PARENT CARE MATTERS

Contraceptives and Breastfeeding

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Summary:

Breastfeeding may delay the return of fertility for the birth parent, but the duration of that delay is dependent on many factors. For that reason, many breastfeeding families opt for an additional form of contraception to assist with family planning. Some contraceptive methods do not interfere with milk production while some can affect the milk supply of some people.

Definition:

The barrier method of birth control (i.e. condoms, diaphragm) refers to methods that prevent pregnancy using a physical barrier. These methods generally do not have an impact on breastmilk production, as they do not affect any systems required for lactation.

The hormonal method of birth control (i.e. the pill, hormone shot or implant, and IUD) use hormones to prevent pregnancy. These methods can impact milk production for some families, as they impact hormone levels in the body that play a part in lactation.

Lactation Amenorrhea Menstruation (LAM) refers to the period after birth up to six months or until the birth parents period returns when they are not ovulating due to exclusive breastfeeding and cannot become pregnant. Exclusive breastfeeding is defined as a baby receiving all its feeds directly from the breast around the clock. Birth parents whose babies receive bottles or pacifiers are not able to use the LAM method. LAM is 97% effective when all requirements are met within the first six months after the baby is born.

Options:

• Condoms, diaphragm
• The pill, hormone shot, implant, or IUD
• Fertility Charting Tool/App

Steps:

  1. Schedule a visit with your healthcare provider (HCP) to discuss the options that are most appropriate for your family.
  2. Consider the implications of how each method can affect your milk production. If you are already dealing with low supply issues consider a non-hormonal birth control method.
  3. If considering a hormonal method, a progesterone only method is often considered the method that will have the lowest impact on your supply. Consider starting with the “mini-pill” (progestin-only pill) for 1 month if you are considering an IUD (intrauterine device) or other implanted treatment. If there is a negative impact on milk supply, the contraceptive pill can be discontinued while looking for a different solution. If there is a negative impact on milk supply with a long term hormonal method it can take weeks or months for the supply to rebound.
  4. If considering Lactation Amenorrhea Menstruation, start charting fertility signs using paper or a charting app. If menstruation resumes or if the baby stops exclusively breastfeeding use another contraceptive method.

Follow Up:

If you have any questions about contraception and breastfeeding, please schedule an appointment with your HCP and/or your lactation professional. If you have started taking a new oral contraceptive and you feel that it has reduced your milk supply, please call your lactation professional for assessment and a plan.

Research & Resources:

The contraceptive effect of breastfeeding

Infant Risk Center is the world’s leading resource for medication safety during pregnancy and lactation. Located at the Texas Tech Health Sciences Center, they operate at hotline to answer questions about OTC or prescription medications while pregnant or nursing at
1 (806) 352-2519
Monday – Friday 8am – 5pm CT.

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