I have been breastfeeding my son for two years now. Because of my work schedule my son breastfeeds on-again-off-again. Can breastfeeding in this manner cause hormonal fluctuations that would affect ovulation and periods? During ovulation, I have noticed light pink spotting, occuring 12 to 14 days after my period for a day or two. My periods are regular but are sometimes heavy or light. My OB-GYN told me that breastfeeding would not cause these things to happen and would not have any effect on my hormone levels after the first few months, but he is not an advocate of extended breastfeeding, and he suggested that I stop now. Is breastfeeding hurting me?

-- E.

No, breastfeeding is not hurting you; in fact, it may be helping you. Women who breastfeed are less likely to develop breast cancer (especially breast cancer before menopause), and the longer one breastfeeds the more protection is attained. Exclusive breastfeeding, such as occurs in the first few months of life (if the baby is getting no supplemental bottles or solid foods), may prevent ovulation and menstruation -- but that is not universal! Later on, when supplemental feedings are given, your body will return to its normal patterns, even if you continue to breastfeed once or twice a day.

Some women do have spotting associated with ovulation, and this is not necessarily abnormal. Infection, ovarian cysts and abnormal cells inside the uterine cavity must all be ruled out, but most of the time this midcycle spotting is found to be a normal variant. Irregular bleeding may also indicate that you are not ovulating or that you have a thyroid imbalance; again, these should be ruled out.

If worrisome causes for midcycle spotting have been ruled out and you and your child enjoy the closeness and comfort of breastfeeding, then by all means continue. Most children will wean themselves by age four, and it is only in Western society that we look askance at women who continue to nurse beyond baby's first birthday. In most of the world, breastfeeding continues well into toddlerhood. The current recommendation of the American Academy of Pediatrics is to breastfeed for at least the first year of life. As an OB-GYN, I commend you for breastfeeding as long as you have.