Breastfeeding and hormonal birth control

If you’re breastfeeding, and you’re not quite ready for your little one to have a baby brother or sister, finding the right contraceptive can be an important decision. While barrier methods like condoms or a diaphragm still work perfectly well when you’re breastfeeding, many women find that hormonal birth control is more convenient and more effective for them.

Is hormonal birth control safe during breastfeeding?

No negative health effects have been seen in babies whose mothers use hormonal birth control while breastfeeding, so there’s nothing dangerous about using hormonal birth control during this time. Breastfeeding also does not change the effectiveness of hormonal birth control.

Concerns about hormonal birth control during breastfeeding are mostly focused whether hormonal birth control containing estrogen can reduce the amount of milk that the body produces. The research on the subject is conflicting, causing different providers to have different opinions and recommendations. Some women do report a drop in milk production when taking estrogen-including hormonal birth control, especially women who have previously had trouble breastfeeding, women who have had certain medical or pregnancy conditions, or women who have had preterm delivery. It’s for this reason that healthcare providers may recommend using a different type of birth control until the end of breastfeeding.

On the other hand, recent research found no difference in milk supply between women taking birth control with estrogen and those who were not. Past research suggested that estrogen-containing birth control could reduce milk supply, even at the time, the World Health Organization found problems with the designs of these studies.

Other types of birth control

Progestin-only types of hormonal birth control, including oral birth control pills, hormonal IUDs, the Nexplanon implant, and the Depo-Provera injection are generally agreed to be perfectly healthy for use during breastfeeding by most major health organizations. However, the World Health Organization advises against using hormonal IUDs before 4 weeks postpartum and advises against using the other options before 6 weeks postpartum. Other, non-hormonal types of birth control like the copper IUD, have been shown to have no effect of breastfeeding. In fact, nursing mothers tend to experience less discomfort during IUD insertion than women who are not nursing. IUDs are one of the most commonly recommended types of birth control for use after giving birth.

  • E. Espey, et al. “Effect of progestin compared with combined oral contraceptive pills on lactation: a randomized controlled trial.” Obstetrics and Gynecology. 119(1): 5-13. Web. January 2012.
  • Family Physicians Inquiries Network. “Combined Oral Contraceptives for Mothers Who Are Breastfeeding.” American Family Physician. 72(7): 1303-1304. Web. October 1 2005.
  • J.J. Kelsey. “Hormonal contraception and lactation.” Journal of Human Lactation. 12(4): 315-8. Web. December 1996.
  • La Leche League International. “The Breastfeeding Answer Book.” March 2012 Update, Web.
  • Mayo Clinic Staff. “Minipill (progestin-only birth control pill).” Mayo Clinic. Mayo Clinic, November 24 2014. Web.
  • Victoria Nichols-Johnson. “The Breastfeeding Dyad and Contraception.” Breastfeeding Abstracts. 21(2): 11-12.
  • “Hormonal and nonhormonal birth control during breastfeeding.” National Center for Biotechnology Information. Cochrane Database of Systematic Reviews: Plain Language Summaries, March 2 2015. Web.
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