Birth control while breastfeeding - Evidence Based Babie
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Birth control while breastfeeding

Birth control while breastfeeding

There’s a lot of birth controls options out there, some are completely safe while breastfeeding, while others may cause issues with the milk supply.

It’s recommended to wait until at least 6-8 weeks before starting birth control. Seeing as it is recommended to wait until the 6-week mark before commencing sexual intercourse, contraception is not needed before then either. Studies has shown that the hormones from birth control does pass into breastmilk, though it’s extremely small amounts and hasn’t been found to be harmful to babies. But, due to a newborn’s liver being unable to metabolize the hormones, it can be a cause for concern.

The use of any hormonal birth control before 6 weeks may reduce the milk supply, including progestin only contraceptive. It has been found that the use of hormonal birth control, especially in higher-than-average doses, may alter or decrease breastmilk composition including, protein, nitrogen and lactose. Some mothers have reported that their babies became fussier then usual when they started birth control, and that the fussiness wore off after discontinuing the use of birth control.

Different birth control methods

Non hormonal birth control:

Non hormonal birth control is the safest option for breastfeeding mothers.

– The Lactation Amenorrhea Method (LAM)

The Lactation Amenorrhea Method (LAM) is a natural, but short-term method of birth control that relies on exclusive and responsive breastfeeding for effectiveness.

Amenorrhea refers to the natural postpartum infertility that occurs in women who is not yet ovulating and menstruating.

The physiologic basis for lactation infertility is not completely understood. During pregnancy, the level of circulating prolactin is greatly elevated. The elevated blood levels of prolactin begin at 8 weeks and rise to levels of 200 ng per ml at term. In lactating women, prolactin levels stay elevated, with spikes of increased secretion during and following suckling. The evidence points strongly to the fact that persistent hyperprolactinemia caused by breastfeeding postpartum results in an anovulatory or oligo-ovulatory state, and this results in relative infertility.

You may have heard that LAM is a myth and that it isn’t effective, but this statement itself is a myth. LAM is actually 98% effective. But it has to be done correctly. There is a very specific criteria that should be met, and just like any other birth control method, it’s not 100% guaranteed, especially not if you don’t follow the guidelines.

For LAM to be successful:

– The mother should not be menstruating yet

– The baby be 6 months of age and younger

– The baby should be exclusively breastfed (no formula or other liquids and no solids)

– The baby should be breastfeeding on demand and frequently (no intervals longer than 4-6 hours during both the day and the night)

Once these guidelines are not followed perfectly or one is no longer relevant, the effectiveness of LAM will no longer be as high, and the chance of pregnancy will be much higher.

– Barrier methods (Condoms, diaphragms etc.)

Barrier methods are also a great natural birth control method that won’t affect the milk supply.

Condoms are 98% effective

Diaphragms are 94% effective

Internal condoms are 95% effective

Cervical caps are 86% effective

– Spermicide

Spermicide is also a good choice for birth control, but on its own, it’s not very effective. If spermicide is used, it’s best used with another method.

Spermicide is 82% effective

– Non hormonal IUD

Non hormonal IUD’S are 99% effective

– Natural family planning

Natural family planning is another great natural method of birth control, and when done effectively and all the steps are followed and done correctly, it is 99% effective.

Hormonal birth control

Progestin-only contraceptives

Progestin–only contraceptives are preferred for breastfeeding if a hormonal method is desired or needed. Most mothers do not experience any problems with their milk supply when using progestin-only forms of contraception when started after the 6th-8th week postpartum. However, there are a number of anecdotal reports that some women experience issues with their milk supply when using progestin-only methods of contraception.

– Progestin-only pill (also called the mini-pill)

The progestin-only mini pill is 91% effective

– Progestin injection

The progestin injection is 96% effective

– Progestin releasing IUD

Progestin releasing IUD’S are 99% effective

– Progestin implant

The progestin implant is 99% effective

All of the above figures are based on best or perfect use. If it’s not used 100% correctly, it will be less effective than mentioned. It is important to remember that every birth control method has its own pros, cons and side effects. No birth control method is 100% effective, and parents will have to weigh all of their options to see what works best for them.

Important note:

Combination contraceptives or any birth control containing estrogen has been found to reduce milk supply, and therefore it is not recommended for breastfeeding mothers. Progestin only contraceptives are a much better alternative, although some mothers may find it can also cause a reduction in milk supply. The best option will always be natural birth control methods when possible.

Additional information and resources:

Planned parenthood

Contraceptives, Oral, Combined

Hormonal contraception and lactation

The effect of lactation on ovulation and fertility

Multicenter study of the Lactational Amenorrhea Method (LAM): I. Efficacy, duration, and implications for clinical application


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