Is Breastfeeding Really Birth Control? The Truth About the Lactational Amenorrhea Method (The Nursing Method)

Breastfeeding is often praised as a natural and convenient form of birth control. You may have heard, “If you’re breastfeeding, you can’t get pregnant.” Well-meaning healthcare providers in the hospital even tell some women this after birth. It sounds almost too good to be true—nourish your baby, bond, and avoid another pregnancy without lifting a finger. But is it really that simple?

Like most things in women’s health, the reality is more complicated than a simple yes or no. The Lactational Amenorrhea Method, or LAM, is a real, science-backed way to prevent pregnancy, but only under particular conditions. And that’s where the confusion starts. Many women assume that as long as they’re nursing, they’re protected, only to find themselves staring at a positive pregnancy test months after giving birth.

I’ve seen it firsthand—women coming to me completely shocked, saying, “I didn’t even get my period yet! How is this possible?” The answer? Because the body doesn’t operate on myths. Ovulation can return without warning, and if you don’t understand how LAM works, you may be relying on a birth control method that stopped being effective weeks—or even months—ago.

This article is about giving you the facts that should have been explained from the start. If you’re relying on breastfeeding to prevent pregnancy, you need to understand when it works, when it doesn’t, and what backup options you may need.

So let’s break it all down: how does breastfeeding prevent pregnancy? When is it actually effective? And when is it about as reliable as crossing your fingers and hoping for the best?

How the Lactational Amenorrhea Method (LAM) Works

The concept behind LAM is straightforward: breastfeeding naturally suppresses ovulation. However, the reality is far more nuanced than simply stating that “nursing prevents pregnancy.” While it can serve as an effective form of birth control in certain situations, those situations are pretty specific—and if they are not fulfilled, the effectiveness declines rapidly.

LAM’s core is the hormone prolactin, which is essential for milk production. When a baby suckles frequently, the brain receives signals to maintain high levels of prolactin. As a result, prolactin suppresses gonadotropin-releasing hormone (GnRH), which triggers ovulation. If ovulation is suppressed, no egg is released, and without an egg, pregnancy cannot occur.

But here’s the catch: for LAM to be effective, all three of the following conditions must be met—and maintained:

1. You are exclusively breastfeeding. This means no formula, pacifiers, bottles, or long stretches between feeds (both day and night). The more time your baby spends at the breast, the stronger the ovulation-suppressing effect.
2. Your baby is under six months old. Around six months, babies typically start sleeping longer stretches or beginning solid foods, which can lower prolactin levels and allow ovulation to return.
3. You have not had a postpartum period yet. Once your period returns, even if irregular, your fertility is back in action, and LAM is no longer as reliable as birth control.

When followed correctly, LAM can be up to 98% effective, which puts it on par with some hormonal birth control methods. However, even minor deviations—like skipping feedings, supplementing with formula, or a baby naturally spacing out feedings overnight—can significantly reduce its reliability.

One of the biggest misconceptions about LAM is that any breastfeeding is enough to prevent pregnancy. But casual or occasional nursing won’t cut it. This method relies on constant and intensive breastfeeding, which is why it’s not a long-term birth control solution for most women.

So, while LAM can work in the right conditions, its effectiveness window is short, and understanding when that window closes is crucial for avoiding an unplanned pregnancy.

When LAM Fails: The Common Mistakes That Lead to Pregnancy

Many women depend on breastfeeding for birth control, only to end up unexpectedly pregnant. Why? Because even minor deviations from the strict guidelines of LAM can trigger ovulation sooner than anticipated. If you’re counting on breastfeeding to prevent pregnancy, it’s crucial to understand what can undermine its effectiveness.

1. Introducing a bottle or pacifier too early
   Many new moms believe occasional bottle-feeding or pacifier use won’t affect breastfeeding. However, even brief intervals away from nursing can decrease the frequency of breastfeeding, which lowers prolactin levels and may trigger ovulation earlier than anticipated. Additionally, babies who use pacifiers might spend less time suckling at the breast, which could further diminish the hormonal suppression of ovulation.
2. Longer gaps between feeds
   Breastfeeding as a form of birth control relies on frequent, around-the-clock nursing. If your baby sleeps through the night or extends feeding intervals during the day, prolactin levels may decrease, raising the chances of ovulation returning. Some women are caught off guard when their baby naturally begins to sleep longer—something most parents celebrate until they realize it could also indicate the return of their fertility.
3. Starting solids before six months
   Once a baby begins eating solid foods, they usually nurse less frequently. While breastfeeding may continue, the decreased demand can lower prolactin levels sufficiently to permit ovulation to resume. Some women think they are protected since they are still nursing, but adding solid foods can swiftly change the situation.
4. Your period returns
   Some women get their period back sooner than expected, even if they are exclusively breastfeeding. The return of menstruation indicates that fertility has resumed, which means LAM is no longer a dependable birth control method. Some women may ovulate before their first postpartum period, making pregnancy possible even without visible signs of fertility returning.
5. You’re past the six-month mark
   Even if you’re still nursing frequently, the effectiveness of LAM significantly decreases after six months. Prolactin levels naturally decrease over time, and their feeding patterns change as babies grow. By this point, many women begin to ovulate again, even if they haven’t had a period yet.

The bottom line is this: breastfeeding can suppress ovulation, but it’s not foolproof. If all the criteria for LAM aren’t met consistently, pregnancy can occur. Even when women adhere to all the guidelines, exceptions may still arise—because nature sometimes has its fertility plans.

Surprise Pregnancies: The Reality of Relying on Breastfeeding for Birth Control

Many women have been caught off guard by a positive pregnancy test while still breastfeeding—especially if they haven’t yet had a postpartum period. It’s a common misconception that if you’re not bleeding, you’re not fertile. However, the reality is that ovulation can occur before your first period. If you ovulate and engage in unprotected sex, pregnancy is possible, even if you haven’t observed any signs of your cycle returning.

I can’t tell you how many times I’ve heard women say, “I didn’t think I could get pregnant while breastfeeding.” They assume that because they haven’t resumed regular periods, their bodies aren’t capable of conceiving. But the truth is, just because you don’t see a cycle doesn’t mean your ovaries aren’t quietly gearing up in the background.

Some women may go months—or even a year or more—without having a period postpartum. That doesn’t necessarily mean they aren’t sporadically ovulating. The first ovulation can come unexpectedly, and without an obvious sign like menstruation, it’s impossible to predict when fertility has returned.

If you’re not ready for another pregnancy, it’s essential to understand the limitations of LAM. Breastfeeding can delay ovulation, but it doesn’t ensure protection. If you’re serious about preventing pregnancy, having a backup plan is crucial.

What Are Your Options If You Want to Avoid Pregnancy?

If you love the idea of hormone-free birth control but want to avoid the risk of an unexpected pregnancy. In that case, there are safer and more reliable alternatives to solely relying on breastfeeding. While LAM can be effective temporarily, many women discover they need a backup plan—especially as their baby grows and their cycles return unpredictably.

Here’s what you need to know about your options:

1. Fertility Awareness Methods (FAM)

Natural family planning methods, such as tracking basal body temperature, cervical mucus, and ovulation patterns, can help identify fertile and non-fertile days. The challenge? Postpartum cycles can be highly unpredictable, making this method more complicated in the initial months after giving birth. For it to work, you must be extremely consistent with your tracking and understand that ovulation can be erratic before your cycle fully regulates.

• Pros: It is entirely natural, has no side effects, and allows you to align with your body’s rhythms.
• Cons: requires daily tracking, can be unreliable when cycles are irregular, and demands significant commitment and precision.

2. Barrier Methods

If you want an easy, non-hormonal option that doesn’t rely on cycle tracking, barrier methods like condoms, diaphragms, and cervical caps are solid choices. These physically block sperm from reaching the egg, and when used correctly, they can be very effective.

• Condoms: Readily available, easy to use, and protect against STDs. When used correctly, male condoms are about 98% effective.
• Diaphragms & Cervical Caps: These require proper fitting and use with spermicide for maximum effectiveness, but they allow for spontaneity once inserted.
  • Pros: No hormones, easy to use, and reversible.
  • Cons: Requires correct and consistent use, and diaphragms/caps must be inserted before intercourse.

3. Non-Hormonal IUD (Copper IUD)

While I’m not a fan of IUDs in general, the copper IUD (Paragard) is an entirely hormone-free, long-term option. It prevents pregnancy by creating an inflammatory response in the uterus that is toxic to sperm. Once inserted, it provides over 10 years of contraception without affecting breastfeeding.

• Pros: 99% effective, long-lasting, and hormone-free.
• Cons: Can cause heavier periods and more cramping, and some women experience discomfort with insertion.

4. Withdrawal (The Pull-Out Method)

Withdrawal has a bad reputation, but it can be up to 96% effective when used correctly. The problem? “Correctly” is a big ask. This method requires trust, control, and perfect timing—things that aren’t always realistic in the heat of the moment. Even with perfect use, there’s still a small risk of pregnancy due to pre-ejaculation, which can contain sperm.

• Pros: No cost, no hormones, and always available.
• Cons: Requires a partner with excellent control and is far less effective with typical use.

5. Timing Sex Around Fertility (Natural Family Planning)

For couples who want a completely natural approach, waiting to resume intercourse until cycles become more predictable can be a cautious strategy. This is essentially an extension of FAM but requires abstinence during the postpartum period until ovulation patterns can be tracked accurately.

• Pros: No medical intervention, fully natural.
• Cons: Requires patience, may mean long periods of abstinence, and depends on diligent tracking once cycles return.

6. Hormonal Birth Control (Pills, Patches, Shots, and IUDs)

Hormonal birth control—including the pill, patch, shot, implant, and hormonal IUD—works by preventing ovulation, thickening cervical mucus, and thinning the uterine lining. While these methods are highly effective, I rarely recommend them to my clients due to their well-documented side effects, including low libido, mood changes, increased risk of blood clots, and potential long-term hormonal imbalances.

If you are considering hormonal birth control, here are some things to keep in mind:

• Estrogen-containing options (combination pills, the patch, and the ring) can reduce milk supply in some women, especially in the early months of breastfeeding.
• Progestin-only options (mini-pill, shot, hormonal IUD, and implant) are considered safer for breastfeeding, but they can still impact mood, weight, and libido.
• The Depo-Provera Shot is particularly notorious for causing extended delays in fertility return after discontinuation.

While hormonal birth control may be the right choice for some women, I encourage anyone considering it to research the potential downsides and make a fully informed decision. If you want to read more about my concerns about hormonal contraception, check out my article: “The Libido Trap: How Birth Control Could Be Killing Your Sex Drive (and What to Do About It)”.

Final Thoughts: Know the Risks, Make an Informed Choice

Breastfeeding is a beautiful, natural process that offers countless benefits for both mother and baby. But when it comes to birth control, it’s not a foolproof solution. The Lactational Amenorrhea Method can be effective—but only if followed precisely. And even then, nature has a way of surprising us.

For too long, women have been given incomplete or misleading information about their reproductive health. Many have been led to believe that as long as they’re nursing, pregnancy is off the table—only to find themselves staring at a positive pregnancy test before they’re ready. You deserve better information, real options, and the ability to make decisions based on facts—not outdated myths.

Here’s what matters most: your body, your choice. If LAM works for you, great. If you’d rather have a backup plan, that’s smart. Either way, the key is knowing the actual risks and not assuming that breastfeeding alone will keep you from conceiving.

So, if another baby isn’t in the plans just yet, take control of your fertility. Explore your options. Get informed. And above all else, trust yourself to make the right decision for your body, future, and family.

— Stay Strong! Jaelin —

Next Steps

• What was your postpartum birth control plan? Did you rely on LAM, or did you take a different approach? Let’s talk in the comments!
• Read more women’s health topics at SHEis.com

Additional Reading

• Taking Charge of Your Fertility by Toni Weschler
• The Womanly Art of Breastfeeding by La Leche League International
•  Natural Birth Control – Options & Suggestions – MamaNatural
• Fact or Fiction? You Can’t Get Pregnant While Breastfeeding – HealthLine

Note: Full disclosure: SHEis Online earns a small (very small) commission on any links in the article that take you to Amazon.

About the Author:

Jaelin Stickels, CNM, WHNP, is a deeply passionate and highly skilled Certified Nurse Midwife, Women’s Health Nurse Practitioner, and the owner of Holistic Heritage Homebirth in Houston, Texas. With over a decade of experience, Jaelin has had the privilege of helping several hundred women welcome their babies into the world. In addition to her advanced practice licensure training, she has additional advanced training in twin and breech births, making her one of only a few with these skills in her area.  Jaelin approaches every birth with expertise, compassion, and a deep respect for the birthing process. Jaelin is finishing her doctorate and looking forward to being Dr. Jaelin in early 2025.

Jaelin’s journey into midwifery began with a profound love for supporting women through the incredible experience of pregnancy, labor, and postpartum. Since 2010, she has been dedicated to walking alongside families during these transformative moments, offering guidance, support, and care tailored to each individual’s unique needs. She is a big believer in informed consent and ensures clients are given the best evidence-based information to make the best decisions for themselves and their families.

Married to her high school sweetheart Ted (aka Chef Ted) since 1984, Jaelin is the proud mother of three grown children and the delighted grandmother of one amazing granddaughter. When she’s not assisting in births, Jaelin finds joy in going to the movies with her husband, quilting, and cherishing time with her family. Known by the other midwives in her practice (Holistic Heritage Homebirth) affectionately as the “Birth Hog,” she brings an unmatched dedication and enthusiasm to her work—no one loves birth quite like she does.

Read Jaelin’s Bio

Find out more about Jaelin’s Homebirth Practice (Holistic Heritage Homebirth) in Houston, TX