Contraceptives While Breastfeeding

Before taking any medication, breastfeeding mothers need to weigh the benefits with the possible risks. To prevent a subsequent pregnancy, the breastfeeding mother might be interested in contraceptives, both hormonal and non-hormonal. Many of these methods are compatible with breastfeeding, and mothers should determine which method works best for their situation.

Types

Contraceptives---both hormonal and non-hormonal---can prevent pregnancy during lactation. Non-hormonal methods include barrier methods, spermicides and non-hormonal intra-uterine devices. Hormonal methods available include progestin-only methods, such as the minipill, IUDs, vaginal rings, injectables and implants.

Effects

"The Breastfeeding Answer Book" by Nancy Mohrbacher and Julie Stock says that barrier methods that do not contain spermicide generally do not have negative effects on breastfeeding. If a breastfeeding mother uses spermicide, though, she might absorb a small amount into her blood and possibly pass to the milk; however, no adverse affects to babies have been reported. In addition, non-hormonal IUDs don't have an effect on breastfeeding.

Progestin-only hormonal methods are compatible with breastfeeding. Progestin-only methods work to thicken cervical mucus, block ovulation and make it difficult for sperm to penetrate.

Hormonal methods with progestin and estrogen are not the best choice for breastfeeding mothers, according to askdrsears.com and "The Breastfeeding Answer Book."

Time Frame

Mothers can take non-hormonal methods of birth control at any time post-partum. They can take progestin-containing hormonal forms as early as six weeks post-partum, once they have started breastfeeding.

Mothers should not use birth-control methods that contain estrogen until the baby is at least six months old, and he is eating solid foods and doesn't rely on breast milk as heavily.

Warning

Introducing a hormonal contraceptive early---even a progestin-only pill---could have some adverse effects. Mothers taking hormonal methods should watch for a drop in milk supply. It does seem, though, that with progestin-only methods, the mother shouldn't worry about adverse affects to the baby. "The Breastfeeding Answer Book" cites a study that followed breastfed babies whose mothers were on a progestin-only method until the children were 17, and the study noted no negative effects.

Breastfeeding mothers should not take contraceptives that contain estrogen, as they have been cited to reduce the milk supply and overall duration of breastfeeding. As a matter of fact, "The Breastfeeding Answer Book" says that methods with estrogen could decrease total milk supply by 20 to 40 percent. The book also states that the American Academy of Pediatrics consider estrogen and progestin compatible with breastfeeding.

Considerations

Some breastfeeding mothers have success with the lactation amenorrhea method of pregnancy prevention. This method assumes that the mother is exclusively breastfeeding and not supplementing with formula or solid foods, has not resumed her menstrual cycle since pregnancy and her baby is under six months old. Planned Parenthood says that two to eight women out of 100 practicing LAM will experience a pregnancy, and "The Breastfeeding Answer Book" claims that LAM is 98 percent effective in the first six months of the baby's life.