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Birth
Control While Breastfeeding
Contraception
that's safe for breastfeeding women.
You probably
used some form of birth control before having your baby. But contraception
can be a whole different ball game for new moms who are breastfeeding.
Here are your major birth control options--and what they mean for
you and your breastfeeding baby.
Nonhormonal Methods
There are no
limitations to a breastfeeding mom who decides to go with a nonhormonal
method of contraception, such as a barrier method, family planning,
or surgical sterilization. These nonhormonal methods are optimal for
breastfeeding women--they don't affect breastfeeding or pose even
a theoretical risk to the infant. Barrier methods of birth control
include:
Male and female
condoms
Diaphragm
Copper intrauterine contraceptive devices
Cervical cap
Vaginal sponge
Spermicidal cream, jelly, or foam
Women who decide to use a diaphragm must be remeasured by their ob-gyn
after giving birth. Pregnancy may change the size or shape or your
vagina or cervix, so your old diaphragm may no longer be effective.
Family planning, also known as the "rhythm method" or "safe
period," is the oldest form of birth control around--women have
been using it for centuries. It involves abstaining from sexual intercourse
during a woman's fertile period each month. This can be a bit complicated
for breastfeeding women--they're fertile before they get their first
period after giving birth. It's highly recommended that you attend
a class on family planning before relying solely upon this method.
If you're looking
for a more permanent type of birth control, sterilization (vasectomy
for a man, tubal ligation for a woman) may be the right option for
you. Similar to barrier methods, these surgical options pose no risk
to breastfeeding.
Hormonal Methods
This is where the subject of birth control and breastfeeding gets
slightly more complicated. There's no definitive answer as to whether
hormonal methods of contraception pose any risk to breastfeeding women.
Contradictory lines of thought have resulted in conflicting recommendations
from generally authoritative sources. Therefore, a woman should seriously
consider all her options before deciding on hormonal contraception
if she's lactating. Here's what the American College of Obstetricians
and Gynecologists (ACOG) advises breastfeeding women who wish to go
with hormonal methods of birth control:
Progestin-only
contraceptives: This is the method of hormonal birth control recommended
by ACOG for breastfeeding women. This includes "minipills"
and Depo-Provera. Progestin-only contraceptives are not thought to
affect the quality of breast milk--in fact, they may slightly increase
the volume of milk while breastfeeding compared with nonhormonal methods.
Because it may have some effect on breast milk, lactating women should
not begin taking these contraceptives prior to two or three weeks
postpartum.
Combination estrogen-progestin
contraceptives: Any contraceptives containing estrogen have been shown
to reduce the quantity and quality of breast milk. The World Health
Organization recommends that the breastfeeding woman wait at least
six months after childbirth to start using these pills. And their
labels, written by the Food and Drug Administration, currently read,
"If possible, the nursing mother should be advised not to use
oral contraceptives but to use other forms of contraception until
she has completely weaned her child."
But it can be
argued that these warnings are a result of earlier studies, when combination
pills used higher doses of estrogen. The lower-dose tablets used today
probably have less effect on the quality and quantity of breast milk.
As a result, there is no definitive answer regarding if and how much
a combination pill taken today may affect breast milk.
If there are
strong reasons that you would prefer to start using combined estrogen-progestin
contraception, it's important to understand and weigh the potential
disadvantages. Since most women experience reduced milk as a result
of taking combination pills (and this may be dealt with more easily
after breastfeeding skills and patterns are established) a woman who
chooses to breastfeed should not begin taking these pills prior to
six weeks postpartum. If you begin to take them following that six-week
period, it's recommended that you meet regularly with your ob-gyn
or a lactation specialist for a breastfeeding evaluation.
The Lactational Amenorrhea Method
Breastfeeding doesn't have to be a hindrance to birth control. In
fact, it could be your main method of birth control! In some ways,
lactation is a natural method of contraception, often known as the
Lactational Amenorrhea Method (LAM). If your breastfeeding pattern
meets all these criteria, you may not need to use any other form of
birth control for the first six months postpartum:
You plan to breastfeed
six months or longer
Your baby is getting at least 90 to 95 percent of its food intake
from breast milk
You breastfeed at least every four hours during the day and six hours
at night
You have not gotten your period yet
LAM can actually provide you with more than 98 percent protection
in the first six months after giving birth. This effectiveness rate
is higher than that of most nonhormonal methods of birth control!
However, if you're not sure that your breastfeeding habits meet all
the criteria, or if you're not sure that you'll stick with breastfeeding
for the long haul, you might want to consider other forms of birth
control as well.
Your
should know:
The
information on this Web site is designed for educational purposes
only. It is not intended to be a substitute for informed medical
advice or care. You should not use this information to diagnose
or treat any health problems or illnesses without consulting your
pediatrician or family doctor. Please consult a doctor with any
questions or concerns you might have regarding your or your child's
condition.
Rebornne Baby. American Baby
