Types of Birth Control for Breastfeeding Women

Woman taking birth control
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Although postpartum exhaustion levels may be nothing you've ever experienced and you may wonder if you'll ever have the energy to be intimate again, it's a good idea to start thinking about your postpartum birth control options sooner rather than later.

If you're breastfeeding, you may be wondering what type of birth control you should use. You have a choice of methods, some of which contain hormones and some that do not. You can choose the one that best meets your needs.

There are three categories of birth control methods you can choose from when you're breastfeeding: nonhormonal, progestin-only, and combination/estrogen-containing methods.

Nonhormonal Methods

  • Condoms. Condoms do not have any effect on the breastfeeding mother or baby, and they are the most effective nonhormonal birth control choice. However, breastfeeding mothers tend to have very low estrogen levels. Low levels of estrogen can cause vaginal dryness so condoms might be irritating to the vagina. To combat any discomfort, you can use additional lubrication. 
  • Diaphragm. The use of a diaphragm has no effect on the breastfeeding mother or baby. It is an efficient method and a good option for breastfeeding women. 
  • Spermicide. Spermicide does not affect breastfeeding, the breastfeeding mother, or the baby. Although, it is important to note that small amounts of spermicide may be absorbed into your bloodstream. Trace levels of spermicide in the blood may pass into your breast milk, but there is no known effect on the baby.
  • Nonhormonal Intrauterine Device (IUD). The nonhormonal IUD, or copper IUD, is also known as ParaGard. Since this method of contraception does not contain any hormones, it is a safe and effective method to use while you're breastfeeding. 
  • Natural Family Planning (NFP) (also called periodic abstinence). NFP has no effect on breastfeeding and can be a very effective choice. However, it takes time to learn, and it may be difficult to figure out signs of fertility while you're breastfeeding.
  • Vasectomy (also called male voluntary surgical sterilization). This has no effect on breastfeeding and is almost 100% effective. 
  • Tubal Ligation (also called voluntary female sterilization). Tubal ligation is also known as having your tubes tied. It is nearly 100% effective. While a tubal ligation does not technically affect breastfeeding, it is a surgery so it can interfere with breastfeeding in that way. Since the actual procedure requires anesthesia, you will be away from your baby for a short while, and the anesthesia can also pass into your breast milk. Anesthesia in breast milk can make your baby sleepy and difficult to nurse.
  • Lactational Amenorrhea Method (LAM). You have to be very careful with this method of contraception. To use this, you must be breastfeeding your baby exclusively, you can not have any vaginal bleeding or spotting after lochia ends, and your baby must be under six months old.

Progestin-Only Methods

The progestin-only birth control methods contain the hormone progestin (progesterone). If you decide to use a hormonal type of contraception, the progestin-only options are preferred. ​

Whether you choose the mini-pill, injectables, implants, or an IUD, progestin-only birth control is very effective at preventing pregnancy. These methods may also increase your breast milk volume.

Since there are hormones in these methods, a little bit of these hormones will pass into your breast milk. However, studies have shown that these small amounts do not appear to be harmful to breastfeeding babies.

Estrogen-Based Methods

The combination pill contains both estrogen and progestin. Combination pills work extremely well as birth control, but the estrogen in them can cause a decrease in your supply of breast milk

As with progestin-only methods, the hormones in combination birth control can pass into your breast milk.

While the small amount of hormones that pass through will not be harmful to your baby, the drop in your breast milk supply that may be associated with it could interrupt your breastfeeding routine.

You may prefer to avoid using contraception that contains estrogen. If birth control containing estrogen is your only option, your doctor may prescribe the lowest dose possible. 

When you're ready to discuss birth control options, let your doctor know that you're breastfeeding. As you begin your new contraceptive method postpartum, be sure to monitor your milk supply and your baby's growth

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  • Riordan J. Auerbach KG. Breastfeeding and Human Lactation. Jones and Bartlett Publishers, 2009.

By Melissa Kotlen
Melissa Kotlen is an International Board-Certified Lactation Consultant and Registered Lactation Consultant.