If you’ve just had a baby and are breastfeeding, you’re likely wondering about the safest, most effective birth control for this time in your life. Although breastfeeding provides natural pregnancy protection, it isn’t foolproof. Understanding your choices will enable you to make an informed decision based on your health, lifestyle, and family planning desires.
Is Birth Control Safe While Breastfeeding?
The good news is that most forms of birth control are safe to use while breastfeeding. They will not hurt your baby or affect your milk supply, but the type and timing of contraception matter.
Hormonal contraceptives that include estrogen, such as combination oral contraceptive pills, patches, or vaginal rings, are usually discouraged in the first six weeks post-birth. Estrogen decreases milk production, which could result in issues such as your baby not receiving adequate nourishment or dehydration. Progestin-only methods, however, like the minipill, implants, or hormonal IUDs, are safer for lactating mothers.
Nonhormonal options, such as copper IUDs or barrier methods (consider condoms or diaphragms), are just as great because they have zero effect on milk supply.
Why Birth Spacing Matters
Experts suggest waiting a minimum of 18 months between pregnancies. This interval allows your body to complete recovery and minimizes health risks to your second baby. Becoming pregnant too early after delivery may boost the risk of premature birth, low birth weight, or giving birth to a baby smaller than average.
Curiously, waiting too long between pregnancies, over five years, can also have some risks associated with it, such as an increased risk of developing preeclampsia. That’s all the more reason, then, to seek out a form of birth control that suits you at this postpartum stage.
Your Birth Control Choices
Progestin-Only Options
- Minipill: This daily pill is well-liked by breastfeeding parents since it will not affect milk supply. It’s approximately 93% effective with normal usage, but must be used at the same time each day.
- Arm Implants: Nexplanon is a tiny rod implanted under the skin of your upper arm. It releases progestin and protects for three years. It’s a “set it and forget it” solution that’s safe during breastfeeding.
- Depo-Provera Shot: This injection prevents ovulation and lasts around three months. It’s another progestin-only solution that can be initiated immediately after delivery.
Intrauterine Devices (IUDs)
IUDs are the most effective form of contraception, with more than 99% efficacy. Two forms exist:
- Hormonal IUDs (names such as Mirena, Skyla, Kyleena) release minimal levels of progestin intra-uterinely and guard for 3 to 8 years. They have no impact on milk production and can be inserted immediately after giving birth.
- Copper IUDs are hormone-free and last for a maximum of 10 years. They’re an excellent choice if you don’t want to take hormones at all.
Barrier Methods
Barrier methods, such as condoms, diaphragms, and cervical caps, do not use hormones and can be started as soon as your doctor gives the go-ahead for sex (typically six weeks after delivery). Although not as effective as hormonal methods, they’re an excellent noninvasive option.
- Condoms also protect against sexually transmitted infections (STIs).
- Diaphragms and Cervical Caps need to be properly fitted, especially after childbirth, as your body may have changed.
Permanent Solutions
If you’re confident your family is complete, permanent methods like tubal ligation or vasectomy are options. These are highly effective but should be considered carefully, as they’re usually irreversible.
When to Start Birth Control After Giving Birth
The best time to begin depends on the method:
- IUDs and implants can often be inserted immediately after delivery, though waiting 4 to 6 weeks may lower the chance of the device coming out.
- Progestin-only pills and shots can start right after childbirth.
- Combination pills with estrogen should be delayed until at least six weeks postpartum to protect milk supply.
- Barrier methods can be used as soon as you’re cleared for sexual activity.
Things to Keep in Mind
Breastfeeding does provide some natural protection against pregnancy through the Lactational Amenorrhea Method (LAM), but it’s only effective if you’re exclusively breastfeeding every 4 to 6 hours and your baby is under six months old. Even then, it’s not 100% reliable, so using an additional method is usually recommended.
Selecting the proper birth control while breastfeeding is an individual decision that will depend on your health, lifestyle, and future family planning. Whether you want the hormonal or nonhormonal type, or even a permanent one, discussing this with your physician will ensure you will get the best one for your specific circumstances.