As many of you will now know, I’m expecting baby number two in July. Exciting times!! I’ll be updating lots of my blogs on Pregnancy Nutrition very soon, and writing lots more content about this area too. Today I wanted to work with a specialist all about tips for getting your fertility back on track for baby number two.
What you need to know from an obstetrician and gynaecologist
Written by Dr Brooke Vandermolen. Obstetrics & Gynaecology doctor, medical writer & blogger www.theobgynmum.com
It’s a big step when you decide it’s time to try to conceive again, and your cycles may have changed since you conceived the first time! There are so many factors that can play into that decision as to whether you’re ready.
Once you know that it is time to expand your family, it can be frustrating if things don’t happen immediately! Here are some tips you may need to know about your body after pregnancy, and trying to conceive your next child.
Menstrual Cycles after pregnancy
- The breastfeeding hormone (prolactin) suppresses the other hormones involved in the menstrual cycle and so prevents ovulation, so most women experience at least a few months without a period whilst nursing.
- You may notice your first period is heavier and slightly more painful than before pregnancy
- This may continue for the first few cycles, which may be irregular at first. It usually settles over time as the hormone levels balance out.
- If your periods remain heavy and difficult to manage, you should see your GP for basic blood tests and an ultrasound.
What influences whether periods restart?
- Frequency of nursing – the more often baby feeds throughout day and night, the less likely periods are to restart. It appears that night feeds are even more important for suppression of ovulation, so increasing the gap between night feeds, or continuing night feeds with expressed milk from a bottle might be enough to allow ovulation to restart.
- After time the introduction of solid foods may reduce the amount of milk baby takes and the frequency of feeds.
- Use of bottles/dummies reduce nipple suckling so increase likelihood of ovulation restarting.
Once you begin to see your periods you can track them. If they are regular, it is likely you are ovulating again. It may take 6 months to regulate from when breastfeeding stops (or from birth if not breastfeeding).
Can I get pregnant while breastfeeding?
- The short answer is yes but the factors above will affect how quickly this happens.
- If periods returned regularly then it is likely fertility is close to normal.
- If you’re wanting to conceive another baby, and your periods haven’t restarted you may wish to consider weaning baby off the breast, if this is right for your family. Abrupt cessation of lactation is likely to cause a quicker return to fertility.
- You can continue breastfeeding and still conceive if you change the pattern of feeds (shorter feeds, with more gaps between them by introducing some expressed bottles in-between. This is particularly relevant for night feeds too).
Most women find their periods return between 9-18 months post partum although but we do know that continued breastfeeding will cause spikes in prolactin levels which can be enough to impact fertility.
Preparing your body to conceive
- Step 1 – prepare your bodies.
Optimise your diet and take part in regular exercise, which can help you to achieve a healthy weight
Supplements – mainly folic acid is recommended when trying to conceive
Caffeine – keep to under 200mg per day, about 2 mugs of instant coffee
Alcohol and smoking- reducing this for both of you increases your chances of conceiving, improves sex drive and semen quality.
Anabolic steroids and cannabis – avoid these as they are known to affect fertility
Try to improve the quality of your sleep and reduce stress (much easier said than done when you are already parents!)
- Step 2 – get to know your cycle
Observe your natural fertility indicators
Calculate when you expect to ovulate
If you have a regular cycle you may use a fertility monitor or ovulation prediction kit.
- Step 3 – regular intercourse
It is better to avoid storing sperm, so regular intercourse every 2 to 3 days is best so there are plenty of new swimmers available!
- Step 4 – know when it is time to seek help
if you have done all this, but it hasn’t happened for you yet, here’s when to see your GP:
No medical probs, woman is under 36 and TTC for 12 months
2. No medical probs, woman is over 36 and TTC for 6 months
3. You have concerns about your fertility or are taking any medications
4. If your periods are irregular (outside of the range 21 to 35 days) and you have been #TTC for over 6 months then see your GP.
This is where you already have a child but it takes over one year to conceive again.
Reduced or impaired sperm count
structural damage such as tube blockage, adhesions from surgery, worsening endometriosis
Reduced or impaired ovulation
Lifestyle factors that affect fertility such as smoking, obesity and breastfeeding
Investigations and Treatment:
Although you may not be eligible for NHS funded IVF, you can still have all the basic tests on the NHS. There is more information about what tests your GP would arrange after your initial visit here.
You can receive treatment on the NHS for any easily reversible conditions such as medication for ovulation.
Secondary infertility can be very isolating. Everyone expects that once you have one child that it will be easy in the future. Or if you had fertility treatment the first time that you should be ‘grateful’ to have one child. Above all, take things at your own pace and however works best for your family.
This is a blog all about trying for a second baby and how to prepare your body, especially from a medical and cycle position. If you’re interested in whether foods can help with this too, check out my blog on “fertility foods” which might be helpful!