Birth Control + Breastfeeding: Compatible Methods
What’s the scoop on breastfeeding and birth control?
Is it true that breastfeeding prevents pregnancy?
What birth control options are safe for breastfeeding or pumping moms?
Birth Control During Lactation: FAQ’s + Tips
When can I expect my period to return?
It depends on the level of stimulation your body is receiving for lactation. If you are not breastfeeding or pumping, or are breastfeeding or pumping infrequently- it’s possible for your period to return as early as 4-6 weeks postpartum. This is due to low levels of prolactin which stimulates milk supply. Without adequate stimulation of this hormone through milk removal (whether by choice to combination feed or formula feed) ovulation and the return of your cycle can return.
Why does my supply go down when my cycle returns?
Hormone changes that occur after ovulation {an increase in estrogen and progesterone levels} can cause a decrease in milk production for some women. Typically this last for a few days and then milk supply regulates (returns to previous level). If you notice your milk supply changes when your cycle occurs, you can:
Continue lots of on demand feedings: This helps stimulate your prolactin hormone level
Consider talking to your lactation consultant about taking a calcium/magnesium supplement. We typically recommend trialing 1000 mg calcium/500 mg magnesium for 3-4 days before and during your menstrual cycle to help with the dip.
Why is my baby fussier when I have my cycle?
Hormones changes can change the taste in your mix and your baby may be more sensitive to this change. Consider adding in the magnesium/calcium supplement above, offering on demand feedings and know that your baby may want to nurse more frequently {it is actually their intuitive way of trying to help increase your milk production}
I thought breastfeeding could be used as a form of birth control- is that true?
It can be but it has very specific guidelines for it to be effective. See our section on Lactational Amenorrhea Method (LAM) below.
What birth control options are safe for me during lactation?
>>> Progestin-Only Methods
Progestin-only options, like the "mini-pill," hormonal IUDs (such as Mirena or Skyla), implants (like Nexplanon), and injections (like Depo-Provera), are generally considered safe for breastfeeding mothers and are the most commonly recommended by OBGYN’s and midwives.
When it comes to pills and synthetic birth control options, it is recommended to avoid estrogen containing options, this can decrease your milk supply.
>>> Non-Hormonal Methods
Barrier methods, such as condoms, diaphragms, and cervical caps, offer a hormone-free way to prevent pregnancy. Additionally, copper IUDs provide long-term, hormone-free contraception that doesn’t interfere with breastfeeding.
>>> Natural Family Planning (NFP)
Natural family planning (tracking your cycle using the fertility awareness method or tracking your temperature can be a viable option. This involves tracking your menstrual cycle and understanding fertility signals, like basal body temperature and changes in cervical secretions. It requires commitment and attention to detail, but can be very effective when practiced correctly.
>>> Lactational Amenorrhea Method (LAM)
The return to fertility is individual for each mother and it is possible to get pregnant while breastfeeding. However, 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? (this also requires that baby received no pacifier, bottles as this can reduce your hormone level)
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. It is worth considering that when a condom fails you are extremely likely to know about it and have the opportunity to take immediate action, whereas when LAM fails you are likely to find out only at a point in time when your options are reduced.
When is it safe to begin birth control?
If you are considering synthetic birth control, it is recommended to wait six weeks postpartum before starting hormonal birth control. This allows time for your milk supply to stabilize. While estrogen-containing contraceptives are effective, they may decrease milk production in some women, making progestin-only or non-hormonal methods a preferred choice during the breastfeeding period..
Trust your instincts, consult with your healthcare provider, and know that you’re doing an amazing job nurturing your baby and taking care of yourself. Remember, every mother’s journey is unique, and finding what works best for you is the key- you’ve got this!
If you would like personalized guidance in selecting a birth control method compatible with breastfeeding, contact our experienced team of IBCLCs on our website, or give us a call at (760) 274-0149 to schedule an appointment!