Swipe through the slides to check out the options of birth control while breastfeeding. After you have a baby, you may not be ready for another one, or you may be done having children, so what type of birth control is best if you’re breastfeeding? You can discuss this with your healthcare provider before delivery but you also will likely have some time after that to decide as well because generally it’s not recommended to have sex until 6 weeks after delivery.
The general consensus: use hormonal birth control with caution (especially estrogen-containing types) because it can lower milk supply. Use the lowest dose possible. If you do notice a drop in supply, you may want to switch methods.
There are lots of options for breastfeeding moms so talk to your medical provider to see what’s the best for you.
LACTATIONAL AMENORRHEA
Exclusive breastfeeding can sometimes be used as a reliable form of contraception in the first six months after birth, if your periods haven’t returned yet. This is called Lactational Amenorrhea Method (LAM).
In order to use the LAM, you must be able to answer “yes” to ALL three of these questions:
- Is my baby less than six months old?
- Is my baby fully or nearly fully breastfed, and breastfeeding frequently both day and night? (‘Nearly fully breastfed’ means that the baby may receive ‘taste-sized’ portions of solids occasionally.)
- Have I had no vaginal bleeding (not even spotting) since six weeks after my baby was born?
If you can answer ‘yes’ to ALL of these questions, your chances of becoming pregnant are less than 2%, making LAM about as effective as using condoms.
FERTILITY AWARENESS METHOD (FAM)
These methods help to track your menstrual cycle so you know when you’re ovulating (which is when pregnancy can occur). The days leading up to ovulation are considered the “fertile days”, so avoiding sex these days or using a backup method during that time, like condoms, can be used to prevent pregnancy.
There are a few different FAMs that help to track fertility such as The Temperature Method, The Cervical Mucous Method, and The Calendar Method, combining all of these methods (called The Symptothermal Method) will have the highest likelihood of preventing pregnancy.
However, using FAM is only 76-88% effective. If you want something more effective, check out some of the other options.
BARRIER METHODS
Barrier methods prevent pregnancy by blocking sperm from reaching an egg.
Different types are: Male condom (85%), female condom (79%), cervical cap (71-86%), diaphragm (88%), contraceptive sponge (76-88%), spermicide (72-86%). (%’s are how effective the method is against pregnancy).
These methods don’t work as well as other methods such as IUD’s or hormonal methods. The advantage of the male condom is that it protects against STI’s.
WITHDRAWAL
AKA pulling out. This is 78% effective in preventing pregnancy. It is best to use this method with another type of birth control such as the pill, ring, or condom.
NON-HORMONAL IUD
The copper IUD (Paragard IUD in the US and this lasts for up to 12 years). This is a small piece of flexible plastic shaped like a T that has copper wrapped around it. It uses copper to prevent pregnancy. Sperm doesn’t like copper and it changes the way sperm cells move so they can’t swim to an egg. If sperm can’t make it to an egg, pregnancy can’t happen.
HORMONAL OPTIONS: COMBINED CONTRACEPTION
Combination contraception: These contain progestin (synthetic progesterone) and estrogen and come in a few different forms: pill, patch, ring.
-The effectiveness of the pill, patch, and ring are all 91% effective against preventing pregnancy (However, if taken perfectly, it’s 99% effective).
***Contraceptives that have estrogen have been linked to reduced milk supply and early cessation of breastfeeding even when started after milk supply is well established and baby is older. Not all mothers who take contraceptives containing estrogen experience lower milk supply, but many do. It is only recommended to use contraceptives containing estrogen with caution, particularly those mothers who have had challenges with their milk supply.
HORMONAL OPTIONS: PROGESTERONE-ONLY
This form is preferred for breastfeeding if a hormonal method is needed/wanted. When starting after 6-8 weeks postpartum, milk supply is usually not effected.
Different forms of progesterone-only contraceptives:
-Pill, injection, IUD, and implant.
-Out of these options, the IUD (Mirena) is the most effective at preventing pregnancy (99%).
-The injection (DepoProvera) is 94% effective
-The pill is 91% effective (this number accounts for missing doses, so if taken perfectly – 99% effective).
A small amount of the synthetic hormones in contraceptives will enter breastmilk. There is no evidence that this is harmful to infants. Some babies younger than six weeks may have difficulty metabolising the hormones and for this reason it is not recommended to start using a hormonal contraceptive until baby is 6-8 weeks old.
MORE PERMANENT OPTIONS
If you are sure you are done having children, you could look into an option like a tubal ligation or your partner getting a vasectomy which are 99% effective at preventing pregnancy.
TUBAL LIGATION
AKA getting your tubes tied. Some moms will opt to have this done during a C-section if they know that are done having kids.
If you decide this later, it does not technically effect breastfeeding but it’s a surgery and it requires anesthesia which can pass into breastmilk so speak with your provider about the medications used and their safety with breastfeeding.
