Once a woman starts recovering after childbirth, it is possible to resume sexual activity. Although breastfeeding can act as a natural contraceptive, it is recommended to use an additional contraceptive method during lactation to prevent an unintended pregnancy so soon after the previous one.
However, due to the special circumstances, it is necessary to use a safe contraceptive method (for both mother and baby) that does not affect breastfeeding. Therefore, a woman may have questions about which contraceptive methods can be used while breastfeeding.
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Breastfeeding as a natural contraceptive method
Breastfeeding is a natural contraceptive method. A woman who breastfeeds her baby stops ovulating as a physiological mechanism to prevent a new pregnancy while the baby is still an infant and the mother is still recovering from the previous pregnancy.
High levels of prolactin during the first months of breastfeeding cause this hormonal regulation that prevents ovulation.
Prolactin is the hormone that, stimulated by the baby's sucking on the nipple while breastfeeding, helps maintain lactation by continuing the secretion of breast milk.
This natural contraceptive method is known as LAM (Lactational Amenorrhea Method). However, for LAM to be reliable as a contraceptive method, breastfeeding must meet the following requirements:
- Exclusively maternal, with no formula milk or other foods given to the baby.
- On demand, with frequent feedings during the day and night. The most widely recommended guideline is that no more than 4 hours should pass during the day and 6 hours at night between feedings.
- Without using a breast pump. The baby must breastfeed, as suckling stimulates prolactin secretion.
Therefore, breastfeeding should only be used as a contraceptive for a maximum of 6 months after the baby's birth. At 6 months, when complementary feeding begins, the baby starts consuming other foods, and breastfeeding is no longer exclusive. Consequently, its contraceptive effectiveness decreases (due to reduced prolactin), and ovulation may resume.
Similarly, if menstruation occurs before these six months, breastfeeding is no longer effective as a contraceptive.
Thus, breastfeeding is a natural contraceptive method, but it can only be used temporarily. However, the uncertainty of when a woman will ovulate again makes it unreliable, and it is therefore recommended to use an additional contraceptive method alongside breastfeeding.
Contraceptive methods during breastfeeding
The uncertainty about when ovulation will resume after giving birth makes it advisable, even while breastfeeding, to use a contraceptive method in addition to LAM to prevent an unintended pregnancy. However, given the special stage the mother and baby are in, it is necessary to use a contraceptive that does not affect breastfeeding and is safe for both.
Below, we will mention different types of contraceptive methods and their use in relation to breastfeeding, as it is important to know which ones are compatible with nursing.
In any case, the woman should discuss her specific situation with her gynecologist or midwife, so they can advise on the contraceptive method that best suits her.
Condom
The condom is a widely used contraceptive method during the breastfeeding period. It is a highly effective barrier method with no adverse effects on the mother, baby, or breastfeeding.
However, other barrier methods, such as the diaphragm or cervical cap, should be avoided at least during the first 6 weeks after giving birth.
The reason is to allow time for the woman’s reproductive tract to recover after pregnancy and childbirth. Additionally, size adjustment may be necessary.
Hormonal contraceptives
In general, it is recommended to avoid combined hormonal contraceptives (containing both estrogen and progesterone) during breastfeeding, as the estrogen component can affect the quality and quantity of breast milk. Therefore, during lactation, a woman may choose hormonal contraceptives that contain only progesterone.
These progesterone-only hormonal contraceptives include:
- Progesterone-only pill (or mini-pill).
- Subdermal implant, a small rod implanted under the skin of the arm that gradually releases the hormone, protecting against pregnancy for 3 years (though it can be removed earlier if desired).
- Progesterone-only contraceptive injection, administered quarterly.
Although these contraceptive methods are compatible with breastfeeding, the timing for starting them may vary. Therefore, it is recommended to consult a specialist about the most suitable method and the best time to begin it.
It is important to note that during the first 6 weeks after childbirth, non-hormonal methods (such as condoms) should be the first choice.
Intrauterine device (IUD)
Regarding intrauterine devices, a woman can use either a copper IUD (non-hormonal) or a levonorgestrel IUD (hormonal) during breastfeeding.
These devices are usually inserted 6 weeks postpartum, although they can be placed shortly after delivery.
This contraceptive method lasts for several years, depending on the type, but the IUD can be removed whenever desired.
You can read more about this contraceptive method at this link: How does the IUD work? What are its advantages and disadvantages?
Permanent contraceptive methods
Only if one is certain about not wanting more children, irreversible contraception can be considered. For women, this procedure is known as tubal ligation, and for men, as vasectomy.
Both procedures require surgery to block the ducts that transport gametes (eggs or sperm), preventing fertilization and, therefore, pregnancy.
Tubal ligation can be performed at the same time as a cesarean delivery, with prior consent.
You can read more about this type of contraception in this article: What are the main permanent contraceptive techniques?
FAQs from users
Can contraceptive patches be used during breastfeeding?
Contraceptive patches are usually a combined hormonal method, meaning they contain both estrogen and progesterone. Since the estrogen component can affect milk supply, it is recommended to avoid them during breastfeeding. If a hormonal contraceptive is chosen, it is better to use one that contains only progesterone.
However, it is always advisable to consult a specialist to determine the most suitable contraceptive method for each individual case and the best time to start it.
What are the advantages and disadvantages of contraceptives in breastfeeding?
The main advantage of using contraceptives during breastfeeding is to avoid an unwanted pregnancy and to prevent it from occurring too early, without the woman having recovered properly from the previous one.
As a disadvantage, it could be mentioned that some of the contraceptive methods could have some adverse effect on the woman, the baby or breastfeeding, so not all of them are valid during this period and a specialist should be consulted as to which method is the most appropriate for each particular case and when to start it.
Can the morning-after pill be used while breastfeeding?
The morning-after pill, as an emergency contraceptive method, can be used during breastfeeding. However, it is important to follow the recommendations indicated for each specific type. For example, in some cases it is recommended to feed the baby just before taking the pill and then avoid breastfeeding for at least 8 hours.
Recommended readings
If you want to read about how nutrition should be during breastfeeding, you can visit the following link: Feeding and nutrition of the mother during lactation.
On the other hand, if you want to learn more about the benefits of breastfeeding, we recommend reading this article: Benefits of breastfeeding for the baby and the mother.
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References
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FAQs from users: 'Can contraceptive patches be used during breastfeeding?', 'What are the advantages and disadvantages of contraceptives in breastfeeding?' and 'Can the morning-after pill be used while breastfeeding?'.
