I have talked before about how breastfeeding is a fairly good birth control mechanism. However, like all birth control, you have to follow “the directions.” In order to keep the prolactin levels high enough to prevent ovulation, you do have to nurse on demand, sleep with the baby near you, and refuse pacifiers and/or sippy cups. Breastfeeding has been shown to be 98% effective in preventing pregnancy when all of the ‘rules’ are followed.
However, still women sometimes choose to use birth control to prevent pregnancy. Sometimes it’s that they cannot breastfeed that much–maybe they have to go back to work. Perhaps they got their period back. Of course, some women choose birth control because they feel strongly that they don’t want another baby at this time and are unsure of the effectiveness of solely using breastfeeding as birth control.
Progestin Only Birth Control
Birth control pills that are progestin based include the mini-pill, Norplant, or Depo-Provera. It is true that some of the hormone may enter the milk but I could not find anything that suggested there are adverse effects from this. Generally speaking, any medication that a mother takes will enter her milk but it’s often in such minute quantities that doctors don’t worry about it. Of course check with your practitioner as well as your child’s pediatrician before taking anything.
Progestin based birth control MAY have the side effect of increasing your milk supply but only after lactation has been established. Generally, women would start taking this birth control after about six weeks post partum. However, for some women, good lactation takes longer to establish. It is also important to note that progestin based hormones are no more effective than breastfeeding in preventing pregnancy.
Estrogen Based Birth Control
Most pills are a combination of estrogen and other hormones. While the hormone will pass into your milk, the bigger concern is that estrogen will decrease your milk supply. There is a high correlation between women who take estrogen based birth control and early weaning. The advantage is that they are highly effective. However, if you want to keep breastfeeding this is not the way to go.
Some women report that they suffer no decrease in supply. This is likely because if they weren’t going to take the pill, they would’ve had too much milk. Some women also use the pill to decrease their milk supply on purpose, especially if they have too much. In this case, I would suggest pumping the excess milk and either freezing it or donating it. Pumping is not as effective as the baby sucking at the breast and this is a natural way to decrease your milk over a long period of time. It also has the added benefit of helping someone else out.
Ideally, the best forms of birth control to use while breastfeeding are non-hormonal, barrier based methods such as the diaphragm, or condoms. If you choose to let nature take its course and use no birth control, the average space between children is two years.
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