Breastfeeding questions

Curious Female
My boyfriend's sister and I are pretty good friends, so we're pretty open with each other. She has a four year old daughter and a one year old baby that she is breastfeeding. I have a few questions about that. 1) She said she doesn't get her period because she's breastfeeding. Why is that? 2) Are her nipples ever going to be normal again? I know that when a woman breastfeeds the nipples tend to look like bottle tips. 3) Should she have stopped breastfeeding her baby by now? He's almost 13 months. Thanks for reading!
Sarah replies:

Breastfeeding can have a variety of impacts on one's periods. Some women will start having periods again soon after birth (even if they are breastfeeding). Others may not start having periods again for 6 months or more. Some never have a period until they stop breastfeeding entirely. This is really something that varies from woman to woman. It's usually pretty much impossible to pin down what it is that for sure causes this, however there are a couple of factors that can be at play here. First, the hormone prolactin is released during breastfeeding. Prolactin can suppress menstruation. Specialists also feel that things like how often and for how long one breastfeeds, the mom's age, the number of children she has had, and some individual body factors can all influence when menstruation starts again. This is not to say that a breastfeeding woman is not (or cannot be) fertile. In the past, women were told that they could not become pregnant while breastfeeding, however we know this is not strictly true. Some women can and do become pregnant while breastfeeding, so it is wise to use some method of birth control if the woman does not wish to become pregnant.

Discussing what's "normal" when it comes to human bodies is also a pretty difficult thing. What exactly is "normal"? People's bodies (nipples included) are pretty darn different from the get go. Breastfeeding does often cause changes in the breasts. For example, women who breastfeed often find they have an increase in breast size. Sometimes this will go away after they stop and other times it does not. For some women, nipples may also change in size and appearance, this also may or may not change after they stop breastfeeding. Either way, it isn't a bad thing, a harmful thing, or even an abnormal thing. It's okay if they do change again and it's also okay if they don't.

It is also up to each woman to decide when she wishes to stop breastfeeding. The American Academy of Pediatrics (AAP) recommends that women breastfeed for at least the first year of the baby's life. The World Health Organization (WHO) suggests breastfeeding for the first 2 years. In the US, we find that women have tended to breastfeed less than in many other parts of the world. Part of this was due to the availability of formula (and clean water to mix it with) and the encouragement of formula manufacturers. Many workplaces in the US are also not particularly "friendly" to breastfeeding (not providing private areas for pumping, no place to store the milk, the child is not available for on-site breastfeeding, etc.), and since many women return to work right away, they may quit breastfeeding when they return to work. Some of these issues have begun changing in recent years, and frankly it's becoming more "fashionable" to breastfeed again, but there are still many many women who do not breastfeed for very long at all. In the long run, breastfeeding has benefits (for both the mom and baby) for pretty much as long as they keep it up. It is not dangerous or negative in any way. So really, your partner's sister can and should breastfeed for as long as it is agreeable for both her and the child.

If you have more questions about breastfeeding, you may want to contact your local La Leche League. They are an organization that promotes breastfeeding. You can also check out information from The National Institutes of Health about breastfeeding or from The World Health Organization about breastfeeding. The National Women's Health Information Center also has a page of information that you may find helpful.

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