Questions about TTC while nursing

[SKJ2011]

Hi All.  I have a few questions about TTC while breastfeeding and was wondering if any experts out there can help me.  Here goes:

 I got my PPAF when my DD was 11 months old.  She's been STTN for the most part for a while (she's now 14mo). I had to travel for work a few weeks ago and increase my pumping to make sure she had enough milk when I was gone.  Since I was "nursing" more, could that have an impact on my cycles/fertility?  I ask b/c I usually have a noticeable supply dip before and during AF, and this past month, AF was lighter/shorter than usual, I had no supply dip, and my temps didn't show a clear temp shift, so I think I didn't O. Is this kind of thing normal?  

I've also had more spotting at odd times during my cycles.  It's not O spotting or spotting around AF.  Is that normal for anovulatory cycles?  

Thanks for any insights.  I'm pretty confused about anovulatory cycles in general.  If anyone has a good resource to learn more, I'd love to know about it.

[carmen358]

You could try asking on the nursing and ttc thread..lots of experience nursing and ttc there!

http://www.mothering.com/community/forum/thread/1320526/nursing-mamas-ttc-july

[JMJ]

I looked at your chart from last cycle, and I think you did ovulate.  Your CM was pretty clear, and while you had a lot of disturbed temperatures (open circles), you did have a pretty clear rise if you take out the disturbed temp from CD 16.  It looks to me like you ovulated on CD 20-21 and had a 6-7 day LP.  Have you been charting before this, or was this your first chart?  Do you know how long your LP has been in the past few cycles?

Extra pumping or nursing can certainly have an effect on your cycles, though cycle "abnormalities" are common while nursing, especially in the early months of your cycle.  When I look at your chart, I see the telltale signs of low progesterone.  This is quite normal postpartum, but it can make TTC very difficult.

Progesterone and prolactin are somewhat antagonistic to one another.  This is why it is difficult to get pregnant when your child is exclusively breastfeeding and why most mothers experience a huge drop in milk supply around the beginning of the second trimester when the placenta begins making a significantly greater amount of progesterone.  It also explains the supply dips you get before your period.

It's an emotional rollercoaster to TTC before your cycles have regulated postpartum.  a 6-7 day LP is not long enough to get pregnant and sustain a pregnancy.  You need at least 9 or 10 days.  This past cycle could have been a fluke because of the extra pumping. or your cycles may still be regulating in general.  It often takes several months of cycling, and if you've only been cycling for 3 months, I'm not surprised that you're experiencing symptoms of low progesterone.  Fertility is a continuum, not a light switch.  Only about 1/3 of women have a fertile ovulation before their first period.  Another 1/3 have inadequate LP's, and the last 1/3 don't even ovulate at all but experience a period-like hormonal bleed.  Many women experience several months of anovulatory cycles or inadequate LP's.  It is just what is normal postpartum, even though it would be considered to be abnormal any other time.

It's really a difficult time from a family planning perspective, no matter which way you're trying to go on it.  You can't assume that you won't get pregnant because your cycles could fall into place at any time (I had 5 cycles with 8 day LP's, and then it jumped to 11 days.).  It's also difficult to TTC because any cycle that has an inadequate LP will not allow you to get pregnant and sustain that pregnancy, but there's always a chance that your next cycle will be fertile enough.

There are also some things that people have used to lengthen their LP's, such as Vitamin B6.  There's some older threads on this forum with big lists of things that might help if that's the way you want to go.  Just understand that they push the progesterone-prolactin balance in favor of progesterone and could have an effect on your milk supply.

[SKJ2011]

Thanks so much for the detailed response JMJ.  I wish I had started charting with my first PPAF, but I tried and the wake-up times were so all over the place that I just threw in the towel .  So far, my June cycle is the only one I charted.  I thought I O'ed at first - I had all the symptoms and my CF did dry up, but the strange thing is that this cycle's temps are still in the post-O range from last cycle.  Also, my supply didn't drop at all, and my AF was very strange - much lighter and shorter than usual.  Those things made me think that I geared up to O but didn't.  Everything was so much easier when I was TTC and not nursing   

I think I'm gearing up to O in the next few days this current cycle.  If so, I hope that means my LP will be a little longer than 7 days.  I did start on a B 50 complex this cycle, so maybe that will help.

One last question - you mention that fertility is a continuum, not a light switch - I wonder what that implies for increased nursing when DD is sick or teething.  She's been nursing MUCH more during the day the last few days due to a fever and teething.  She's still STTN, save for one wake up.  I'm wondering what affect this new pattern can have on my cycle.  I am asking b/c I def. don't want to reduce nursing DD, but want to keep my expectations realistic for this cycle.

Thanks again!

[TenzinsMama]

JMJ, what is showing up on a chart, when someone has low progesterone?  I am wondering if I can go back to look and see if that is what is showing up on mine... (I've had 6 ppaf so far).  Also, I didn't know that about milk supply around AF-- I was wondering if maybe my hormones or something was altering the taste of my milk somehow and that is why my DS was fussing more around that time when nursing (on/off, on/off) but now I'm thinking it has been a supply issue...

[JMJ]

TenzinsMama, your question is easier, so I'll tackle it first.  According to Marilyn Shannon (author of Fertility Cycles and Nutrition), the signs of low progesterone are:

-Short luteal phase (fewer than 9-12 days of temperature rise or fewer than 9 days of post-peak dry up of CM)

-premenstrual spotting

-post-menstrual brown bleeding or spotting

-poor temperature rise after ovulation

-extended mucus

-poor mucus quality

-amenorrhea

-early miscarriage

-infertility

The things near the top are more likely related to low progesterone, and the ones near the bottom may have other causes.  Some of the symptoms make conceiving and maintaining a pregnancy very difficult (such as amenorrhea or short luteal phase), and some things may not be deal breakers.  I just got pregnant while still having some of the signs of low progesterone.  I waited until I had a cycle with an 11 day LP (both with temperatures and CM) and conceived the next cycle.  I ovulated on CD 36, had a 29 day mucus patch with decent quality mucus.  It was pretty poor quality until the last 6 days before ovulation, and while I had a "dry-up" past peak day to less-fertile mucus, it didn't reach "dry" until 11 days after peak day and didn't stay dry.  I had a slow temperature rise, hovering mostly at or below the high temperature line (.4F above the highest of my pre-shift 6) for a whole week after ovulation, but then had another jump for a triphasic pregnancy chart.  There were definitely some signs that my hormones hadn't regulated yet, but it was enough that I got pregnant, and I'm still pregnant at 7 weeks now.

SKJ, I see what you're saying, but I still think you ovulated.  Early periods postpartum can be a little strange, often lighter than normal and mixed with EWCM.  On your chart, I see a 6 day lighter than normal period.  I see a big temperature drop (with accurate temperatures) on the day your period started, and most of the higher temperatures I see have open circles, meaning that they are disturbed temperatures, either because of taking them at a different time, sleep deprivation, or otherwise.  In any case, it's hard to glean a whole lot of information from disturbed temperatures, so if we just focus on the closed circle temperatures, we see a more definite temperature drop beginning at AF.  The higher temperatures that follow a few days later may indicate that your pre-O temperatures are moving upwards, or it is normal for temperatures to bounce around a bit when ovulation is delayed.  The lower temperature today could indicate that your estrogen is regulating (estrogen causes lower temperatures), and that you may be getting ready to ovulate, or it could be more bouncing around of your temperature if ovulation is delayed.  Your lack of supply drop could be a sign of your body getting used to having a period again or another sign that you had low progesterone (and it didn't interfere with prolactin).

Your last question is a very difficult one.  When dealing with postpartum cycles, your cycles may progress steadily from infertile to fertile, regardless of short-term changes in nursing patterns, they may be decidedly infertile for a time and then suddenly jump to fertile regardless of changes in nursing patterns, or you may have some more fertile cycles and some less fertile cycles, and you could progress from infertile to fertile in a non-linear progression, sometimes seeming to be moving forward, and sometimes seeming to be moving backwards, and you may or may not notice a relation between this and your child's feeding patterns.  I didn't notice much change except to delay ovulation.  In my 4th postpartum cycle, we both got very sick, and I lost weight and didn't gain it back.  My ovulation was delayed, but my luteal phase was the same length as the cycle before it and the cycle after it when I had regained the weight, and we were healthy: 8 days.  The cycle I got pregnant, I had delayed ovulation for an unknown reason.  DD got a tooth shortly after I ovulated, so there was a huge increase in nursing the day after I ovulated, and I think that was part of why I had a slow temperature rise, but it obviously wasn't enough to be fatal to my baby.  I admit, it is all very confusing.

[SKJ2011]

Thanks JMJ.  I guess it is all about waiting and seeing - something I'm terrible at   I thought I was gearing up to O the last few days, but all my OPKs have been negative.  Then today, my CF is back to creamy.  Not sure what is going on.  Anyways, if you have any additional thoughts, please let me know.  Your input has been invaluable!

http://www.fertilityfriend.com/home/SKJ2011