I am a mother of about 10 months old son. I am breastfeeding the baby. Due to there being no periods, I was told that I may have become pregnant again. I immediately took some medicine for terminating the pregnancy within a few days. However, I am still not getting periods. What is your opinion? Do you feel that I may be pregnant again? Due to a young child, I am not interested in becoming pregnant again? What precaution should I take?

Answer (by Dr. Neelam Dhamija): When you breast feed your baby you may not get periods. The logic behind this is that sucking of nipples during breast feeding has two effects:

(i) reduction in the levels of gonadotropin releasing hormones (Luteinizing  and Follicle stimulating hormones) and so there may be no periods. This is also known as lactational amenorrhoea.

(ii) increased secretion of prolactin hormone, which is turn increases milk production. When the baby is exclusively on breast feeding (day and night), then during the first six months after delivery, the menses are mostly anovulatory (when during a menstrual cycle there is no ovulation) and the fertility is also low.

Breast feeding is highly efficient method for spacing pregnancy. Thus breast feeding has been used as a highly effective method of contraception (natural method for birth control). When breast feeding a baby, a woman may sometimes not have menses for 18-24 months. This does not mean that you cannot become pregnant for as long as you are breast feeding and you do not have menses.

If you do not want to become pregnant you must use some or the other contraceptive method so as to avoid pregnancy. This means that you cannot rely blindly on breast feeding as a birth control method.  In your case, you may not be having menses either because you are breast feeding your baby or that you may be pregnant. Are you using any method for not becoming pregnant (contraception)?

If your reply is yes, then there are less chances of you becoming pregnant and please continue to use these contraceptive method so long you are not desirous of becoming pregnant. If your reply is no, then you may be pregnant. Various methods are available nowadays to prevent pregnancy, some of them are: condom, copper-T (for 3 years/5 years/10 years), injections to be given to a woman every three months, vaginal spermicidal sponge, cervical cap, various types of oral contraceptive pills etc. As I have earlier mentioned that you cannot rely blindly and forever on breast feeding as a method for preventing pregnancy. To confirm about your pregnancy you can do a urine pregnancy test. If urine pregnancy test is negative you can repeat the test after a week or so. If it is again negative then you are  definitely not pregnant. Urine pregnancy test may not give positive report if the pregnancy is very early. If you are very much anxious to know the result at the earliest, you can opt for blood test for hCG. This test is very sensitive and is the first to become positive in very early pregnancy. This test can detect pregnancy as early as 11 days after conception. You must not take pregnancy termination pills without your doctor’s advise. Please  take precautions in future so that you do not get pregnant. You may use any of the methods mentioned above for not becoming pregnant. Consult your gynaecologist with the reports, she will examine you and go through the reports and prescribe you necessary treatment.

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