding and Fertility: Breastfeeding can naturally delay the return of fertility, but it is not a foolproof method of contraception. If you are actively trying to conceive, it’s important to monitor your cycle and be aware of ovulation signs.

- Nutritional Considerations: Preparing for pregnancy while breastfeeding requires attention to nutrition. Ensure you are consuming a balanced diet rich in vitamins and minerals to support both your health and the health of your breastfeeding child. Folic acid is particularly important for women trying to conceive.

- Consulting Healthcare Providers: If you have concerns about your menstrual cycle, ovulation, or the effects of breastfeeding on your fertility, it’s advisable to consult with a healthcare provider. They can provide personalized advice and may suggest tracking ovulation through methods such as basal body temperature or ovulation predictor kits.

In summary, while breastfeeding can influence your menstrual cycle and fertility, it is still possible to conceive. Monitoring your body’s signals and maintaining open communication with your healthcare provider can help you navigate this journey effectively.

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