Breastfeeding and Hormonal Methods of Birth Control

Hormonal methods of birth control are considered to be quite effective and are often easy for a woman to use. However, for some women, they may impact milk supply.

  • Breastfeeding plays a role in preventing pregnancy by interrupting the hormone cycle. Research estimates that if all breastfeeding were to stop, within a year there would be a 20 to 30 percent rise in the birthrate worldwide. However, it is possible to get pregnant while breastfeeding. Breastfeeding should not be considered the main form of birth control for any woman unless she desires to become pregnant again.
  • Some breastfeeding mothers will resume their period when their baby is a month old, while other women will not resume their period until they fully wean their baby from the breast. However, it is possible to get pregnant even if your period has not yet returned.
  • Birth control methods that contain estrogen have definitely been shown to decrease milk supply and decrease the length of breastfeeding. It is recommended that estrogen methods be delayed until a baby is at least 6 months of age. If a hormonal method of birth control is used, it is recommended that the method contain only progestin.
  • Progestin is safe for your baby. It is approved by the American Academy of Pediatrics for use in breastfeeding mothers. There are several methods of progestin-only birth control: the mini-pill (taken daily at the same time of day), implants under the skin (which may be effective for up to 5 years), DepoProvera (a shot which lasts for 3 months), and the Mirena IUD (which is inserted into the uterus and is effective for up to 5 years).
  • While research has shown that the progestin only methods do not usually impact milk supply, some women are particularly sensitive to hormones. Some find that their supply decreases within days, and others more gradually over days or weeks after they start a progestin-only method. For this reason, methods that are reversible – such as the mini-pill and the IUD – may be a wiser choice. Depo-Provera is not reversible once it has been injected and Norplant/Implanon are difficult to remove.
  • It is recommended that any progestin-only method of birth control be delayed for at least 6 to 12 weeks after birth to allow for a good milk supply to be established. This wait must be balanced with the desire to prevent pregnancy and may not be possible for some women. However, many women find it devastating to have their milk supply drop unexpectedly after starting a hormonal method of birth control.
  • Barrier methods of birth control (such as condoms), along with natural family planning, may also help to prevent a pregnancy. Exclusive breastfeeding a baby for the first 6 months can prevent your menstrual cycle from returning IF you never go longer than 6 hours between breast feedings. This is called the Lactational Amenorrhea Method (LAM) and it is 98% effective.

Have you experienced low supply as a result of hormonal birth control?

If so, PLEASE consider reporting it to the FDA as an adverse event. It's very easy to do as a consumer/patient!