Natural Family Planning: Specifics of Natural Child Spacing

God has wisely ordered laws of nature and the incidence of fertility in such a way that successive births are already naturally spaced through the inherent operation of these laws (Humanae Vitae, n.11).

To draw attention to Natural Family Planning Week (July 22-28, 2007), I am blogging daily on breastfeeding and natural child spacing.

The Specifics of Natural Child Spacing
My contribution to the promotion of breastfeeding and natural child spacing has been the teaching that there is more to natural child spacing than exclusive breastfeeding, that there are certain mothering practices that make a significant difference in prolonging natural infertility.

Exclusive breastfeeding is insufficient by itself to maintain amenorrhea. There are many mothers who experience an early return of menstruation while exclusively breastfeeding. I learned this while listening to mothers at La Leche League meetings for a dozen years. Studies on the Lactational Amenorrhea Method also prove that about 50% of mothers have an early return of menstruation while exclusively breastfeeding.

In the early 1970s, I emphasized not only the concept that you need to do more than exclusively breastfeed but also that you need to be with your baby, that mother-baby togetherness plus the frequent and unrestricted suckling are the keys to natural child spacing.

In the first and second editions of Breastfeeding and Natural Child Spacing (1st, self-published; 2nd, Harper & Row), I inserted a questionnaire at the back of the book for mothers to fill in and return after they had completed their breastfeeding experience. The survey had detailed questions about their mothering practices, their use of any form of natural family planning or birth control, and the return of their first bleeding, spotting, or period. This collection of surveys eventually led to published research.

In our original research John and I focused on mothering practices in our survey-questionnaire. In those days the criteria were:
No pacifiers used
No bottles used
No solids or liquids for the first five months or exclusive breastfeeding for five months
No feeding schedules
Presence of night feedings
Presence of lying-down nursing

We later added a seventh standard that summarized the previous six and these practices became known as the Seven Standards of Ecological Breastfeeding. We called this type of breastfeeding “ecological breastfeeding” to show that it involved a special mother-baby relationship. We also called this form of baby care “natural mothering.” In the second edition of Breastfeeding and Natural Child Spacing: The Ecology of Natural Mothering (Harper & Row, 1974) and the first edition of The Art of Natural Family Planning (Couple to Couple League, 1972), ecological breastfeeding and natural mothering were terms already in use.

John and I isolated each Standard to see if any one standard had more of an impact on maintaining infertility than any of the others. What our research showed was that each Standard was important in maintaining breastfeeding infertility and that no Standard was sufficient by itself. It was for this reason that I often used the example of a “breastfeeding infertility” pie when giving talks. The pie is made up of seven pieces. Each piece is important. A mother interested in breastfeeding infertility needs more than just one piece of the pie and definitely more than just exclusive breastfeeding. She needs all seven parts or standards.

The Seven Standards define what kind of mothering is involved with ecological breastfeeding, and I placed a stronger emphasis on the Seven Standards in the fourth edition of Breastfeeding and Natural Child Spacing in 1999. I also noticed that this strong emphasis eliminated the counseling calls from mothers who said they were doing ecological breastfeeding but had an early return of menstruation. The Standards are also helpful when teaching natural child spacing.

What are the Seven Standards? The Seven Standards of Ecological Breastfeeding are these:
1. Do exclusive breastfeeding for the first six months of life; don’t use other liquids and solids.
2. Pacify your baby at your breasts.
3. Don’t use bottles and pacifiers.
4. Sleep with your baby for night feedings.
5. Sleep with your baby for a daily-nap feeding.
6. Nurse frequently day and night, and avoid schedules.
7. Avoid any practice that restricts nursing or separates you from your baby.

For those teaching or using the Seven Standards, what are the common practices that shorten breastfeeding infertility?
• Offering solids to a baby less than six months of age.
• Offering other liquids as a substitute for breast milk during the early months of
life.
• Using bottles.
• Using pacifiers. Pacifiers can shorten the time of mother’s infertility.
• Not taking a nap once during the day when the baby nurses to sleep. A short nap gives the mother a better disposition during the remainder of the day.
Some medical persons believe the natural spacing mechanism works best
when the mother is relaxed and at rest.
• Not sleeping with the baby during the night. Babies who sleep next to
their mother at night nurse more often and longer than babies who sleep
separate from their mother.
• Not providing opportunities for non-nutritive suckling.
• Encouraging the baby to go a long time between feedings or having the baby
on a strict nursing schedule.
• Encouraging the baby to sleep through the night. Going a long time without
nursing during the night may end the mother’s infertility.
• Leaving the baby at home when mother goes out.
• Relying on other equipment or gadgets or family members to keep the baby
occupied so the mother can delay nursing the baby. Or the mother walks, rocks, or tries to distract the baby to avoid nursing the baby at that time.*
(*taken from online NFP manual, Part 3, pages 9-10)

The Seven Standards
Nursing mothers who follow the Seven Standards of ecological breastfeeding have one of the best natural family planning methods. It’s so natural that it is hard to see it as a method, but today people like to talk in those terms. For instance, any vaginal bleeding can be ignored during the first 56 days in determining fertility or amenorrhea if the mother is exclusively breastfeeding or doing ecological breastfeeding.

Most importantly, the Seven Standards of ecological breastfeeding provide extended natural infertility. During the first three months postpartum, the chance of pregnancy occurring is practically nil if the ecologically breastfeeding mother remains in amenorrhea. During the next three months postpartum, there is only a 1% chance of pregnancy if the ecologically breastfeeding mother continues to remain in amenorrhea.

The Six Standards
Sometime between six and eight months of age, the baby begins to take some solid food. As the American Academy of Pediatrics stated in their new “Breastfeeding Policy Statement” (Pediatrics, 496-506, February 2005) exclusively breastfed babies “may not be ready to accept other foods until approximately 8 months of age” (p. 499). Once solid foods are begun, there are only Six Standards operating for ecological breastfeeding. Breastfeeding infertility usually continues, however, because the amount of nursing is usually not decreased at first and the frequent, unrestricted nursing continues.

Our two studies show that American nursing mothers who followed these practices or Standards averaged 14.5 months of amenorrhea. (J. and S. Kippley, “The Relation between Breastfeeding and Amenorrhea: Report of a Survey,” JOGN Nursing, Nov.-Dec. 1972, 15-21. Also “The Spacing of Babies with Ecological Breastfeeding,” International Review, Spring/Summer 1989, 107-116.) These and other studies on breastfeeding infertility are available at our website.

H. William Taylor
Later studies concerning ecological breastfeeding were done by H. William Taylor; he and his wife were NFP teachers. His latest research confirmed that ecological breastfeeding certainly spaces babies. Mothers who nursed in a cultural way had a median time of 8.2 months before their first menses, while mothers who nursed more in line with ecological breastfeeding had a median time of 12.8 months before their first menses. (“Continuously Recorded Suckling Behavior and Its Effect on Lactational Amenorrhoea,” Journal of Biosocial Science, 1999, 31: 289-310) In this study he also established a sub-group of mothers whose practices were close to the Seven Standards. That is, Taylor eliminated those mothers who returned to work outside the home, who did not sleep with their baby at night, who introduced solids before six months, and who nursed less than a median of 9 times a day in the first three months. Thus he ended up with a group of mothers who were following a more ecological breastfeeding program; these 55 mothers had a median delay of 15.9 months before their first menses. (Personal correspondence after previous research was submitted to Cambridge University for publication, May 27, 1998)

In my opinion the Seven Standards of ecological breastfeeding should be included in any discussion or teaching on natural family planning. Worldwide, breastfeeding is used much more than systematic NFP to space children naturally. Since the beginning of the human race and up to the early 1900s, breastfeeding was the only option in accord with Catholic teaching for spacing babies except total abstinence.

Breastfeeding as a form of NFP should be given more attention by health and church associates throughout the world. It is an excellent form of natural family planning.

Tomorrow: Points to be made about breastfeeding related to natural family planning

Sheila Kippley
NFP International
www.nfpandmore.org
Author: Breastfeeding and Catholic Motherhood (Sophia, 2005)
Natural Family Planning: TheQuestion-Answer Book (e-book
at this website, 2005)

One Response to “Natural Family Planning: Specifics of Natural Child Spacing”

  1. Bekah says:

    Thank you for this synopsis, Sheila. I am an apprentice midwife and we have a community of Mennonites which we serve. While some don’t mind closely spaced children, others seem to desire a little bit more than a year between births. We’ve noticed that babies tend to be weaned early (well, early to me which is roughly around the year mark) and I suggested and printed off the chapter [Part 3] on Breastfeeding amenorrhea from your Q&A book for my senior midwife. This post might be useful as a good teaching tool for moms. I’ve also been able to educate my senior midwife a little more on NFP and phrases to use to differentiate it from contraception. I do not know if this population would be open to a form of charting at all, but I think LAM should be acceptable.

    Sheila: Bekah, thanks for your interest in promoting eco-breastfeeding. We took 50 clear folders (containing all of Part 3 on the breastfeeding from the online manual) to the recent LLLI Convention. They were all taken. Many mothers stopped by our booth to show their appreciation for this type of mothering. I agree with you that Part 3 is an excellent teaching tool and it’s only 14 pages. Thanks so much for helping moms.