Breastfeeding and Birth Control – Part 1

One topic that comes up often among breastfeeding mothers is how to go about birth control without it affecting their milk supply. There are many options out there for birth control, some with hormones and some without.  Those birth control forms that use hormones use different types and different levels, and it is important to remember that the hormones will affect everybody differently.

Here are The MAAAM’s opinions and evidence based information on hormonal forms of birth control to help you make informed decisions regarding your reproductive health.  The topic is so vast that you could make multiple textbooks on it, but this is just a quick glance and in relation to how different birth controls can affect a mothers milk supply.

Birth Control with Hormones

Combination Hormonal Options

The Pill

The ‘Pill’, is a combination hormonal non-long term form of birth control.  It contains progestin and estrogen, and works by keeping your body from releasing an egg.  You take a week of placebo pills that bring on your period with most forms of the pill, however there are some extended-cycle pills that will keep you from getting your period for three months at a time. The majority of mothers who take birth control with estrogen experience a dip in supply and struggle to continue to breastfeeding.

Taking the pill alone does NOT provide protection from STDs, so if you are having intercourse outside of monogamous relationship, use of a condom is recommended.  It’s important to remember to take the pill at the same time everyday for maximum effectiveness.

The MAAAMs thoughts: If your goal is long term breastfeeding (which I advocate for) I would steer clear of any birth control containing estrogen.

The (Nuva) Ring

The (Nuva) Ring is another combination (estrogen and progestin like the pill) hormonal birth control option, only this one you insert into your vagina, yes you read that correctly.  It pretty much looks like a silicone hair tie that you insert into your vag. The majority of mothers who take birth control with estrogen experience a dip in supply and struggle to continue to breastfeeding.

Nuva ring

You leave the ring in for three weeks, take it out for one to have your cycle, then place in a new one.  The ring must be stored in the refrigerator. Using the ring alone does NOT provide protection from STDs, so if you are having intercourse outside of monogamous relationship, use of a condom is recommended.

The MAAAMs thoughts: If your goal is long term breastfeeding  I would steer clear of any birth control containing estrogen.

Progestin Only Hormonal Options

These are going to be your best bet for using a hormonal option of birth control and continuing breastfeeding. If your goal is to continue breastfeeding,  you will want to start using them no sooner than 6-8 weeks postpartum and if you are experiencing any lactation production issues you may want to consult with your IBCLC and healthcare provider to before getting on hormonal birth control.

The ‘Mini Pill’

The Mini Pill is the most often recommended form of hormonal non-long term birth control.  It is a pill (taken by mouth) that only contains one hormone, progestin, and works by thickening cervical mucus to keep out the sperm.  The level of progestin in the mini pill doesn’t seem to affect the majority of women’s milk supply, however like I said, its important to remember that it affects everyone differently so some moms may notice a dip in supply while using the mini pill.

minipill

Taking the pill alone does NOT provide protection from STDs, so if you are having intercourse outside of monogamous relationship, use of a condom is recommended.  Taking the mini pill requires you to take the pill the same time everyday to ensure effectiveness, if you take it more than three hours from the normal time you will need to use a back up method of birth Control.

The MAAAMs thoughts: If you aren’t affected by the hormones, you aren’t looking for long-term birth control, and you can remember to take that little pill at the same time everyday, then go for it! If you’re looking for a long-term birth control method, them this can be a good tester to see if progestin works for you, but not the end choice. If you’re a sleep deprived hot mess who can’t remember what day it is….. I feel ya mama, you’re not alone, but maybe this method isn’t for you.

Depo-Provera

The Depo-Provera is a longer term progestin only birth control given through an injection.  It lasts at least 12 weeks and in some cases up to a year.  While the level of progestin in the Depo-Provera injection doesn’t seem to affect most women’s milk supply, however since some women’s supply can be affected by progestin, it’s recommended that you try out the mini pill first to make sure progestin doesn’t affect your supply.

Using the Depo-Provera alone does NOT provide protection from STDs, so if you are having intercourse outside of monogamous relationship, use of a condom is recommended.

The MAAAMs thoughts: Once you are sure that progestin doesn’t affect your milk supply, this isn’t a bad option for busy moms since you don’t have to remember to take a pill everyday

Implant

The implant, also known as Nexplanon, is a long term hormonal birth control in the form of a little rod that is inserted into your arm and slowly releases progestin over time.  It can last up to 4 years.  While the level of progestin in the implant doesn’t seem to affect most women’s milk supply, like with other long term forms of progestin, it’s advised you test out how it affects you with the mini pill before embarking on something that is not as easily reversed as the mini pill.

Impanon

Using the implant alone does NOT provide protection from STDs, so if you are having intercourse outside of monogamous relationship, use of a condom is recommended.

The MAAAMs thoughts: Once you are sure that progestin doesn’t affect your milk supply, this isn’t a bad option for busy moms since you don’t have to remember to take a pill everyday. However, personally, the thought of something being implanted into my arm gives me the creeps.

IUD with hormones

There are different options when it comes to IUDs (intrauterine device), the ones with hormones contain low doses of progestin that are delivered directly into the uterus. An IUD is a tiny device in the shape of a T that is inserted into your uterus by a health provider (OBGYN, CNM, NP, PA).  There are a few different hormonal IUDs out there on the market, and they last from 3-6 years depending on which one you get.  The dosage is so low that it doesn’t seem to affect milk supply, but if you’re concerned, then I would stick with my previous recommendation of trying the mini pill first.

IUD

Having an IUD alone does NOT provide protection from STDs, so if you are having intercourse outside of monogamous relationship, use of a condom is recommended.

The MAAAMs thoughts: Once you are sure that progestin doesn’t affect your milk supply, this isn’t a bad option for busy moms since you don’t have to remember to take a pill everyday.

 

 

Check out part two!! Where the MAAAM discusses non-hormonal options and her personal cynicism towards fertility awareness methods…

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