Birth Control and Breastfeeding
Planning your next pregnancy
Planning the next pregnancy after childbirth is a very personal decision. After the birth of your baby, it is best to wait at least 18 months before trying to get pregnant again. This gap gives a woman’s body time to recover and gives a better chance for the next baby to be healthy. Talk to your health care provider about what is right for you.
Breastfeeding and birth control are compatible. Breastfeeding itself can be a highly effective form of birth control. This method is called Lactational Amenorrhea Method (LAM) and can reduce the chance of pregnancy by 98% but only if you answer yes to all of the following statements:
- My baby is less than 6 months old.
- My monthly periods have not returned.
- My baby is fully or nearly fully breastfed. Fully breastfed means that your baby gets all food from suckling at the breast. Nearly fully breastfed means that your baby is receiving vitamin D and or one or two mouthfuls once or twice a day of any other fluids or solids.
- My baby breastfeeds at least every four hours during the day and no longer than six hours between feedings at night.
If you answered no to any of the statements, the chance of pregnancy increases greatly. If you do not want to get pregnant, you will need to use another form of birth control.
The effectiveness of LAM in exclusively breastmilk pumping mothers may not be equivalent to direct breastfeeding.
Non-hormonal birth control choices
The following choices have no effect on breastfeeding and can generally be started soon after childbirth or the postpartum check-up:
- Condoms and spermicides
- Copper Intrauterine Device (I.U.D)
- Vasectomy (permanent for male)
- Tubal ligation (permanent for female)
Hormonal birth control choices
Hormone-based birth control choices can also be compatible with breastfeeding. Current research suggests that estrogens and progestins in birth control are not harmful to infants, but it is known that estrogen can reduce a woman's milk supply. For this reason, progestin-only birth control is recommended for breastfeeding women starting no sooner than six weeks after childbirth. There have been some reports of low milk supply with some progestin-only choices.
Progestin-only birth control:
- Mini pill
- Depo-Provera
- Hormone releasing I.U.D.'s
- Emergency contraceptive (Plan B)
Estrogen and progestin birth control:
- Birth control pill
- Birth control patch
- Vaginal contraceptive ring
- Emergency contraception (Ella)
It is wise to begin with a short acting progestin only contraceptive such as the mini pill before beginning a longer acting form such as Depo-Provera as it lasts 3 months and cannot be reversed once administered.
Sex and U has additional information on birth control options and effectiveness.
Talk to your health care provider to choose a method that is right for you.
Resources:
- Safe Use of Birth Control While Breastfeeding - Infant Risk Center
- Medications and Drugs While Breastfeeding (PDF) - The Society of Obstetricians and Gynaecologists of Canada (SOGC)
- Contraception - Sex and U