Avoiding a Pregnancy While Nursing Pre-Term Infant


Question regarding NFP and Breastfeeding
I am currently seven weeks post-partum and breastfeeding exclusively, if not ecologically. I had a complicated pregnancy and c-section and my doctor warned I should not conceive for at least a year. This is my 4th baby and second c-section. I am a devout Catholic and can only use NFP.

My concern is that my baby was born pre-mature and was in the NICU for three days right after birth. He was put on IV and I wasn’t permitted to nurse him until 18 hours after he was born. I did nurse and hold him as long as possible and on demand…but when I had to return to my room to rest (the baby was not allowed to leave the NICU) the nurses gave him a pacifier. No more than two or three hours ever went by with me not going back to nurse him…then when I took him home he develped jaundice and was slow to gain weight. (He lost over a pound in the hospital.) My milk supply was low because even though I was nursing every two to three hours, he was just too sleepy and had a weak suck reflex. My doctor told me to supplement him for 24 hours to clear the jaundice so he would not have to work hard for a few ounces.

I was devastated, as I know this can ruin breastfeeding….I did what I thought would help my milk supply increase…I breastfed the baby on both sides and then immediately went to the pump for an additional 15 minutes. I gave the baby whatever expressed milk I got in the bottle….then usually I would bring him back to the breast hoping to prevent nipple confusion or flow preference. I only had to do this for about a week and my milk supply was adequate and I stopped all bottles and pumping. Since then, I ONLY breastfeed … day and night. I sleep with the baby in my bed and I let him nurse as long as he wants. He is only given a pacifier when I am in the car and can’t nurse him or if someone visits and wants to hold him…but that is very limited…only about 15 minutes. I never give him the pacifer at home or at night.

Do you think I can consider myself an ecological breastfeeder? That is my goal. Or is it not possible because of the problems in the beginning? I have not gotten my period yet. We only had intercourse once at five weeks. My husband is wonderfully supportive and fears that if I conceive I will die from a uterine rupture. I miss the intimacy with my husband. We had to abstain for nearly my entire pregancy because I had a placental separation and hemorrhaged at 11 weeks. I feel that my marriage would survive if we can’t engage in martial relations…but we both certainly miss being together.

Despite the rough start with my baby…I breastfeed all day long and frequently at night too. I carry him in a sling or in my arms…I am never separated from him. I just need to know if I can depend on my breastfeeding as NFP? I would greatly appreciate any help in this matter…God Bless you and thank you for this web site that is so informative!!

Sincerely, Lisa


Last Updated: December 1, 2021
Dear Lisa,

You are a hero—-going to great lengths to offer your baby the best mothering. You have nothing to apologize for, or regret.

You seem to equate any pattern of breastfeeding other than your intended one with a pregnancy sooner than desired. I would stress instead of focusing on achieving delay of fertility through a specific pattern of nursing, that you focus instead on being confident in recognizing the signs of fertility, whenever they return, permitting you to delay the next pregnancy until a more suitable time, for your health, and to fulfill your responsibilities to your family.

You were blessed to be able to continue to nurse your child, even while in the NICU, albeit not on the schedule you might have, had the baby been with you 24 and 7. It is entirely possible, even with your rough start, that with the pattern of nursing you describe, fertility may not return any sooner than it has in the past for you.

Perhaps in the past, you did not have a serious reason to avoid a pregnancy, and it worked best for your family to simply rely on breastfeeding to space your children. But with your current desire to avoid pregnancy for the near future, and with serious reason, the key is to be confident in identifying the return of fertility, rather than relying on breastfeeding to delay for any specified period of time. This will permit you and your husband to have the intimacy you express a desire for, with confidence in your ability to delay the next pregnancy, using the most effective means available, and without compromising the integrity of your marital relationship.

Though you have used NFP, if you have not felt a strong need to avoid pregnancy, you may not have ever been so concerned with accuracy in the past. The key now is to learn an effective method, or be re-educated in an effective method, and to work closely with an instructor to receive feedback that you are correctly understanding and applying the principles.

You can consult our website for a list of teachers in California, or call our office for more information.

Congratulations on the birth of your child, and kudos for your conscientious attention to the needs of your children, your husband, and your convictions!

Sheila St. John

Answered By:

Sheila St. John
Sheila St. John is the Executive Director of the California Association of Natural Family Planning, coordinating the non-profit’s education and advocacy efforts throughout the state. Initially attracted to NFP as a healthy, effective method for planning families, drug, device and surgery free, her passion for NFP has grown over the last 42 years as she has journeyed with the over 900 couples she has personally instructed in its use, and been privileged to witness its role in overcoming infertility, women’s health, and the transformation that occurs in lives of men, women, and families, when we embrace God’s design for love and life.

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