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Breastfeeding protocol
for fertility monitor


Breastfeeding protocol
for mucus


NFP and long cycles

NFP and short cycles

Perimenopause

NFP after using
hormonal contraception


Stress

Vaginal Hygiene
and Vaginal Infections


Premensteual Syndrome (PMS)

Continuous Mucus
and Other Body Fluids


Management of
Continuous Mucus


Return to fertility
after child birth


Medical referral
for women's health problems


NFP and unusual bleeding




 
The Marquette Model of natural family planning
(NFP) was developed for use with the ClearPlan Easy Fertility Monitor (also called the ClearBlue Easy Fertility Monitor) along with other natural biological markers of fertility as a means to avoid or achieve pregnancy.



These instructions assume you have purchased a ClearBlue Easy Fertility Monitor (CEFM) and have read the fertility monitor instruction booklet. The instructions (on the right) start on the first day of your user’s next menstrual cycle. The menstrual cycle begins on the first day of your period (i.e., menses).
Return of Fertility After Child Birth

A woman’s fertility may return at any time after the birth of her baby if not breast-feeding and at any time during the weaning period for a breast-feeding woman. The breastfeeding woman also should be informed that Lactational Amenorrhea Method (LAM) is no longer effective when (as defined by the World Health Organization (WHO) LAM protocol and expressed by the World Alliance for Breastfeeding Action:

1. Her menstrual period returns.
Menstrual bleeding is the most important indicator of fertility. After the initial 56 days postpartum, two consecutive days of bleeding/spotting or the woman’s perception that her period has returned, whichever of the two comes first, should be considered an indication that fertility is returning. A woman can ovulate before her period returns, however, studies indicate this rarely occurs when the woman is breastfeeding intensively and less than six months postpartum.

OR

2. She begins feeding her baby other liquids or foods regularly, or her baby sleeps through the night.
Ovulation is suppressed in the breastfeeding woman as the baby suckles at the breast. When the baby begins taking foods or liquids she/he generally suckles at the breast less, thus reducing the fertility-suppressing effect of breastfeeding. This is also true when the baby begins sleeping through the night-long intervals between breastfeeds (more than four hours during the day and six hours at night) should be avoided.

Note: Expression of breast milk does not suppress fertility, only suckling at the breast.

OR

3. Her baby is older than six months.
At about six months the baby should begin eating other foods as their nutritional needs change at this time. Usually the baby will breastfeed less when this happens, thus, LAM becomes less effective.

As fertility approaches, the woman might experience more frequent signs of mucus, the mucus will become more abundant and the mucus will take on peak signs (i.e., become clear, slippery and stretchy). The temperature will also begin to level off. These signs are a reflection of rising levels of estrogen.

Factors that will precipitate the return of fertility are:
when breast-feeding becomes less frequent,
the addition of other foods
the baby is older than six months old,
the baby sleeps through the night, and
the experience of stress, anxiety or illness.

Up to 40% of women will not experience blood loss before the first ovulation. The first few cycles after the first ovulation will vary in length and the pattern of cervical mucus will most likely be different than what was experienced before pregnancy. Variability of cycle lengths and cervical mucus will be more pronounced in women who continue to breast-feed from time to time. Some women will experience continuous mucus and will need further help from their NFP teacher. The following are instructions for avoiding intercourse in the first cycle after fertility returns.

Continue to have intercourse only at the end of the day on dry days (or a basic infertile pattern or BIP of unchanging mucus) before ovulation
Before ovulation consider any day of mucus (or any change from the BIP) and 3 days past as fertile
If using the CleaBlue Monitor or LH testing - intercourse may resume at the end of the 4th day past the last ClearBlue Monitor Peak Day.
If using cervical mucus signs only, continue to have intercourse at the end of the day on dry days only during the first cycle. In subsequent cycles, if the woman is confident that it is her peak day of cervical mucus than intercourse may resume at the end of the 4th day past peak.
Be aware of variability in cycle length and of the return of mucus if you are experience a continuous pattern of mucus and are confused with you fertility signs - then see your NFP teacher!

See Breastfeeding Protocol for the Clearblue Fertility Monitor and Breastfeeding Protocol for Mucus Only.




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