Although postpartum exhaustion levels are like nothing you've ever experienced, and you probably can't imagine ever having energy to have sex again, thinking about appropriate birth control when breastfeeding is something that should be considered. There are three categories of birth control methods from which a breastfeeding mother can choose: nonhormonal, progestin-only, and those containing estrogen (although this is one option that should be avoided as best as possible). Here is the breakdown:
Nonhormonal Methods
- Condoms: They have no effect on the breastfeeding mother or baby, and they are the most effective choice. At the same time, breastfeeding mothers tend to have very low estrogen levels, which can cause vaginal dryness, and condoms might be irritating to the vagina. Additional lubrication can combat any discomfort.
- Diaphragm: This has no effect on the breastfeeding mother or baby and is a very effective choice.
- Spermicide: This has no effect on the breastfeeding mother or baby and is a very effective choice. It is important to note that small amounts may be absorbed into your bloodstream, which may result in trace levels being passed into breast milk, but there is no known effect on the baby.
- Non-hormonal Intrauterine Device (IUD): This has no effect on breastfeeding. It is a very effective method.
- Natural Family Planning (also called periodic abstinence): This has no effect on breastfeeding and can be a very effective choice. However, it may be difficult to figure out signs of fertility while you're breastfeeding.
- Vasectomy (also called male voluntary surgical sterilization): This has no effect on breastfeeding and is 100% effective.
- Tubal Ligation (also called female voluntary sterilization): This has no effect on breastfeeding and is 100% effective. However, the actual procedure requires anesthesia, which can pass into breast milk and have an effect on the baby (drowsiness resulting in difficulty with feedings).
- Lactational Amenorrhea Method (LAM): You have to be very careful with this method of contraception. In order to use this, you must be breastfeeding your baby exclusively -- having no vaginal bleeding or spotting after lochia discontinues -- and the baby must be under six months old.
Progestin-Only Methods
Whether you choose the mini-pill, injectables, implants or the Mirena IUD, this form of birth control is very effective and may actually increase milk volume. Because there are hormones in these methods, some of them will pass into breast milk. However, studies have shown no adverse effects on the baby from the minute amount that is passed through.
Estrogen-Based Methods
Combined oral contraceptives contain both estrogen and progestin. They are extremely effective as birth control, but estrogen may reduce your milk supply. As with progestin-only methods, the hormones will pass into breast milk. While this will not have a negative effect on the baby, a drop in milk supply will obviously cause problems in your breastfeeding relationship.
Source:
Riordan J. Auerbach KG. Breastfeeding and Human Lactation. Jones and Bartlett Publishers
