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Birth Control and Breastfeeding

Breastmilk is the ideal source of nutrition for infants. Good contraception options for breastfeeding women are:

  • The Lactational Amenorrhea Method (see chart)
  • The barrier method (including male and female condoms)

Other contraception options for lactating women are:

  • Depo provera* (see chart below) injection.
  • Mirena IUS.
  • Permanent male and female sterilization (tubal and vasectomy).

The combined pill, patch, and nuvaring are not good options for lactating women. They all contain the hormone estrogen which will decrease the amount of breast milk.

For more information on any of the methods on birth control and breastfeeding, please contact your local Healthcare Provider.

Method
Effectiveness
Impact on Breastfeeding
Spermicides and Barrier Methods
(including condoms)
80-95%
Has no impact on breastfeeding.
Tubal Ligation
100%
Delay breastfeeding immediately after anaesthesia to reduce transfer of anaesthetic agent to the infant.
Depo Provera
(the shot)
99.7%
Can affect milk production in some women. It is advised that breastfeeding women begin with a short acting progestin only contraceptive prior to beginning a long acting version such as Depo Provera because if the medication reduces her milk supply she can more easily change to a different contraceptive and restore her milk production.
Wait until milk is in and breastfeeding is well established to start.
Intra-uterine System (Mirena)
99.8 %
Wait until breast milk is in and breastfeeding is well established.
6 week post partum.
Has no impact on breastfeeding.
Nuva Ring
99.7%
Should not be used by breastfeeding moms.
There will be a decrease in milk supply, if considering using, wait two to three months postpartum and expect a decrease in milk.
Evra (the patch)
99.7%
Should not be used by breastfeeding moms.
There will be a decrease in milk supply, if considering using, wait two to three months postpartum and expect a decrease in milk.
Oral Contraceptives
(the pill)
99.7%
Progestin only pills can be taken and will not decrease the milk supply for most women. Combined oral contraceptives that contain both progestin and estrogen should not be taken because it will decrease milk production.
Lactational Amenorrhea Method (LAM)
98%
This method has no effect on breastfeeding. If planning on using this method, please talk to your health care provider for information as the failure rate can be very high if not done properly.

The four key questions for LAM to be a safe birth control method are:
(you must answer “no” to all three questions)

  1. Are you giving your baby other liquids to drink or feeding solids?
  2. Is your baby more than 6 months old?
  3. Has your period returned? (a period is 2 days of bleeding in a row, 8 or more weeks after delivery).
  4. Is your baby going longer periods without breastfeeding? (longer than 4 hours in the day and 6 hours at night).

If you answer “no” to all four questions, you have less than a 2% chance of becoming pregnant.
If you answer “yes” to any one question, you should use another birth control method to protect yourself from pregnancy.
Emergency Contraceptive Pill (ECP or the morning after pill)
Effectiveness varies depending on when taken
Has no impact on breastfeeding.

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