Karmienie piersią jako metoda antykoncepcji. Czy jest skuteczna? Karmienie piersią jako metoda antykoncepcji. Czy jest skuteczna?/ iStock

Karmienie piersią jako metoda antykoncepcji  – czy jest skuteczne? 

Po ciąży w ciele kobiety zachodzi wiele zmian. Jedną z nich jest możliwy zanik miesiączki w trakcie laktacji, który wielu osobom kojarzy się z niepłodnością pozwalającą w okresie karmienia piersią bezpiecznie współżyć bez martwienia się o następną ciążę. Czy karmienie piersią faktycznie może być skuteczną metodą antykoncepcji? 

Spis treści:

Czy laktacja wpływa na życie seksualne? 

U kobiet po porodzie i w okresie karmienia piersią często obserwuje się spadek libido i zainteresowania współżyciem seksualnym. Autorzy przeprowadzonego w 2005 roku badania ankietowego, obejmującego 100 matek karmiących w okresie do 12 miesięcy po połogu jako główne przyczyny wskazują:

  • zmniejszone potrzeby seksualne lub ich brak – 32%
  • lęk przed zajściem w kolejną ciążę – 27%
  • odczuwanie bolesności podczas stosunku – 17%
  • zmniejszenie ilości wydzieliny pochwowej – 15%
  • uczucie niedopasowania narządów płciowych – 9%
  • trudności w osiąganiu orgazmu – 9%
  • bolesność piersi – 8%

Chociaż aż 83% respondentek deklarowało współżycie seksualne co najmniej raz w miesiącu, tylko nieco ponad połowa z nich (56%) określała częstość współżycia jako mniejszą niż przed ciążą, a połowa (50%) nie stwierdziła problemów w realizacji roli partnerki seksualnej.

Zmiany w poziomie libido po porodzie 

Zachowania i potrzeby seksualne kobiet po porodzie ulegają zmianom pod wpływem zachodzących w organizmie procesów hormonalnych. Hormony odpowiedzialne za laktację wpływają hamująco na libido – dochodzi do podwyższenia produkcji prolaktyny przy jednoczesnym spadku stężeń hormonów estrogenowych, które:

  • pobudzają pracę gruczołów szyjki macicy,
  • zwiększają regenerację nabłonka pochwy,
  • wpływają na układ naczyniowy i nerwowy, poprawiając ukrwienie narządów rodnych,
  • wywierają pozytywny wpływ na pożądanie i przyjemność ze współżycia.

Czy w okresie karmienia piersią można zajść w ciążę? 

Karmienie piersią i związane z nim zmiany w organizmie młodej matki bywają także postrzegane jako naturalna metoda antykoncepcji. Jednakże wbrew powszechnemu przekonaniu, że w trakcie laktacji dochodzi do zaniku miesiączki i czasowej niepłodności, doświadczyło go zaledwie 35% ankietowanych – pierwsza miesiączka pojawiła się u 65% kobiet, a 60% miało także dalsze, nieregularne. Jednocześnie aż 66% respondentek nie prowadziło obserwacji cyklu miesiączkowego, a 15% nie stosowało żadnych metod antykoncepcji.

Metoda LAM – laktacja jako antykoncepcja 

Obserwacja cyklu miesiączkowego i śledzenie zachodzących w organizmie zmian hormonalnych jest kluczowym elementem tzw. metody LAM (lactational amenorrhea method – metoda laktacyjnego braku miesiączki), będącej naturalną metodą regulacji ciąży. Jak wskazują badania, prawidłowo stosowna może charakteryzować się nawet 98% skutecznością, konieczne jest jednak spełnienie trzech głównych założeń:

  • wiek dziecka nie może przekraczać 6 miesięcy,
  • dziecko powinno być karmione tylko (lub przede wszystkim) piersią – w ciągu dnia nie rzadziej niż co 4 h, w nocy nie rzadziej niż co 6 h. 

Przeciwwskazaniami do stosowania metody LAM są m.in.: nosicielstwo HIV/AIDS, przyjmowanie leków wykluczających karmienie piersią, dolegliwości dziecka utrudniające karmienie piersią. Jej skuteczność znacznie spada po upływie 6 miesięcy od porodu i od momentu pojawienia się pierwszej miesiączki.

Alternatywne metody antykoncepcji dla matek karmiących 

Lęk przed kolejną ciążą jest czynnikiem często wskazywanym jako jeden z powodów niechęci do współżycia seksualnego w okresie laktacji. Problem ten nasila obawa młodych matek przed przyjmowaniem w czasie karmienia piersią leków, które mogłyby potencjalnie zaszkodzić dziecku. Oprócz metody LAM istnieje jednak także szereg alternatywnych metod antykoncepcji dla matek karmiących, charakteryzujących się wysoką skutecznością i bezpieczeństwem:

  • prezerwatywy – antykoncepcja mechaniczna jest obojętna dla organizmu matki i dziecka,
  • jednoskładnikowe tabletki hormonalne – mogą być bezpiecznie stosowane po ustabilizowaniu laktacji (po upływie 6–8 tygodni od porodu), nie przenikają do mleka matki, ani nie zaburzają laktacji,
  • wkładki domaciczne – uwalniające progesteron, który nie przenika do mleka matki,
  • minipigułki – pozbawione estrogenów, zawierające jedynie gestagen, który przenika do mleka matki w minimalnym stopniu, bez szkody dla dziecka.

 

Źródła:

  1. Sipiński A, Kazimierczak M i Ciesielska B (2005) Ocena zachowań seksualnych kobiet karmiących. Seksuologia Polska 3(2): 52–59.
  2. World Health Organization & Johns Hopkins Bloomberg School of Public Health. Center for Communication Programs. (‎2020)‎. Family planning: a global handbook for providers: evidence-based guidance developed through worldwide collaboration. Chapter 20: lactational amenorrhea method.

 

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