Birth Control & Breastfeeding
Breastfeeding as Birth Control For some women, breastfeeding exclusively can keep pregnancy at bay. The approach is called lactational amenorrhea method (LAM) and it can be used effectively until your baby is 6 months old—or when solids are introduced, says Kelly A. Hightower, R.N., a certified lactation counselor and owner of Bright Birth in Decatur, GA. The kicker is that you absolutely cannot provide any supplementation, so if you're pumping and providing a bottle, you're disqualified. It's the sucking that helps suppress ovulation. "The baby must nurse on demand no less then every three to four hours during the day, and six hours at night," Hightower says.
Return to the Pill If you took the Pill before you got pregnant and don't plan on nursing, it's safe to begin again three weeks postpartum.
Start Mini-Pills Opting for oral contraception while continuing breastfeeding? "It's recommended that nursing moms take mini-pills because they contain a low dose of progesterone and no estrogen," says Hightower. That's important because estrogen-containing contraception has been linked to a diminished milk supply. You can begin once your babe is six to eight weeks old.
According to Elizabeth Pryor MD, FACOG, breastfeeding moms frequently use a progesterone-only pill called Micronor, which is marketed specifically at lactating women and doesn't contain estrogen. "The downside with this pill is the cost, as it's more expensive than other pills," says Pryor. "The other very important aspect that a woman considering this pill should understand is that she must take it within three hours the same time every day. We've all forgotten a pill at night and say to ourselves, 'I'll just take it in the morning'--but this is not the pill to do that with. You must take it the same time every day."
Do a Test Run Other long-lasting progesterone-only female birth control options, like the injectable Depo-Provera, a hormonal IUD, and the implant, may be considered as well. However, "nursing moms should be encouraged to try mini-pills for several months first," Hightower says. If you find that your milk supply drops because of the mini-pill, you can simply stop taking it. But if your milk decreases with a longer-term birth control option, you're stuck until it's fully out of your system. (Depo-Provera lasts at least 12 weeks; a progesterone IUD and implant can last up to five years.)
Skip the Patch and Ring "Both are very convenient, but contain estrogen as well as progesterone; this can cause a decrease in milk supply, which can lead to a shorter duration of breastfeeding," Hightower says. These options may be reconsidered after six months of breastfeeding. Consult with your physician and lactation consultant beforehand.
Consider a Copper IUD Unlike its progesterone-only sister, copper IUDs have no impact on breastfeeding. As a bonus, breastfeeding moms actually experience less pain during insertion of the device, according to research in the American Journal of Obstetric Gynecology.
Think about a diaphragm. According to Pryor, those looking for contraception when breastfeeding can also use a diaphragm. "But i's important to be properly fitted for a diaphragm as your body changes with breastfeeding," she says. "A diaphragm may not fit as well or be as effective if you continue to lose weight in the postpartum period. You should be refitted if you lose more than 15 pounds."
Stay Safe with Barrier Methods. Pryor says barrier birth control methods such as a condom used with contraceptive foam have no systemic effects, and they're safe to use while breastfeeding.