If you’re a breastfeeding mom committed to nursing your baby for a while, you want to avoid anything that might hurt that precious milk supply. But if you’re not ready for baby to have a younger brother or sister in nine months, you need a birth control plan. So what are the best options for breastfeeding and contraception that won’t decrease milk production?
Breastfeeding as Birth Control
You may have heard that you can’t get pregnant while breastfeeding, but relying on nursing alone to prevent pregnancy probably isn’t an air-tight plan. Although breastfeeding as birth control can be highly effective, Planned Parenthood explains that for it to work you must “nurse at least every 4 hours during the day and every 6 hours at night, and feed your baby only breast milk.” So as soon as you’re nursing less often than that, or as soon as your period has returned, you’ll need another pregnancy prevention strategy.
Birth Control Pills While Breastfeeding
Hormonal birth control containing estrogen isn’t considered safe for any new moms (breastfeeding or not) for the first month or so, since it increases the risk of dangerous blood clots during this period. After the first month, birth control methods that contain both estrogen and progestin still aren’t an ideal choice for breastfeeding moms, because estrogen can decrease milk supply. So doctors usually recommend that women stick with progestin-only contraceptives, such as a progestin-only pill (aka the “minipill”) until they are done breastfeeding. These medications are considered safe for a nursing infant.
“I was really afraid that taking any kind of medication could pass to my baby. I was afraid to take even Tylenol when I was pregnant,” says Laura, who is breastfeeding her second child and hopes to have a third in a couple of years. “My doctor recommended the mini pill. She told me I had to take it at the same time every day to make sure it worked, but it would not affect my milk supply.”
Laura has continued to successfully breastfeed while taking her progestin-only birth control pill. “My milk supply dropped when he was about four months old, and I struggled to keep up without having to supplement, but it increased around six months. He is nine months now, and I have not had a problem since,” responded Laura.
Breastfeeding and Contraception Shots, Implants and IUDs
As Laura’s doctor made clear, it’s especially important to take progestin-only pills every single day, ideally at the same time, for them to be effective. If remembering to do that daily is too much for your sleep-deprived mom brain, consider a progestin-only birth control method that you don’t have to think about so often, such as the birth control shot, implant, or IUD.
“I had the progesterone-only pill after my first, but I was not good at taking pills,” says Brooke, who is breastfeeding her third child. “So I decided to choose one this time that I would not have to worry about. My doctor told me I could go on a pill, have the Depo shot, have an IUD, or get an implant.”
Because she doesn’t plan to have more children, Brooke chose an IUD, which can be left in place for five years or more (depending on the type of IUD), and she hasn’t seen any decrease in her milk supply, or any other issues. “My biggest fear with changing from an estrogen-type pill contraceptive was that it wouldn’t work as well and I would have a higher risk for pregnancy,” says Brooke. “When I chose an IUD, I was concerned about possible problems with it coming out, but figured it was my best option.” So far, Brooke is happy with her choice.
Other longer term birth control methods, such as the birth control patch (which you change once a week) and the Nuvaring (which you replace once a month), aren’t great choices for breastfeeding women because they contain estrogen in addition to progestin.
Choosing the right contraceptive while breastfeeding your child will largely have to do with whether you plan to have another child soon, or what method of contraceptive you prefer. Most progesterone-only contraceptive methods can help preserve your milk supply while properly preventing conception. Talk to your healthcare provider about the best contraception option for you.
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