The midwives and GPs are correct if one culturally breastfeeds. In our society, breastfeeding is often scheduled to some degree instead of feeding completely on demand, which often means the child feeds little and often. Co-sleeping is frowned upon, so many babies are moved into their own rooms after the first 6 months. Since prolactin levels are highest at night, cutting out night feeds can often bring about the return of fertility. If a woman is returning to work, fertility is likely to return more quickly, since the child isn't nursing as much. Dummies are often used, and babywearing isn't all that common.
Seeing as these things are quite common, I do understand why the midwives and GPs might think that breastfeeding doesn't suppress fertility. However, fertility is less likely to return with either the Lactional Amenorrhoea Method (LAM) or Ecological Breastfeeding. There are seven standards for Ecological Breastfeeding:
- Breastfeeding must be the infant’s only source of nutrition – no formula, no pumping, and (if the infant is less than six months old) no solids or water at all.
- The infant must be pacified at the breast, not with pacifiers or bottles or by placing a finger in the mouth.
- The infant must be breastfed frequently. The standards for LAM are a bare minimum; greater frequency is better. Sucking should include non-nutritive sucking when the infant cues the mother, not just breastfeeding as a means of nutrition. Scheduling of feedings is incompatible with LAM.
- Mothers must practice safe co-sleeping as it is the proximity of the child to the mother that increases prolactin.
- Mothers must not be separated from their infants. This includes substitutes for mother such as babysitters and even strollers or anything else that comes between mother and physical contact with her child. Babywearing (using cloth carriers) means tactile stimulation between mother and child and increases access to the breast. Any separation from the mother will decrease the efficacy of ecological breast feeding.
- Mothers must take daily naps with their infants.
- A mother must not have had a period after 56 days post-partum (bleeding prior to 56 days post-partum can be ignored).