Birth control options for breastfeeding moms



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The most common type of contraception used by breastfeeding women in North America is the barrier method: condoms, contraceptive foams, diaphragms and spermicidal jellies.

These have no side effects for mother or baby and are relatively inexpensive and highly effective when used as directed (especially combined with the natural contraceptive effects of breastfeeding). If you used a diaphragm before pregnancy, it has to be re-fitted after your baby is born. Couples find the main drawbacks to barrier methods are aesthetic. Some find it unpleasant to interrupt their intimacy to use barrier contraception.

Intrauterine devices
(IUDs)

Intrauterine devices (IUDs)
have no effect on breastfeeding.
Some studies have
shown an increased risk of
perforation of the uterus
during lactation; others have
shown no effect at all. Talk
to your doctor. If this is the
choice for you, an IUD will
be inserted at your six-week
check-up.

Oral contraceptives

Progesterone-only birth
control pills are safe while
breastfeeding if you prefer
oral contraceptives. Small
amounts of the hormone
may pass into your milk, but
this is not considered harmful
to the baby.

Some experts feel combination
estrogen-progesterone
pills may cause decreased
milk supply. Others feel
the dosage of estrogen in
today’s combined pills is too
low to be of concern and are
acceptable once breastfeeding
is established (around six
weeks after the birth).

The amount of estrogen in
breast milk for women using
combination birth control
pills compares with levels in
breastfeeding mothers not
using the pills.

If low milk supply is a
problem while you take combination
oral contraceptives,
you may decide to discontinue
them and use a barrier
method while you rule them
out as a cause. (True low
milk supply is uncommon.)

Sterilization

Tubal ligation and vasectomy
are surgical procedures that
are considered permanent.

In a vasectomy, a man’s
vas deferens (the small tube
that carries sperm from the
testicles) is severed. In tubal
ligation, a woman’s fallopian
tubes are severed. There
is a very short separation
of mother and infant. The
procedure requires brief
hospitalization and general
anaesthetic. There should be
no impact on breastfeeding.

Breastfeeding as a
contraceptive

Monthly periods and the
release of eggs from the ovaries
are suppressed in
breastfeeding mothers, but
the timing of the return of
menstruation varies among
women.

For some women, breastfeeding
just once a day suppresses
menstruation. For
others, any decrease in the
frequency of breastfeeding
over 24 hours can result in
fertility. There is no way to
know.

Ovulation can occur
before the first menstrual
period after the birth,
although hormones necessary
to support a pregnancy
are usually insufficient.

The LAM method of
family planning

Couples who choose natural
family planning may choose
the Lactational Amenorrhea
Method (LAM).

For this method of contraception
to be effective, your
baby must be fully breastfed
(no supplements, soothers,
restricted or timed feedings,
bottles and other foods),
your monthly periods must
not have yet returned and
your baby should be less
than six months old.

The LAM method is highly
effective when guidelines
are
strictly observed, and it has
no side effects.
Talk to your
lactation consultant, midwife
or physician.

Originally published in ParentsCanada: Best Wishes, Spring 2012.

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