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Contraception During Breastfeeding

I've heard that you can't get pregnant while you breastfeed. Is that true?

Not necessarily. During breastfeeding, the chance of getting pregnant is lower. However, women can still get pregnant.

When should I start using contraception?

It's a good idea to discuss contraception with your clinician before you give birth. Breastfeeding women have many birth control options.

Non-hormonal methods of contraception

  • Condoms and spermicides: These can be used with no impact on breastfeeding. The vagina of the nursing mother might be dryer than normal, which can make condoms irritating. If this is a problem, use additional lubrication.
  • Barrier methods: These methods, such as the diaphragm and cervical cap with spermicides, have no effect on breastfeeding. Check with your clinician to refit the device because you might need a larger device after having a child.
  • The intrauterine device (IUD) non hormonal: This type of IUD is a copper-containing device (ParaGard®). The IUD does not affect the quality and quantity of breast milk. ParaGard IUD is safe and effective for 10 years.
  • Tubal sterilization: This is a surgical, permanent form of birth control, known as “having your tubes tied” that only affects breastfeeding if general anesthesia is required. (That means you are put to sleep for the operation.) Anesthetic medicine can pass through the breast milk.

Hormonal methods of contraception

  • Progestin-only oral contraceptives, or “The Mini-Pill,” contain only a progestin (a female hormone). The method, when used daily, is highly effective for breastfeeding women. This method of contraception has a slightly higher failure rate than oral contraceptives (OCs) containing both estrogen and progestin. During breastfeeding, however, women are not as fertile. A small amount of hormone passes into the breast milk but has no known bad effects on the infant. Indeed, some studies have suggested a good effect on the quantity and quality of breast milk. When the woman stops breastfeeding the baby, or when menses returns, some clinicians suggest switching to combination OCs, which have a slightly higher effectiveness.
  • Combination oral contraceptives, or "The Pill," contain both estrogen and progestin. The American Academy of Pediatrics has approved the use of low-dose OCs in breastfeeding women once milk production is well established.
  • NuvaRing® contains estrogen and progestin, but with a lower systemic absorption than OCs.
  • The intrauterine device (IUD) hormonal: This type of IUD is a progesterone-containing device. The IUD (Mirena®) releases a very small amount of hormone into the uterus, where it works locally. This IUD does not affect the quality and quantity of breast milk. The Mirena IUD is safe and effective for 5 years.
  • Medroxyprogesterone: This is an injection or shot that can be safely used during breastfeeding and does not suppress milk production. At least one study suggests that this method of contraception might have a beneficial effect on the quality of breast milk in terms of its fat concentration, calories, minerals, and protein composition.

Remember: If you are at risk for a sexually transmitted disease (STD), use condoms to protect yourself. Sexually transmitted diseases can happen to anyone who is sexually active, even during breastfeeding. Don't stop taking or using your birth control method on your own. Always call your clinician to talk things over.


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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 7/23/2012…#15280