What Birth Control Is OK When You’re Breastfeeding?

Your new baby is here, and you know that you’re not ready to get pregnant again. So what type of birth control is best while you breastfeed?

You have a little time to decide. Most doctors recommend that new moms not have sex until after the 6-week checkup. So, you may not even need birth control before your baby is 6 weeks old.

When the time comes, you'll have a lot of options for contraception.

Birth Control Pills

You may have heard that some could curb your milk supply, which would make it harder to feed your baby. It’s true that some hormones may have that effect. But not all do.

There are two types of birth control pills:

  • Combination ones include the hormones estrogen and progestin
  • Others only have progestin. Some people call these the “mini-pill.” 

Estrogen may mean you make less milk. So when you tell your doctor that you’re breastfeeding, she'll probably prescribe the mini-pill. It shouldn’t affect your milk supply at all.

If your doctor thinks combination pills are better for you than the mini-pill, she’ll likely wait 5 or 6 weeks, before she prescribes one for you. 

There's another reason why you may need to wait before you take combination pills -- they make blood clots more likely in the first few weeks after you have a baby. So, it’s wise for all women -- even those who bottle-feed -- to hold off on them during the first month after childbirth.

IUDs

If you want long-term birth-control that isn’t permanent, you may want to consider an IUD (intrauterine device). Your doctor can insert it into your uterus after you give birth or 6 weeks later during an office visit. You don’t have to remember to take a pill daily or do anything special before sex for an IUD to work.

Two types are available: one that’s copper and another that contains the hormone progestin. Either one is fine for nursing moms. The copper IUD has no hormones to affect your milk supply. The other has low levels of progestin, which won’t cause problems with your supply.

You may want to wait until your 6-week checkup to get your IUD inserted. If you get it right after your baby is born, there’s a chance that your body will push it out.

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Implants, Injections, and Patches

These hormone-based birth control methods last longer than a daily pill, and some won’t reduce your milk supply.

Implants . You can prevent pregnancy for up to 3 years with a special stick that’s the size of a match. Your doctor implants it just under your skin in your upper arm. This form of birth control only has the hormone progestin, so it doesn’t affect your milk supply.

Injections. Your doctor can give you birth control shots every 3 months. They have more progestin than implants do.

Patches. You peel a birth control patch and stick it on your back, arm, stomach or butt for a week at a time. The patch contains two hormones, estrogen and progestin, like combination birth control pills. Your doctor may not think it’s best for you while you nurse a baby. If she prescribes it, wait 6 weeks, until your milk supply is set.

Vaginal ring. You place it inside your vagina and keep it there for 3 weeks at a time. This form of birth control has estrogen and progestin. Because you’re breastfeeding, your doctor may not want you to use it for the first 6 weeks after you have your baby.

Barrier Methods

These devices, which have no hormones, include:

Condoms. They’re easy to use and can prevent pregnancy if you use them the right way every time. If you also use a spermicide (a foam or cream that kills sperm), you’ll lower your chances of getting pregnant even more. Spermicide doesn’t have any hormones in it.

Diaphragm. Your doctor can fit you for it 6 or more weeks after your baby is born. That gives your body enough time to get back to normal after childbirth. If you had a diaphragm before your pregnancy, ask your doctor whether it still fits. Many women need a new size after childbirth.

Cervical cap. This device covers the cervix (the opening to your uterus). If you already have one from before you were pregnant, ask your doctor to check to see if you can still use it. Your cervix expands quite a bit during childbirth, so you may need a new one.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on May 04, 2018

Sources

SOURCES:

Sharon Phelan, MD, FACOG, professor of obstetrics and gynecology at the University of New Mexico in Albuquerque.

American College of Obstetrics and Gynecology: “Combination hormonal birth control: Pill, patch and ring.”

Nichols-Johnson, V. Breastfeeding Abstracts. November 2001.

FDA: “Birth control: Medicines to help you.” 

American College of Obstetrics and Gynecology: “Long-acting reversible contraceptives (LARC): IUD and implant.”

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