Stephanie,
Fertility is quite variable so even though the mother is exclusively bf a 2
mo old and tandem nursing a 2 yo, her fertility may have returned. The LAM
method advises that mothers consider themselves to be fertile if some
conditions occur, and return of menses is one. If my memory serves me right,
I think 'usually' the first menses is anovulatory and can be considered a
'warning' to expect ovulation to return now.
The mother has many birth control options, as was recently discussed, but a
non-hormonal method would be preferred, to avoid  effect on milk supply.
Is the mother using pacifiers? Is the mother co-sleeping? Is the mother
working away from home at all, with regular separations from  the baby?
These issues have an impact on LAM/fertility too.


Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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