Birth control & Breastfeeding

Birth control & Breastfeeding

So you have just had a baby and the last thing you are thinking about is sex right?
Although it may feel too soon to talk about contraception, without it you may find
yourself pregnant again! Trust me it’s happened to a few of my friends and really taken them by surprise!
Here is how it works!
So after you have given birth, ovulation can occur at any
time, even when you are breastfeeding. Ideally, you will think about contraception before you give birth and discuss with your midwife or GP the method that is suitable for you.
Many doctors will recommend waiting four to six weeks after delivery to have sex. This allows time for the cervix to close and any tears or repaired lacerations to heal. It can be weeks or even months before some women will want to have sex and that is ok.
Remember there are no rules! You do you ;)

There are lots of different methods of contraception that are not considered to be harmful when breastfeeding but some can be harmful to your milk supply. I have outlined them below:

1. LAM - do your research on this one if used correctly can be 98-99.5% effective as long as these three conditions are met.
a. Your baby is less than six months old
b. Your menstrual periods have not yet returned
c. Baby is breastfeeding on cue (both day & night), and gets nothing but
breastmilk or only token amounts of other foods.

2. Estrogen containing contraceptives - these should be used with caution while
breastfeeding as they have been linked to low milk supply and a shorter duration
of breastfeeding (even in mothers who have a well established milk supply).
“Mothers who have problems with milk production and those who are
breastfeeding an older child (one year old or more) should be especially
cautious.” (Thomas Hale).
3. Progestin-only contraceptives are the preferred choice for breastfeeding mothers when something hormonal is desired or necessary (Mini Pill, Depo, Mirena, Implant). Starting these from week 6-8 post partum doesn't usually cause issues with milk supply. However from my professional experience and from many reports from mothers SOME women do experience supply issues. Use with caution. It can be worth trying the mini pill before using a more permanent method.

Morning-after pills should be used only as a last resort, there may be a slight drop in supply a few days after taking it but levels should come back up after.
Here are the main rules to follow:
● Use any birth control with caution (especially those with estrogen)
● Use as low a dose as possible
● If you experience supply issues or baby's weight gain slows or stops and you are using any type of hormonal birth control, try stopping and see if supply comes back up.

Julia Daly
IBCLC
www.morethanmilk.co.nz

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