In an effort to kill several birds with one stone, I'm going to start writing book reports on my blog. This will result in (a) more blogging (b) getting myself back into the swing of writing (c) better comprehension of the books I'm reading and (d) when regarding breastfeeding books, getting the book reports written which are necessary for becoming a La Leche League leader (which I'm considering).
Okay so here's the first. Beware: This could bore some readers.
Breastfeeding and Natural Child Spacing by Sheila Kippley
The title is clear enough; this book is about how breastfeeding can result in natural child spacing. Yet for a book on child spacing and infertility (known also as lactational amenorrhea), there is extremely little information on the biology of the female reproductive system and how lactation affects ovulation. Perhaps this is because so little is yet known about it, though the book fails to mention even the very basic mechanics of hormonal suppression, which I expected to be discussed. In fact, the book speaks very little about natural child spacing at all. It focuses primarily on a model of mothering the author calls 'natural mothering' and on total breastfeeding, or in the author's words, 'ecological breastfeeding' (referring to the ecological system of mother and baby both benefiting one another).
Having said that, everything the book discusses is incredibly important for achieving natural infertility through breastfeeding. Though she only brings the discussion back to the topic of child spacing every now and again, the subjects she spends a great deal of time on, such as night feedings/co-sleeping, pacifiers and bottles, weaning, and mother-baby oneness, are all directly related to how long a lactating mother can suppress ovulation.
It is commonly heard that breastfeeding cannot keep a mother from becoming pregnant. There is good reason for this myth, and that is the fact that total breastfeeding is a mostly abandoned practice in urbanised societies. A majority of breastfeeding mothers who claim to be 'only breastfeeding' are actually still resorting to non-breastfeeding-supporting practices such as the use of pacifiers and bottle feeding, even if the bottle is filled with breastmilk. Many have young babies sleeping through the night. Many leave their babies with sitters while going out, resulting in missed feeds. This book explains how breastfeeding can and does cause natural infertility, when it is practiced totally, or completely.
The concept she refers to as natural mothering can be briefly summed up as a mothering style that does not resort to any mother subsitutes. In order for natural infertility to continue as long as possible, though some mothers may get away with more than others, a mother must rely on breastfeeding alone, with no pacifiers/dummies or bottle-feeding - even expressed breastmilk - to both nourish and comfort her baby. This nourishment and comforting must take place consistently and often to achieve long-term post-partum infertility. Even the occasional missed feed, pacifier, or evening out, could be enough for some mothers to resume ovulation.
Night feedings are emphasised as one of the most important factors in post-partum infertility. While society expects, encourages, and sometimes even forces, sleeping through the night, babies must nurse often through the night to produce enough stimulation to avoid early ovulation. It is documented that many mothers resume menstruation once their children begin sleeping through the night. Frequency is important. The author mentions that she often tells mothers that 'if their baby is down to five or six nursing a day, fertility can be expected to return soon if it hasn't already' (p135). The use of pacifiers, bottles or cups, or supplements such as formula, water or solids can also bring an early end to lactational amenorrhea, due to the reduction in nipple stimulation. Some mothers may find that even after only one feeding given by bottle, periods resume. The same goes for any missed feedings, whether they be intentional for weaning purposes or the occasional night out without the baby. (One chapter of the book is solely dedicated to encouraging mothers to take their babies everywhere with them, detailing stories of unusual places mothers have taken their babies, and the ease in which this can be done, thanks to breastfeeding.)
Weaning, which is described as the first time anything other than breast itself, is given to the baby, was also discussed at length. Considering that most babies will be ready for solids sometime around the middle of the first year, one might assume that given the principles of total breastfeeding already described, ovulation ought to resume upon the start of weaning. However, the author explains how gradual and timely weaning can allow amenorrhea to continue, though due to the lack of biological reasoning other than frequent suckling, it is somewhat unclear how this happens. Her belief is that 'it is the entire package we call "natural mothering" that spaces babies; it is that form of baby care that results in the Creator's original form of natural family planning' (Appendix II, p199).
According to research done by the author, 'women who adopt the natural mothering program will average 14.5 months without periods following childbirth' (p81, author's emphasis). This was based on a sample of 98 ecological breastfeeding experiences. (Another study of 112 nursing experiences rendered almost identical results, with an average of 14.6 months amenorrhea.) This result was compared to 186 experiences of typical, or 'cultural', breastfeeding, where an average of 10.3 months amenorrhea was found.
It is important that I also mention a valuable point made by the author: Ecological breastfeeding and natural mothering should not be practiced soley to achieve infertility. Natural child spacing should really be only a fringe benefit of the whole natural mothering concept. I believe this is partially why the book focuses so much on natural mothering and only occasionally relates it to child spacing. The author is not trying to promote child spacing for child spacing's sake, but rather a mothering program that will enrich the lives of mother and baby.
While the book was overall very informative about how to best achieve prolonged lactational amenorrhea, I would be very hesitant to recommend the book to just anybody. Not that I disagree with the material or the points made, but I found the author's bluntness regarding total breastfeeding sometimes off-putting. For a mother who might be sensitive about decisions she's made or difficulties she's had with breastfeeding, which may have led to the use of substitutes, I would not recommend this book. However, to a mother interested in total breastfeeding or natural family planning, I would suggest a giving this book a read - with the caveat that they don't judge themselves too harshly against the 'total mothering' model. None of us are perfect mothers. If you can read the book with that truth firmly and confidently in place, then I think you'll find this book to be extremely interesting and valuable.