Birth Control and Milk Supply: What Birth Control Won’t Tank My Supply?

You might have heard that some birth control options can affect your breast milk supply. So what birth control is effective and safe for breastfeeding? Here is what to consider and what you should know about birth control and milk supply.

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Birth Control You May Want to Avoid While Breastfeeding

If at all possible, avoid hormonal birth control options that contain estrogen:

We have no way to predict the outcome of breastfeeding once estrogen-containing birth control products are started. Some mothers may do fine and others can completely dry up. Therefore, if estrogen containing contraception is chosen, it is advised that women use the lowest estrogen dosage appropriate and monitor their 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.

Common birth control options with estrogen that should be avoided if possible include:

1. Combination birth control pill

There are two types of birth control pills, combination pills with both estrogen and progesterone, and those with just progesterone (also called the mini-pill, and discussed below). The combination birth control pill is made by quite a few manufacturers and is marketed under different names, including Alesse, Estrostep, and Yaz.

Combination pills work by suppressing ovulation and are generally more effective than progesterone-only pills, but as noted above, many not be a good option for breastfeeding mothers because of impacts of estrogen on milk supply.

2. Birth Control Patch

The birth control patch (Climara) also suppresses ovulation; because it contains estrogen, it has the potential side effects to milk supply.

3. Vaginal Birth Control Rings

Nuvaring also works by preventing ovulation, contains estrogen, and should be avoided.

Hormone-based Birth Control That Is Probably Okay While Breastfeeding

If a hormonal birth control option is needed or required, there are progesterone-only options that are available. These all work by suppressing ovulation, thickening cervical mucous, and thinning the lining of your uterus. The different options include:

1. Progesterone-only birth control pill (also called the mini-pill)

This pill is marketed as Ortho Micronor, Camila, and a few others. To maximize effectiveness, it needs to be taken at the same time every day.

(I took the mini-pill as a new mom and struggled to remember to take my pill at the same time since I was up around the clock and didn’t really have a schedule. However, one trick you can use is to set an alarm on your phone for when it’s time to take it to remind yourself.)

2. Depo-Provera

Depo-Provera is a shot containing progesterone that you would need to get every 12-13 weeks.

If you’re considering Depo-Provera but aren’t sure, you can try the mini-pill first as a trial (since you can’t undo the shot).

3. Hormonal IUD

The Mirena and Skyla IUDs are a small, T-shaped plastic device that is inserted into the uterus and releases progesterone. It is effective for up to 5 years.

(I got a Mirena about 8 weeks after my third baby was born, still have it, and love it. I had no issues with milk supply and have much lighter periods.)

4. Birth Control Implant

This implant goes in your arm and prevents pregnancy for up to three years and then needs to be removed.

Again, you can do a test with the mini-pill to see how it makes you feel before committing to it if desired.

Non-Hormonal Birth Control Options That Won’t Tank Your Milk Supply

Below are a few non-hormonal options that have no effect on milk supply.

• Condoms – Both male and female condoms are good non-hormonal options for preventing pregnancy and STDs. They are a good choice when you’re trying to figure out what you method you want to use and as a back-up birth control method if you’re on the mini-pill.
• Abstinence – It’s 100% effective and maybe not that hard to achieve when you’re exhausted with a new baby! However, it may not be the best option for a lot of people for obvious reasons.
• Vasectomy/Tubal Ligation – If you’re sure you’re done having kids, a permanent birth control solution might be the best option.
• Natural Family Planning – This means tracking your cycle by taking and charting your temperature each day. I loved this when I was trying to conceive (definitely read Taking Charge of Your Fertility if you’re interested in this method), but with the odd schedule of life with a newborn and irregular cycles when breastfeeding I struggled. Still, many women like this method.
• Paraguard IUD – This IUD is a plastic device covered with copper coils. The copper produces an inflammatory reaction in the uterus that kills sperm and eggs, preventing pregnancy. It works for up to 10 years.

What is your experience with birth control and milk supply? Tell us in the comments!

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