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Breastfeeding and Birth Control – Family Planning Guide

Breastfeeding is a natural and essential process for both mothers and their infants. It provides numerous health benefits, including important nutrients, immune support, and bonding between mother and baby.

contraception methods
contraception methods

Breastfeeding is a natural and essential process for both mothers and their infants. It provides numerous health benefits, including important nutrients, immune support, and bonding between mother and baby. While breastfeeding, many women are also concerned about managing their fertility and choosing appropriate birth control methods. In this article, we’ll explore the relationship between breastfeeding and birth control, delving into the effectiveness and safety of contraceptive options for nursing mothers.

Lactational Amenorrhea Method (LAM)

Understanding LAM
The Lactational Amenorrhea Method (LAM) is a temporary, natural form of birth control that relies on the suppression of ovulation due to exclusive breastfeeding. When practiced correctly, LAM can be 98% effective in preventing pregnancy during the first six months postpartum.

  • LAM Criteria
    To use LAM effectively, three criteria must be met:
    a. The mother should be exclusively or nearly exclusively breastfeeding (at least every 4 hours during the day and 6 hours at night).
    b. The mother should not have resumed her menstrual periods.
    c. The baby should be less than six months old.

Limitations of LAM
Although LAM can be a reliable birth control method, it has limitations. Once the baby reaches six months of age, or if the mother’s periods return, LAM becomes less effective. Furthermore, introducing solid foods, formula, or regular use of pacifiers may interfere with the effectiveness of LAM.

Hormonal Contraceptives

Combined Hormonal Contraceptives
Combined hormonal contraceptives (CHCs) contain estrogen and progestin, including the pill, patch, and vaginal ring. While these methods are highly effective in preventing pregnancy, they may not be recommended for breastfeeding mothers due to concerns about reduced milk supply and the potential impact on infant growth.

Progestin-Only Contraceptives
Progestin-only contraceptives, such as the mini-pill, injectables (e.g., Depo-Provera), and intrauterine hormonal devices (IUDs), are considered safer for breastfeeding mothers. These methods do not contain estrogen, which is associated with reduced milk production.

Timing of Hormonal Contraceptive Initiation
It is generally advised to delay the initiation of hormonal contraceptives until six weeks postpartum. This allows the mother’s milk supply to become well-established and reduces potential risks to the infant.

Non-Hormonal Contraceptive Methods

Barrier Methods
Barrier methods, such as condoms, diaphragms, and cervical caps, are safe and effective options for breastfeeding mothers. These methods do not interfere with milk production or transfer hormones to the infant. However, their effectiveness may be lower than hormonal contraceptives, and consistent, correct use is crucial.

Copper Intrauterine Device (IUD)
The non-hormonal copper IUD is another safe and highly effective option for breastfeeding mothers. It can be inserted as early as four weeks postpartum and does not affect milk supply or infant growth.

Fertility Awareness-Based Methods
Fertility awareness-based methods (FABMs) involve tracking menstrual cycles, basal body temperature, and cervical mucus to identify fertile days. While these methods are hormone-free and compatible with breastfeeding, their effectiveness may be reduced due to irregular cycles and increased difficulty in interpreting fertility signs.

Emergency Contraception

Emergency Contraceptive Pills
Emergency contraceptive pills (ECPs) can prevent pregnancy after unprotected

sex or contraceptive failure. There are two types of ECPs: progestin-only (Plan B One-Step, Take Action, Next Choice) and ulipristal acetate (Ella). Progestin-only ECPs are considered safe for breastfeeding mothers, while ulipristal acetate requires consultation with a healthcare provider due to limited data on its safety during lactation.

4.2 Copper IUD as Emergency Contraception
The copper IUD can also be used as an effective form of emergency contraception when inserted within five days of unprotected sex. This option is safe for breastfeeding mothers and provides ongoing contraceptive protection.


Tubal Ligation
Tubal ligation, also known as “getting your tubes tied,” is a permanent surgical method of birth control that blocks or seals the fallopian tubes. This procedure can be performed shortly after childbirth or later and does not affect breastfeeding.

Vasectomy is a permanent surgical method of birth control for men, which involves cutting or blocking the vas deferens to prevent sperm from reaching the semen. This procedure does not impact breastfeeding, as it does not include the mother.

Breastfeeding and Contraceptive Considerations

Effectiveness of Contraceptive Methods
When choosing a contraceptive method while breastfeeding, it is essential to consider its effectiveness. While LAM can be effective during the first six months postpartum, its efficacy decreases afterward. Hormonal contraceptives, such as progestin-only pills or IUDs, and non-hormonal methods like copper IUDs and barrier methods offer more reliable protection.

Safety for Mother and Infant
The mother and infant’s safety is a crucial factor when selecting a birth control method during breastfeeding. Non-hormonal methods and progestin-only contraceptives are generally safer than combined hormonal contraceptives, which may affect milk production and infant growth.

Personal Preferences and Lifestyle
Personal preferences, including comfort, ease of use, and lifestyle factors, should also be considered when choosing contraceptives. Some women may prefer long-acting reversible contraceptives (LARCs) like IUDs, while others may opt for barrier methods or FABMs.

Access and Cost
Finally, access to and the cost of contraceptive methods can influence the choice of birth control while breastfeeding. Insurance coverage, availability, and affordability are important factors to consider.

Breastfeeding mothers have various contraceptive options, balancing infant nourishment and effective family planning. It is essential to consider factors such as effectiveness, safety, personal preferences, and access when selecting a birth control method during this period. By consulting with a healthcare provider, breastfeeding mothers can make informed decisions that best suit their needs and those of their infants.

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