Breastfeeding and Birth Control

Breastfeeding and Birth Control: What affects what?

Different kinds of birth control pills.

Different kinds of birth control pills: some affect breastfeeding more than others. (Photo credit: Wikipedia)

Some types of birth control can affect breastfeeding by lowering breast milk production, while other types of birth control do not affect breastfeeding in any way. We explore both categories in this article to help you make the best choice for your situation.

You can also look at the relationship between breastfeeding and birth control from the other direction. Birth control can affect breastfeeding and breastfeeding can affect birth control because, done correctly it can act as a very effective birth control method. Let’s look at this first:

Breastfeeding as Birth Control

Exclusive breastfeeding can be used as a successful birth control method with up to a 98% effectiveness rating. Why does it work? In simple terms the hormone that controls breastfeeding and lactation (prolactin) is suppresses the fertility hormone (estrogen). When prolactin is running the show, estrogen takes a back seat and monthly menstruation cycles and fertility are suppressed.

The key point to remember if you are using breastfeeding as birth control is to keep prolactin running the show. You do this by making sure prolactin is being produced in your body consistently and frequently. How? Prolactin is produced when your baby breastfeeds; therefore you need to breastfeed consistently and frequently.

All of baby’s sucking should be done at the breast so you should avoid giving pacifiers and bottles of any kind. Be sure to breastfeed consistently throughout the day about every three hours. Do not go long stretches at night without breastfeeding. No more than 5 hours is recommended. Any longer than that and you risk estrogen resurging and taking control.

Warning Signs When Using Breastfeeding as Birth Control

As long as you are breastfeeding consistently and frequently, breastfeeding can be an effective form of birth control however be mindful of these warning signs:

  • Return of your monthly cycle: If you’re monthly cycle has returned, it means estrogen – the fertility hormone – has taken over the driver’s seat. You are now fertile again and will need to begin a new method of birth control to prevent pregnancy.
  • Baby starting on solid foods: Around six months of age, babies usually begin the journey of solid foods and they began replacing the calories they start taking less calories through breast milk as they take more calories with solid foods. This decrease in breastfeeding is often enough to allow estrogen to take control and return your body to a fertile state. Once baby begins eating solid food, you should begin a new method of birth control to prevent pregnancy.

The Effects of Birth Control on Breastfeeding

When considering the effects of birth control on breastfeeding there are two broad categories:

  • Birth control methods that don’t affect breastfeeding
  • Birth control methods that do affect breastfeeding

Let’s look at each of these:

Birth Control Methods That Don’t Affect Breastfeeding

There are several methods of birth control that do not affect breastfeeding in any way. They are:

  • Condoms
  • Vasectomy / Tubal ligation
  • Natural Family Planning / Fertility Awareness
  • Diaphragms / IUDs
  • Spermicides

If one of these birth control methods works for your situation, you can rest assured that they will not interfere with breastfeeding or the quality of your breast milk.

Birth Control Methods That Do Affect Breastfeeding

Hormone-based birth control methods can affect breastfeeding. The good news is that hormonal birth control when taken in prescribed doses not pass through breast milk in a significant amount to affect the baby. However a very real risk to breastfeeding remains: lower milk production.

If you read the first part of this article you learned that lactation is governed by the hormone prolactin. Prolactin plays a sort of “King of the Hill” game with the fertility hormone, estrogen. While prolactin is the king of the hill, lactation is emphasized and fertility is suppressed. However when you take hormone-based birth control, especially one that contains estrogen, you’re kicking prolactin off the hill and lactation, milk production and breastfeeding will all suffer.

Your milk production is still at risk if your birth control pill does not contain estrogen, but the risk is far less. Here are the specifics:

Birth Control Methods That Will Almost Certainly Harm Breastfeeding Through Lower Milk Production

  • Oral birth control pills that contain estrogen (aka: combination pills): such as Ortho Tri-Cyclen, Alesse and Desogen.
  • Birth control patches containing estrogen, such as Ortho Evra
  • Birth control injections contain estrogen, such as Lunelle

Birth Control Methods That May Harm Breastfeeding Through Lower Milk Production

  • Oral birth control pills that contain only progestin (aka: the mini pill)
  • Birth control injections that contain only progestin, such as Depo-Provera
  • Patches or implants that contain only progestin, such as Nexplanon
  • Progestin-based IUD, such as Mirena IUD

If you have had any struggles with low milk supply (with this child or with a previous child) you should carefully consider the risk to your milk supply when thinking about this type of birth control. However if you have always produced enough milk, progestin-only contraceptives pose little risk to your milk production. However, little risk, is not the same as no risk and you should always keep tabs on your milk production and baby’s weight gain.

Breastfeeding And Birth Control: Final Thoughts

Breastfeeding and birth control are linked through the interaction of competing hormones. Changes in one, often affect the other. However you are now aware of how the hormones affect each other and you can use that information to for successful birth control and breastfeeding! heart-logo

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