Breast-feeding and birth control

Is it safe to use oral contraceptives, birth control pills while breastfeeding?


There is some controversy about this.

The American Academy of Pediatrics recently stated that it is perfectly safe to use one of the low dose oral contraceptives while breast-feeding once the feeding pattern has been well established.

Use of hormone contraceptives before the body has had time to heal from the pregnancy may increase the risk of blood clots in the legs or lungs.  It is usually recommended to wait at least 6 weeks before starting the medication.

Starting hormone contraceptives before 6 weeks may also interfere with the milk production or dry up the milk completely.

The various pharmaceutical companies that sell birth control pills, still state that it is not a good idea to use the estrogen containing oral contraceptives while breast-feeding.  They describe a decreased quality of the breast milk produced if the mother is taking birth control pills.  Some studies have reported small decreased amounts of protein and lactose in the breast milk of these mothers.

In the past, the “mini-pill” was used.  This is a birth control pill that contains only one hormone, progestin, and no estrogen.   Many doctors are returning to this birth control pill in their breast-feeding mothers.  Only a small amount of the progestin passes into the breast milk.  There have been a number of reports of complaints of decreased breast milk production even with this pill.  There have not been any reports of long term harm to infants that were breastfeed while the mother used progestin contraceptives.

The “mini-pill” is not as effective as the estrogen containing pill. It might be safer to use condoms with the pill as a backup.  Some studies have found that this pill may only be up to 92% to 95% effective versus up to 99% with the other estrogen progestin pills.

The pharmaceutical companies that sell progestin only contraceptives still recommend caution when breastfeeding however.

The Mirena IUD, a device placed inside the womb that releases progestin hormone or Depo Provera, an injectable form of progestin that lasts 3 months, are other options also.


So, to answer the question: A breast feeding mother could use a progestin only contraceptive and starting 6 weeks after breast feeding. She may consider using a backup method along with the pill to ensure 99%+ protection.  If there is a decrease in the milk production, she may consider stopping the medication if she plans to continue breastfeeding.