Dear all,

ptp

I have a mother breastfeeding a 7,5 month old baby. She and her baby enjoy breastfeeding very much and it is all going very well. :-D

The mother has not yet had her period. She and her partner would like to become pregnant again. The mother feeds between 7-9 and expresses her milk at work at 11 am and 15 pm. She then feeds when returning to home about 2 times. The baby sleeps from 21 pm until next morning. 

The mother has a slightly slow working thyroid and both she and her partner are carrier of Progeria. They have lost one child previously. 

The mother takes Citalopram, which states Amenorrhea as a side effect. Now I would think that this might have more impact on her absence of menstruation cycle than when she would cut down in her number of breastfeeds. A part from that my gut feeling would be to wait a month or two and see what happens, but maybe it might be a good idea for her to talk to her doctor about her Citalopram use and perhaps change to Escilatopram as the suggested alternative?

Apart from her medication: what role could the slower working thyroid play in all this? 

I found following percentages: 9-30% of women that begin menstruating again at month 0-3 while breastfeeding, and 19-53% at 6 months, with some not having their cycle back until they fully weaned. These numbers seem quite dated: (1972, 1987 and 1999) Would any of you have more recent references?

Please advice!
Thanks!
Warm regards from rainy monday ;-)
Heidi Akkers, IBCLC in PP
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