Birth Control Options While Breastfeeding: What You Need to Know

Despite science saying that breastfeeding itself can act as a contraceptive, it is not a reliable form of birth control! Let’s explore what safety considerations you will need to bear in mind and what your options are when using birth control during lactation.

Hormonal Birth Control Methods

Hormonal birth control means that the type of birth control you are using releases hormones into the body to prevent and limit your chances of conceiving. The hormones that are used to manage this are called progestogen and oestrogen.

For breastfeeding-friendly options, the types of birth control recommended only contain progestogen.

Will hormonal birth control affect my milk supply?

Prolactin is the hormone that triggers milk production. The presence of progesterone and oestrogen can lessen the amount of prolactin and its effects on initiating milk production. Therefore, it is recommended that birth control for breastfeeding mums begin 4-6 weeks after the birth.

Studies have shown that although there was not much difference between mothers who took the combined pill or the progestogen-only pill, mothers who did not use birth control for the first month breastfed their babies longer than those who did.

As well as hormones, your diet plays a huge part in milk production.

Read more about the best foods for breastfeeding mums and foods to avoid.

Progestogen-Only Pills (Mini Pill)

If you’re breastfeeding, and you want to take birth control in the form of a pill, your doctor could advise you to take a progestogen-only pill (also known as the mini pill). This pill stops your ovaries from releasing an egg each month but is only effective when taken correctly within the guided time frames.

• Each pack contains 28 pills. Once you finish one pack, start the next pack the following day—no break in between. Your fertility will return quickly after stopping the pill.

• It’s less effective if you forget to take a pill.

• It can also be used to treat heavy periods or endometriosis.

Hormonal IUS

A hormonal intrauterine system is a small T-shaped coil that sits inside your uterus and releases progestogen to stop eggs from being released from your ovaries. You can also get non-hormonal versions of the same coil made from copper.

You can get this fitted as soon as you have given birth, however, it is advised to wait 4 weeks because your body can push this out if fitted too soon after labour.

• The IUS can last for 3-8 years before needing to be replaced and is highly effective.

• Your fertility resumes almost instantly once it has been removed.

• It’s not suitable for everyone, some women need to use alternative birth control methods.

Implant, Injections, and Patches

All these options can be used by breastfeeding mothers. However, they all work slightly differently and have varied longevity.

• The contraceptive implant is a small matchstick-size stick that is placed in the back of your upper arm and can be replaced every 3 years. You can remove it within this time and there is a high chance that your periods will change whilst it is fitted.

• Injections of progestogen last for 8-13 weeks. It can take up to a year for your fertility levels to return as they were and for the duration you receive injections, there is an increased risk of weaker bones. This improves after you stop receiving the injection.

• Within a month, you can wear up to three contraceptive patches on your skin and be patch-free for one week. Some medicines or herbal remedies can hinder the effectiveness of the patches, but when used correctly, they are 99% effective.

What are the side effects of using hormonal birth control?

When using any contraception, you may notice subtle changes to your skin, mood, or libido; similar to when you are menstruating. Some types of birth control are not suitable if you have underlying health conditions such as heart conditions, or strokes, or if you have previously had types of cancer.

Other types explain risks that can come from using specific types of birth control. The progestogen-only pill states there is a chance of developing cysts on the ovaries which often cause no issues or require no intervention and will disappear on their own when the treatment stops.

Non-Hormonal Birth Control Methods

If hormonal birth control isn’t an option for you, your alternatives are the copper coil (IUD) or barrier methods such as condoms, diaphragms, or a cervical cap. With any contraceptive, it will not stop you from getting sexually transmitted diseases, so it is recommended that you use a barrier method as well as other forms of birth control to be safe.

Copper IUDs work the same way as the hormone version (progestogen) but instead, it releases copper into the uterus and prevents pregnancies. Once it is removed, your fertility will resume almost instantly. Depending on the type of IUD, it can last for 5-10 years before needing to be replaced and is safe for nursing mums to use.

Lactational Amenorrhea Method (LAM)

Lactational Amenorrhea is a type of birth control that occurs naturally when breastfeeding for the first 6 months because it delays ovulation. For this method to be effective, you need to ensure you are breastfeeding your baby every four hours during the day and every 6 hours at night.

If your periods start within the first 6 months after giving birth, or you are supplementing with formula milk or solid foods, this method will not work. It requires consistent breastfeeding until your ovulation resumes (up to 6 months after giving birth).

There is also a chance that you can ovulate before menstruating and go from one pregnancy to another without having a period. If you think you may be pregnant, speak to your doctor or breastfeeding consultant so they can guide you through any next steps or queries.

Discussing Birth Control with Healthcare Providers

Are breastfeeding-safe birth control options as effective?

Yes, some breastfeeding-friendly contraceptives are 99% effective when taken correctly. For the contraceptive to work at its best, you must take the dose within the advised timeframes. If you forget or take the dose later than recommended, there is a higher chance you could fall pregnant.

What your doctor needs to know before prescribing birth control?

Before recommending any form of birth control, your doctor will ask you about your medical history and any underlying health conditions. This could eliminate certain contraceptives that are not suitable for you.

It also helps to understand your breastfeeding goals so that this can be factored into your decision. It also helps discuss if you are planning or considering any future pregnancies and how quickly your fertility will return once you stop using birth control.

Birth Control Options After Breastfeeding

Your healthcare provider will be able to advise the best birth control available to you after a short discussion on the points explained above. For it to be effective and work at its best, you need to take into account your medical history and lifestyle to get the best birth control option for you.

When you meet with your doctor to discuss birth control options, these are some questions you can ask for full clarity and personalised advice.

1. I have ‘X’ medical condition, which birth control options are safe for me to use if I am breastfeeding?

2. Are there any dietary recommendations alongside using this contraceptive?

3. I have tried ‘X’ contraceptive before and experienced ‘X’, is there an alternative I can try instead?

4. I struggle to maintain a healthy milk supply, which birth control types should I use/avoid?

5. Which birth control would you recommend if I plan to fall pregnant again with ‘X’ time frame?

Conclusion

Don’t feel like you need to rush to decide on birth control straight after giving birth. You have plenty of time to make an informed decision based on your health needs, lifestyle, and if you want to breastfeed. By having all of the information at your fingertips, you can choose an effective solution that will allow you to breastfeed for as long as you want to.