Trying to conceive while breastfeeding

Cicilulu

I am trying to conceive while breastfeeding my 15 month old son. I found this great fact sheet on another site (ivillage, fact sheet created by Jeska).
I thought I knew all the tips but I found some new ones here.
I know this fact sheet is long but when you are trying to conceive it's great to hear all tricks that can work for different women.
Good luck!


When will I get my periods back? What factors influence that? 
On average, nursing moms will have their first post partum period around the 16 month mark. However, a few women will get their cycles back either much earlier or much later than this. Both cases are normal. Exclusive breastfeeding (no bottle, pacifiers, finger sucking, solids) offers 98% birth control for the first 6 months. The likelihood of pregnancy occurring increases once supplemental feedings or pacifiers are added. The chances of ovulation will also improve with night weaning, or if the baby is regularly going 4 hours without suckling at the breast. Even when your menstrual cycles return, there may be high levels of prolactin (a hormone present during breastfeeding) in your body. Prolactin suppresses ovulation and causes luteal phase defects, which can also hinder conception. Some women ovulate about 2 weeks prior to their first period. However, it's also common to be anovulatory for the first few cycles. For a more detailed explanation of how a nursing mother returns to full fertility, read 
Breastfeeding and Fertility By Kelly Bonyata, BS, IBCLC 
http://www.kellymom.com/bf/normal/fertility.html#transition ;.

Is there anything I can do to get my fertility back sooner? 
Here are some things to try:
Night weaning. 
Switching up your usual nursing schedule.
Regularly going more than 4 hours without nursing or occasionally going more than 8 hours without nursing.
The introduction of pacifiers, solids or formula. 
Vitex, vitamin B complex, other herbs and diet therapy.
Time alone plays a large roll. Even in some women who choose to wean fully in order to conceive, their ovulation still may not come back for several months. Weaning, will not guarantee a quick return to fertility. 
Sleep in darkness. Studies show, women who have carefully reduced night lighting in their bedrooms typically experience improvement in their mucus or temperature patterns (BBT) within one to three cycles. Night darkness can also improve the ambiguous mucus of the breastfeeding mother as well as heavy bleeding, prolonged bleeding or constant spotting. "Fertility, Cycles, and Nutrition" by Marilyn M. Shannon 
Low tech ways to help you conceive:
http://www.fertilityplus.org/faq/lowtechfaq.html

Do I have to temp? 
Temp taking (basal body temperature) can be helpful for confirming if and when ovulation takes place. However, temping can be unreliable while breastfeeding, especially if you are co-sleeping or night nursing. The fastest and easiest way to track your fertility is to chart your cervical mucus (http://www.billings-centre.ab.ca/ ). During infertile breastfeeding phases, you will experience dry or sticky vaginal discharge day after day. As fertility begins to return ( http://www.kellymom.com/bf/normal/fertility.html#transition) your body will sporadically produce creamy, watery or egg white consistency cervical mucus. A good rule of thumb is to have intercourse on any day where watery or egg white cervical mucus is present. At some point, if conception has not occurred, you may want to start keeping a BBT chart, using OPKs or a saliva scope to help pinpoint if and when you are ovulating and also to help detect a luteal phase defect. 

How do I know when I'm ovulating? 
Typically, women experience watery, slippery, clear or egg white consistency cervical mucus around the time of ovulation. However, patches of fertile cervical mucus typically appear several times before the first ovulation, in a nursing mother. Simply take note of your cervical mucus when you use the toilet. You may begin to notice clear mucus on your underwear or toilet paper. Track your cervical mucus on a calender.

Other indicators of ovulation are:
Cervical Position: Around the time of ovulation, your cervix will be high, very soft and the opening or os will be open in order to allow sperm to enter the uterus.
Tender breasts
Ovulation pain
Increased sexual drive

You may also want to invest in:
OPKs - Ovulation strips are urine tests much like a pregnancy test. They detect lutenizing hormone (LH), which peaks 12-48 hours before ovulation. OPK's are different from pregnancy tests in that you may not use first morning urine (FMU), your urine sample should be concentrated (dark yellow) but taken later in the day. In addition, to reflect a positive on an OPK, the second test line must be as dark or darker than the control line.
Saliva scope - a small microscope that can be purchased online or at most drug stores. Saliva scopes detect the estrogen surge which begins a few days before ovulation and ends a day or two after ovulation. Simply put a drop of saliva on the slide, let it dry and examine it under the microscope. A few days before ovulation, you will begin to see a ferning pattern. The benefit of saliva scopes is that there is nothing more to buy after the initial investment.

I had one AF early on, but haven't had another one in 2 months. What's going on? 
It's common for nursing mothers to experience irregular or long cycles at first. It doesn't necessarily mean that you are not ovulating. If you're having a hard time pinpointing ovulation, and you have already tried charting your cervical mucus, you can try other methods of charting and ovulation predicting to help you. 
Basal body temperature charting
Ovulation predictor tests
Saliva scope 
Fertility Monitors: Cue Fertility Monitor, Clear Blue Fertility Monitor
In addition, you may try to encourage your hormones to regulate:
Herbs like Vitex and red raspberry leaf
A good diet, a prenatal vitamin, flax oil or fish oil, a B complex vitamin
Sleeping in total darkness
Getting 15 minutes of bright sunlight first thing every morning

Myths vs Facts: 
Breastfeeding During Pregnancy and Tandem Nursing 
http://www.kellymom.com/tandem/resources/myth-fact.html ;
Breastfeeding During Pregnancy LLL
http://www.lalecheleague.org/NB/NBpregnancy.html

Prenatal Vitamins: Doctors recommend that women who are TTC begin taking their prenatal vitamins, or other multi vitamins that include 400 mcg of folic acid, at least 3 months before conception. Folic acid is important in the prevention of neural tube defects. It must be taken before conception and during the first 8 weeks of pregnancy to be effective. 

The Infertility Cure: How Nutrition Makes a Difference
http://www.parentsplace.com/fertility/infertility/articles/0,,238716_620943-3,00.html

Will OPKs, and HPT's work on me since I'm bfing? 
Breastfeeding does not effect pregnancy tests or ovulation predictor test results. However, due to the nature of fertility while breastfeeding, it is possible to detect several hormone surges on an OPK, before the actual ovulation takes place. It's a good idea to keep having intercourse just in case. Read more FAQs on home pregnancy tests and ovulation tests.

When can I take an HPT?
A home early home pregnancy test is generally reliable on the day of the missed period. Or 14 days after ovulation. Example: A Dollar Tree cassette HPT detects 20 mIU/ml HCG. According to the chart below, the Dollar Tree test should give accurate results at 13 DPO. 
Average HCG levels during early pregnancy:
10 DPO: 10 - 50 mIU/ml HCG 
13 DPO: 20 - 100 mIU/ml HCG 
16 DPO: 40 - 200 mIU/ml HCG 
19 DPO: 80 - 400 mIU/ml HCG 
22 DPO: 160-800 mIU/ml HCG

When should we have intercourse? 
As a rule, have intercourse every other day or every day if possible while fertile cervical mucus is present. For the best chances of conception, have intercourse the day before O. 
Chances of conception chart from:
http://www.epigee.org/guide/infert.html ;
If you bd 4 days before O =11% chance of conception
bd 3 days before O = 15 %
bd 2 days before O = 20%
bd 1 day before O = 26%
bd day of O = 15 %
bd 1 dpo = 9%
bd 2 dpo = 5%