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Abstract

Research data acquired from six up-to-date references on the effects of contraception methods and breastfeeding. Areas of interest are advantages, disadvantages, and effects on breastfeeding. There are no clear findings from these articles; the research studies have small parameters. However, they do provide needed education for our mothers in acquiring which contraception method fits their lifestyle and breastfeeding goal.

I’m Breastfeeding and Want Birth Control: Where Do I Start?

To help you decide which birth control method is right for you, ask yourself these questions:

  • • Do I want more children in the future?

  • • What is my breastfeeding goal?

  • • Can I remember to take a pill each day or return to the clinic to get birth control?

  • • What will my insurance company cover?

Your doctor can help you answer these questions and help you to reach your breastfeeding goals while also helping you choose a useful birth control method. In the table in the following text, many types of birth control are listed with how to use and any known effects on breastfeeding (Table 1).

Table 1
Birth Control Types and Impact on Breastfeeding
Birth Control MethodImpact on Breastfeeding
Intrauterine Device (IUD)

  • Works very well, no need to remember to take a pill, fully reversible.

  • Placed inside uterus.

    • 1. Copper IUD (Lasts 10 years)

    • 2. IUD with Levonorgesterol (e.g. Mirena) (last 3–5 years)

  • 1. No known effect on breastfeeding.

  • 2. Not enough info to be found to see if there is an effect on breastfeeding when placed right after birth. No effects if placed 6 weeks after delivery.

    MIRENA
    sgrcl_7_4_158_unfig03

    Photo courtesy of OU Physicians

Progestin-Only Birth Control

  • 1. Mini-pill (must take at the same time every day)

  • 2. DMPA Shot (every three months) (e.g. Depo)

  • 3. Implants (placed under skin, lasts 3 years) (e.g. Implanon, Nexplanon)

  • For all three methods: Not enough info to be found to see if there is an effect on breastfeeding when given or placed right after birth. No effects if started 6 weeks after giving birth.

    NEXPLANON
    sgrcl_7_4_158_unfig04

    Photo courtesy of OU Physicians

Birth Control with Estrogen

  • 1. Pills (must take daily)

  • 2. Vaginal Ring (must place in vagina monthly)

  • 3. Patch (must place on skin weekly)

May decrease milk supply. Not advised.
Barrier Methods

  • Must be used right with each sexual contact to be useful.

    • 1. Diaphragm

    • 2. Male Condom

    • 3. Female Condom

    • 4. Spermicides

None of these methods have any effect on breastfeeding.

What Is Lactational Amenorrhea Method?

Breastfeeding itself has some birth control effects and can be used as a fairly good birth control method but only if you can answer YES to all three of these questions:

  • 1. Are you right now not having your period (since the birth of the baby)?

  • 2. Are you fully directly breastfeeding? (Baby should not be getting any other foods or fluids.)

  • 3. Is your baby less than 6 months old?

If you are able to answer YES to all of these questions, lactational amenorrhea method (LAM) might be a choice for you. However, if you must answer NO to any of the three questions, then your chance of getting pregnant will be higher, and you should choose a more helpful form of birth control (Berens & Labbok, 2015; Kapp et al., 2010; Rodriguez & Kaunitz, 2009).

References

  1. P. Berens, & M. Labbok (2015). ABM Clinical Protocol #13: Contraception during breastfeeding, revised 2015. Breastfeeding Medicine, 10(1), 3–12. 10.1089/bfm.2015.9999
    Google ScholarOpenURLCrossRef
  2. N. Kapp, K. Curtis, & K. Nanda (2010). Progestogen-only contraceptive use among breastfeeding women: A systematic review. Contraception, 82(1), 17–37. 10.1016/j.contraception.2010.02.002
    Google ScholarOpenURLCrossRefPubMedWeb of Science
  3. M. I. Rodriguez, & A. M. Kaunitz (2009). An evidence-based approach to postpartum use of depot medroxyprogesterone acetate in breastfeeding women. Contraception, 80(1), 4–6. 10.1016/j.contraception.2008.12.014
    Google ScholarOpenURLCrossRefPubMedWeb of Science

Figures

MIRENA
sgrcl_7_4_158_unfig03

Photo courtesy of OU Physicians

View in Context
NEXPLANON
sgrcl_7_4_158_unfig04

Photo courtesy of OU Physicians

View in Context

Tables

Table 1
Birth Control Types and Impact on Breastfeeding
Birth Control MethodImpact on Breastfeeding
Intrauterine Device (IUD)

  • Works very well, no need to remember to take a pill, fully reversible.

  • Placed inside uterus.

    • 1. Copper IUD (Lasts 10 years)

    • 2. IUD with Levonorgesterol (e.g. Mirena) (last 3–5 years)

  • 1. No known effect on breastfeeding.

  • 2. Not enough info to be found to see if there is an effect on breastfeeding when placed right after birth. No effects if placed 6 weeks after delivery.

    MIRENA
    sgrcl_7_4_158_unfig03

    Photo courtesy of OU Physicians

    View in Context

Progestin-Only Birth Control

  • 1. Mini-pill (must take at the same time every day)

  • 2. DMPA Shot (every three months) (e.g. Depo)

  • 3. Implants (placed under skin, lasts 3 years) (e.g. Implanon, Nexplanon)

  • For all three methods: Not enough info to be found to see if there is an effect on breastfeeding when given or placed right after birth. No effects if started 6 weeks after giving birth.

    NEXPLANON
    sgrcl_7_4_158_unfig04

    Photo courtesy of OU Physicians

    View in Context

Birth Control with Estrogen

  • 1. Pills (must take daily)

  • 2. Vaginal Ring (must place in vagina monthly)

  • 3. Patch (must place on skin weekly)

May decrease milk supply. Not advised.
Barrier Methods

  • Must be used right with each sexual contact to be useful.

    • 1. Diaphragm

    • 2. Male Condom

    • 3. Female Condom

    • 4. Spermicides

None of these methods have any effect on breastfeeding.
View in Context
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