Breastfeeding and Contraception: Excellent Tips On How To Choose

Breastfeeding and Birth control are important!

Most women of child bearing age often wonder if one can become pregnant while breastfeeding. I know this was a question I pondered on at some time. After going through childbirth experience, I am sure that the majority of women would op to at least a year or two break from pregnancy.

Research has shown that the chances of a woman getting pregnant while breastfeeding is reduced, the possible chances are there.

Knowing When To Start Is Important


During pregnancy a woman and her partner should have already discussed their contraception method with their healthcare practitioner. Nowadays, many couples have more options. Many contraceptives can be started immediately after birth

  • including intrauterine devices (IUDs)
  • arm implants, Depo-Provera® shots
  • and progestin-only pills.
  • The most effective contraceptives are intrauterine devices (IUDs such as Mirena® and ParaGard®), and the arm implant called Nexplanon®.
  • This means there is a much lower chance of getting pregnant when using an IUD or an arm implant, as compared to a birth control pill
  • Depo-Provera shot, condoms, or any other contraceptive.

It is important for you to know your safest methods to use because you do not want to jeopardize your breastfeeding success.

Non-hormonal methods of contraception


  • Condoms with or without spermicides: These can be used with no impact on breastfeeding. The vagina of the nursing mother might be dryer than normal, which can make condoms irritating. If this is a problem, use additional lubrication. It is important to know that this method has a much higher chance of pregnancy as compared to the hormonal methods.
  • Barrier methods: These methods, such as the diaphragm and cervical cap with spermicides, have no effect on breastfeeding. Check with your clinician to refit the device because you might need a larger device after having a child. It is important to know that this method has a much higher chance of pregnancy as compared to the hormonal methods.
  • PARAGARD is an intrauterine device (IUD), which is non-hormonal. This type of IUD is made of copper. The IUD does not affect the quality and quantity of breast milk. PARAGARD IUD is safe and effective for 10 years.
  • Tubal sterilization: This is a surgical, permanent form of birth control, known as “having your tubes tied,” that only affects breastfeeding if general anesthesia is required. (That means you are put to sleep for the operation.) Anesthetic medicine can pass through the breast milk.

Hormonal methods of contraception


Make the right choice in your contraception decision
  • Progestin-only oral contraceptives, or “The Mini-Pill,” contain only a progestin (a female hormone). The method, when used daily, is highly effective for breastfeeding women. This method of contraception has a slightly higher failure rate than oral contraceptives (OCs) containing both estrogen and progestin. During breastfeeding, however, women are not as fertile. A small amount of hormone passes into the breast milk but has no known bad effects on the infant. In fact, some studies have suggested a good effect on the quantity and quality of breast milk. When the woman stops breastfeeding the baby, or when menses returns, some clinicians suggest switching to combination OCs, which have a slightly higher effectiveness.
  • Combination oral contraceptives, or “The Pill,” contain both estrogen and progestin. The American Academy of Pediatrics has approved the use of low-dose OCs in breastfeeding women once milk production is well established.
  • (NuvaRing®) and a skin patch (Ortho Evra®) contain estrogen and progestin, similar to combination oral contraceptives, or “The Pill.” You should discuss with your doctor if this is an appropriate option for you during breastfeeding. Most often, products which don’t contain estrogen are preferred during breastfeeding (preferred products are Mini-Pill, IUDs, progestin only arm implants, etc.).
  • The Mirena IUD
  • releases a very small amount of hormone into the uterus, where it works locally. This IUD does not affect the quality and quantity of breast milk. The Mirena IUD is safe and effective for five years.
  • If you have an untreated genital infection, get infections easily, or have certain cancers, don’t use Mirena. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID).
  • If you have persistent pelvic or stomach pain, excessive bleeding after placement, or if Mirena comes out, tell your healthcare professional (HCP). If Mirena comes out, use back-up birth control. Mirena may go into or through the wall of the uterus and cause other problems.
  • Pregnancy while using Mirena is uncommon but can be life threatening and may result in loss of pregnancy or fertility.
  • Ovarian cysts may occur but usually disappear.
  • Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter, or may stop.
  • Mirena does not protect against HIV or STDs.
  • Only you and your HCP can decide if Mirena is right for you. Mirena is available by prescription only
  • Medroxyprogesterone (Depo Provera): This is an injection or shot that can be safely used during breastfeeding and does not suppress milk production. At least one study suggests that this method of contraception might have a beneficial effect on the quality of breast milk in terms of its fat concentration, calories, minerals, and protein composition. As a Lactation Specialist, I would recommend a mom to wait to take this shot for 6 weeks. Many moms are given the shot within the few days that you are in the hospital after birth. The reason why I recommend to wait 6 weeks is because your milk supply is well established. Furthermore, if you exclusively breastfeeding, giving no bottles, you will not ovulate. You should not use if you have liver disease, blood clots or strokes, gallbladder disease, cancer of the breast or reproductive organs should not use the Depo Provera.
  • Nexplanon, a progestin-only implant is inserted into the upper arm. This is done via a simple office procedure. This is one of the most effective birth control options, and is effective for three years. This can be inserted immediately after delivery of the baby.

Remember: If you are at risk for a sexually transmitted disease (STD), use condoms to protect yourself. Sexually transmitted diseases can happen to anyone who is sexually active, even during breastfeeding. Don’t stop taking or using your birth control method on your own. Always call your clinician if you have any questions.

I hope you become more knowledgeable in how contraceptions work.; especially if you are breastfeeding. Letting your healthcare provider know that you plan to breastfeed after having baby is important . Make sure that they give you the one you are interested in and learn about it, including the side effects. Thank you for stopping by and visit again. If you have any questions, you can let me know below. I wish you a happy, healthy, and safe breastfeeding journey.

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