 |
Question: I am a breastfeeding mom and am worried about becoming pregnant again "too soon." Are there any effective methods of birth control, such as the pill or the shot, that are safe for me to use while I am still breastfeeding my baby? What about that new birth control patch?
Answer: This is a great question and one that is frequently heard from postpartum/breastfeeding moms. We have probably all heard of women whose baby is only 3 or 4 months old and they find out they are pregnant again! They are shocked that they could get pregnant because they have not had a return of normal periods, or had heard that a woman "can't" get pregnant while she is breastfeeding. Let's take a quick look at the contraceptive options available to women and see which ones make better choices for the breastfeeding mom.
Abstinence---OK, this IS the only 100% effective method, but is not usually a realistic option!
Barrier methods---these include condoms and the diaphragm. These methods are quite effective, IF used properly and consistently every time the couple has sex. They also have the added bonus of being chemical-free, for those who are concerned about side effects. They have no negative effect on lactation. However, many couples find barrier methods uncomfortable or cumbersome to use. If you used a diaphragm before pregnancy, be sure to get it re-fit at your postpartum visit. Your old one may not fit properly due to weight gain, giving birth, etc. and will not be as effective anymore.
Lactation Amenorrhea Method (LAM)--- if followed correctly and very stringently, studies have shown this method to be as effective as the birth control pill. To find out more, you can check out the article in this newsletter and www.waba.org.br/lam.htm.
IUD---the intrauterine device is a very safe, effective method of birth control, and a good option for breastfeeding moms who may want to space children by several years, or who do not want to worry about remembering to take a pill everyday, or who want to avoid potential hormone side effects. Some women do notice increased menstrual bleeding with IUDs. However, breastfeeding moms are less likely to experience this.
Birth Control Pills---there are 2 types of pills: the "combination pill" which contains both estrogen and progesterone and the so-called 'Mini-pill" or progesterone-only pill (POP). Studies have shown that the estrogen in combination pills can decrease milk supply, and for this reason it is best to wait to use these pills until after breastfeeding is well established (at least 6 weeks) and to possibly delay their use until the infant is eating solid foods in addition to breastmilk (approximately 6 months). The POP has been shown to have little effect on breastmilk supply and can be started after breastfeeding is established (6 weeks postpartum). There are 2 POPs currently on the market: Micronor and Nor-QD, both equally effective.
|
|
Birth Control "shot"---better known as Depo-Provera. This is an injection that offers contraception protection for 12 weeks. It contains only one hormone, progesterone, like the mini-pill. The injection is safe for breastfeeding moms and has not been shown to adversely affect lactation or milk supply. This is a good choice for women who do not want to remember to take a pill everyday. However, if a woman does experience side effects with the shot, there is no way to "take away" the medicine---it is in the body for 3 months.
Birth Control patch---this is a brand new method called "Ortho-Evra." It is a plastic patch placed on the skin and stays in place for 7 days. It must be applied 3 consecutive weeks out of every month to provide contraceptive protection. It contains both estrogen and progesterone and its side effects and effectiveness are very similar to combination birth control pills. At this time, the manufacturer does not recommend it for women who are breastfeeding.
As you can see, there are several contraceptive options open to women who wish to have some control over their fertility, even if they are breastfeeding. The best advice I can give any woman considering the use of a birth control method is to discuss the methods with her health care provider. Be informed about the methods, how they are used, are they convenient for you, how do they affect breastfeeding, how effective are they and are they safe for you. Be prepared to discuss contraception with your partner and with your provider before your first postpartum check-up, so you can make a decision before you resume your sexual relationship. And finally, be open to changing methods as your situation changes.
Lisa Gittleman, RN, MSN, FNP-C. Lisa is a Nurse Practitioner who works for the County and is a Navy Reservist.
|
|
