Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
Your health care provider will ask you (during your pregnancy and again after you have your baby) about your plans for preventing another pregnancy from occurring too close to this one. Currently, the consensus is that pregnancies closer than two years apart are damaging to the mother's health and, therefore, potentially to the fetus and, if she is still breastfeeding, the older baby.
Cross-culturally, when breastfeeding is not limited, even in cultures which do not have an intercourse taboo while babies are young, pregnancies are spaced about four years apart. This is very much different from what anyone who grew up in the US has experienced, where having "two under two" or more under some slightly higher age, is not uncommon. Buchanan, in Mother Shock describes her own horror of the double stroller, which I thought was a wonderful metonym. In the wake of Teddy's arrival, I've taken to asking all my friends with more than one child (or who are themselves not only children) what they think of child spacing. It's rare to hear someone advocate spacing as far apart as four years, but when one encounters it in the context of relatively reasonable parenting strategies, the outcomes, anecdotally, seem very good. The downside is that, as one friend put it, once you're out of the baby phase, it can be hard to go back.
Royalty during the 18th century, the upper classes during the 19th century, and the middle class in the 20th century avoided breastfeeding their babies. Until the 20th century, this was usually with the intention of having more children, and babies were wet nursed. During the 20th century, formula replaced wet nursing, but the effect was the same. This super-fertility, exported to the rest of the world with the aggressive marketing of formula, has caused a lot of people to forget that breastfeeding exclusively, without limits, is an effective form of naturally spacing children at intervals of 2-4 years. Many health care providers believe that the only truly effective birth control is hormonal birth control, sold in convenient shot, patch or pill form. These are not without side effects for many women, independent of breastfeeding. But estrogen birth control tends to interfere with the hormones involved in milk production, and may furthermore not be doing the child any favors, either. A health care provider truly supportive of breastfeeding will be aware of these issues and help you decide how to safely space children in a way that is best for you, your children, and your family as a whole, without introducing predictable, undesired health consequences such as interfering with breastfeeding. Unfortunately, many health care providers will have no awareness of any of these issues, and some will be dismissive.
LAM as child spacing or interim birth control
Copyright 2006 by Rebecca Allen.
Created February 1, 2006 Updated February 1, 2006