I've talked to several mothers who have trouble conceiving while
breastfeeding a toddler, it is particularly difficult when mom is over 40 and
wondering if her fertility clock will still be ticking if she waits for the
first child to wean naturally.  OTOH she doesn't want to wean only to
discover another child isn't possible for her and then grieve the lost bf
relationship.

I remember a study in which average time to conception during bf *after the
return of menses* was 15 months.  Not sure if prolactin or some other
mechanism is at work, but I'm guessing the issue is more ovulation than
implantation.

She might consider learning more about natural family planning, charting her
ovulation with temperature and/or mucus (or buying those ovulation predictor
kits).  This wouldn't interfere with bf and would yield valuable info.  It
would also focus the couple's efforts on the most likely times of the
month.....that doesn't always happen by accident with a toddler in the house
;-)  She might also consider gently scaling back the frequency of bf
(especially during the night) during the middle of her cycle, small changes
could make a big difference in fertility.

Elaine Ziska
Jackson, MS

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