Some birth control options that are safe while breastfeeding include the progestin-only pill, the IUD, tubal ligation, the birth control shot, and condoms. All of these can help prevent an unplanned pregnancy.
When breastfeeding, it’s important to avoid birth control that contains estrogen. This hormone can interfere with breast milk production because it lowers prolactin levels, which play a key role in stimulating milk supply.
Even so, you should always speak with a gynecologist, who can recommend the safest and most appropriate birth control option during breastfeeding based on your needs and your baby’s needs.
Birth control while breastfeeding
The birth control methods recommended during breastfeeding include:
1. Birth control pill
The birth control pill recommended during breastfeeding is the minipill, which contains only progestin.
This type of pill lowers the risk of blood clots and reduces the chances of decreased milk supply. It also does not affect a baby’s growth or development.
When to start the minipill depends on the hormone prescribed by the doctor, and is typically prescribed as:
-
Norethindrone (Micronor): can be started at any time after delivery, as long as a healthcare provider is reasonably certain you are not pregnant. If starting 21 days or more after delivery and your period has not returned, a barrier method, such as condoms, should be used for the first 2 days to prevent an unplanned pregnancy.
It’s important to take the pill at the same time every day. If a dose is delayed or missed, a barrier method such as condoms should be used.
2. Subdermal implant
The subdermal progestin implant, known as Nexplanon, is a small rod inserted under the skin that slowly releases the daily amount of hormone needed to prevent ovulation.
Implanon can be inserted starting at the 4th week after delivery. During the first 7 days, condoms should be used to prevent an unplanned pregnancy.
Insertion is done by a gynecologist using local anesthesia in a quick procedure on the arm. The implant can remain in place for up to 3 years but can be removed at any time.
3. IUD
The IUD is a very effective and practical contraceptive method because it does not require daily action or reminders.
The two types of IUDs that can be used while breastfeeding are:
-
Levonorgestrel (Mirena IUD): may be inserted starting at the 4th week after delivery, as recommended by a doctor
-
Copper IUD: may be inserted immediately after birth, from the 4th week after a vaginal birth, or from the 12th week after a cesarean section
The IUD must be inserted by a gynecologist, in a clinic or hospital. It can be removed at any time by the doctor when the woman wishes.
4. Diaphragm
The diaphragm is a barrier birth control method that can be used while breastfeeding.
It is inserted before intercourse and prevents sperm from reaching the uterus.
However, fitting should be done at least 6 weeks after delivery. This allows time for the uterus and cervix to return to their normal size, which can affect diaphragm sizing.
5. Condom
Condoms are barrier methods that can be used at any time during breastfeeding because they do not affect breast milk.
Both female and male condoms are good options for women who cannot or prefer not to use hormones, and they also protect against sexually transmitted infections.
Male and female condoms have effectiveness rates of 98% and 95%, respectively, for preventing unplanned pregnancy.
6. Birth control shot
The birth control shot, Depo-Provera, contains medroxyprogesterone acetate, a form of progestin used to prevent pregnancy while breastfeeding.
This injection does not affect a baby’s development and may be used starting at the 6th week after delivery.
The shot must be administered by a healthcare professional every 12 weeks with medical guidance.
7. Tubal ligation
Tubal ligation is a permanent birth control method considered safe during breastfeeding, with a 99% effectiveness rate. It can be done shortly after delivery.
This surgery involves cutting, tying, or placing a ring on the fallopian tubes, blocking the connection between the ovaries and the uterus so that sperm cannot reach the egg.
What is the best birth control while breastfeeding?
There is no single best birth control method during breastfeeding because the choice depends on each woman’s needs, desired effectiveness, and personal preferences.
However, the safest options while breastfeeding are barrier methods or those that contain only progestin.
Natural contraceptive methods
Natural contraceptive methods include:
-
Withdrawal
-
Rhythm method
-
Temperature tracking
However, these methods are not recommended because they are less effective and increase the risk of an unplanned pregnancy.
Is breastfeeding a contraceptive method?
Breastfeeding can act as a contraceptive method if the baby is under 6 months old and exclusively breastfed.
Frequent breastfeeding increases prolactin levels in the mother, which can suppress ovulation by altering estrogen production.
Even so, this does not completely prevent pregnancy, and therefore breastfeeding is not recommended by doctors as a reliable contraceptive method.