Contraceptive Use and Its Impact on your Milk Supply: Breastfeeding and Birth Control

Nov 22, 2023 | Breastfeeding

Contraceptive use while breastfeeding

Bringing a child into the world is an incredible experience, one that comes with its own set of challenges and responsibilities. For many new mothers, breastfeeding is not only a vital part of nurturing their newborns but also a personal choice. However, the question of birth control often arises when considering family planning while breastfeeding. This article explores the various aspects of breastfeeding and birth control, highlighting the options available to women and their impact on breastfeeding.

Breastfeeding is widely recognized as one of the most beneficial ways to provide essential nutrition and establish a strong emotional bond between mother and child. The World Health Organization (WHO) and the American Academy or Pediatrics (AAP) recommends exclusive breastfeeding for the first six months of an infant’s life, followed by continued breastfeeding alongside complementary foods up to two years or beyond. The benefits of breastfeeding include bolstering the infant’s immune system, reducing the risk of infections, allergies, and chronic diseases, and aiding in the mother’s postpartum recovery.

Breastfeeding and Fertility

While breastfeeding provides numerous advantages for both mother and child, it is not always a reliable method of contraception. The Lactational Amenorrhea Method (LAM) relies on the suppression of ovulation during exclusive breastfeeding in the first six months, but its effectiveness decreases as the baby grows older, feeds less frequently, or starts solid foods. Thus, relying solely on breastfeeding as a contraceptive method is risky, and other birth control options should be considered in addition to LAM.

Contraceptive Use for Breastfeeding Mothers

  1. Barrier Methods: Barrier methods such as condoms, diaphragms, and cervical caps do not interfere with breastfeeding and are generally considered safe options.
  2. Progestin-Only Birth Control: Progestin-only contraceptives, like the mini-pill or progestin-only implants (e.g., Nexplanon), are suitable choices for breastfeeding mothers. They should not affect milk production and can be started after childbirth when you’re ready to begin having sex again.
  3. Intrauterine Devices (IUDs): Both copper IUDs and hormonal IUDs are considered safe for breastfeeding mothers. They offer long-lasting contraception without affecting the quantity or quality of breast milk. If you have one placed and notice a change in your milk production, seek the support of an IBCLC
  4. Depo-Provera: The Depo-Provera shot is a progestin-only contraceptive injection administered every three months. While it does not interfere with breastfeeding, some women may experience a decrease in milk supply as a side effect.
  5. Combined Hormonal Methods: Birth control methods containing both estrogen and progestin, such as combined oral contraceptives (the traditional birth control pill), may slightly reduce milk supply in some women. However, many healthcare providers still consider them safe for breastfeeding mothers, especially if started after the baby is six weeks old and your breastmilk supply is readily established with no other feeding or breastmilk production concerns.

Consultation with a Healthcare Provider

Before selecting a birth control method while breastfeeding, it is essential to consult with a healthcare provider who can assess individual circumstances and provide tailored advice. Factors such as the mother’s health, the baby’s age and feeding patterns, and any underlying medical conditions should be considered when choosing an appropriate birth control method.

Potential Impact on Milk Supply

One concern among breastfeeding mothers is the potential impact of certain contraceptives on milk supply. While some methods, like the Depo-Provera shot or combined hormonal contraceptives, may affect milk production in a minority of women, most birth control options have minimal impact on breastfeeding. Monitoring the baby’s weight gain and consulting with an IBCLC or healthcare provider can help address any concerns regarding milk supply. 

The Trash the Pump and Dump website provides a helpful summary of CDC and WHO recommendations for contraceptive methods and lactation.

Balancing breastfeeding and birth control is a critical aspect of family planning for many new mothers. While breastfeeding provides a myriad of benefits for both mother and child, it should not be solely relied upon as a contraceptive method. Fortunately, there are several safe and effective birth control options available for breastfeeding mothers. Consulting with a healthcare provider is essential to make an informed choice that suits individual needs and circumstances. Ultimately, with the right contraceptive method, mothers can enjoy the benefits of breastfeeding while taking proactive steps to manage their family planning goals.

References: 
Trash the Pump and Dump website   https://trashthepumpanddump.org/contraceptives

Sarah Early - MSN, APRN-FNP-C, IBCLC

Sarah Early, MSN, APRN, FNP-C, IBCLC, is a clinically trained Integrative and Functional Health Family Nurse Practitioner who specializes in women's health and is the owner of Peony Women's Integrative Health and Lactation Room. She graduated with a Master's in Nursing and Family Nurse Practitioner with high distinction and is a member of the Sigma Theta Tau International Honor Society of Nursing. Sarah has been a practicing International Board Certified Lactation Consultant (IBCLC) since 2011 and opened Lactation Room in 2014. Lactation Room specializes in supporting parent/baby dyads who are struggling with infant oral dysfunction, feeding difficulties, and tongue-and-lip ties. They earned the prestigious IBCLE Care Award from the International Board of Lactation Consultant Examiners® (IBLCE®) and International Lactation Consultant Association® (ILCA®) have recognized Lactation Room for excellence in lactation care. She is a member of ILCA, USLCA, MBC, AANP, IATP, and MBC.