Breastfeeding and the Types of Birth Control

Birth control options for breastfeeding. Safe, effective methods of contraception.
Which type of birth control should you use when you're breastfeeding?. Peter Ardito/Photolibrary/Getty Images

What Kind of Birth Control Can You Take When You're Breastfeeding?

Although postpartum exhaustion levels are like nothing you've ever experienced, and you probably can't imagine ever having the energy to have sex again, you should still consider your birth control options. There are three categories of birth control methods from which a breastfeeding mother can choose: nonhormonal, progestin-only, and those containing estrogen.

However, if it's possible, you should do your best to avoid using contraception that contains estrogen.

Here is the breakdown:

Nonhormonal Method

  • Condoms: Condoms do not have any effect on the breastfeeding mother or baby, and they are the most effective nonhormonal birth control choice. However, breastfeeding mothers tend to have very low estrogen levels. Low levels of estrogen can cause vaginal dryness so condoms might be irritating to the vagina. To combat any discomfort, you can use additional lubrication. 

     

  • Diaphragm: The use of a diaphragm has no effect on the breastfeeding mother or baby.  It is an efficient method and a good option for breastfeeding women. 

     

  • Spermicide: Spermicide does not affect breastfeeding, the breastfeeding mother, or the baby. Although, it is important to note that small amounts of spermicide may be absorbed into your bloodstream. Trace levels of spermicide in the blood may pass into your breast milk, but there is no known effect on the baby.

     

  • Vasectomy (also called male voluntary surgical sterilization): This has no effect on breastfeeding and is almost 100% effective. 

     

  • Tubal Ligation (also called voluntary female sterilization): Tubal ligation is also known as having your tubes tied.  It is nearly 100% effective. While a tubal ligation does not technically affect breastfeeding, it is a surgery so it can interfere with breastfeeding in that way.  Since the actual procedure requires anesthesia, you will be away from your baby for a short while, and the anesthesia can also pass into your breast milk. Anesthesia in the breast milk can make your baby sleepy and difficult to nurse.

     

  • Lactational Amenorrhea Method (LAM): You have to be very careful with this method of contraception. To use this, you must be breastfeeding your baby exclusively, you can not have any vaginal bleeding or spotting after lochia ends, and your baby must be under six months old.

Progestin-Only Methods

The progestin-only birth control methods contain the hormone progestin (progesterone).

 If you decide to use a hormonal type of contraception, the progestin-only options are preferred.  

Whether you choose the mini-pill, injectables, implants, or the Mirena IUD, this form of birth control is very effective and can possibly increase breast milk volume. But, since there are hormones in these methods, a little bit of these hormones will pass into your breast milk. The good news is that studies have shown that the small amount that passes to the baby is not harmful. 

Estrogen-Based Methods

The combination pill contains both estrogen and progestin. Combination pills work extremely well as birth control, but the estrogen within them can cause a decrease in your supply of breast milk.  

As with progestin-only methods, these hormones can pass into your breast milk. The small amount of hormones that pass through will not be harmful to your baby, but a drop in your breast milk supply can indeed cause problems in your breastfeeding relationship.

If birth control containing estrogen is your only option, your doctor may prescribe the lowest dose possible.  Be sure to let your doctor know that you're breastfeeding, and monitor your milk supply and your baby's growth.  

Source:

Riordan J. Auerbach KG. Breastfeeding and Human Lactation. Jones and Bartlett Publishers

Edited by Donna Murray

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