Birth Control while Breastfeeding
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Birth Control while Breastfeeding
March 2009
Any day now, I will be a new mom, so my doctor has asked me to
start thinking about birth control again. For years, I've used
the pill but won't be able to while nursing. My doctor has
recommended both the IUD (made of plastic and partially covered
by copper) and the IUS (made of plastic and containing a form of
progestin). I'd appreciate some feedback (pros/cons/advice) from
moms who have used either the IUD or the IUS. I'd also like to
welcome recommendations for other forms of birth control that
would be safe for a nursing mother. Thank you.
mom-to-be
I used the mini pill while breastfeeding my daughter. It's a birth
control pill, but only
has one of the two hormones most pills have. It worked fine for me,
although I got
spotting. You might want to ask your doctor about that option too.
Sarah
Congrats on your new baby! I used an IUD which emitted a small
amount of Progesterone and it worked fine and gave me no
trouble whatsoever. However, this was about 30 years ago so I
know my experience is out-of-date. Good luck.
Sandy
i had the copper iud after the birth of my second child. it
was really great for a year and then my periods became **very**
heavy, a reported side effect. it was intolerable to me as i
am very active and had to have double protection against the
bleeding. so i had it removed. i am going to get the mirena
(progestin secreting IUD) in a few weeks since i heard it
doesn't have this side effect. the bleeding aside, i liked the
iud- it was easy to insert and remove, had no effect on future
fertility and we never noticed it. incidentally, i nursed my
kids for a couple years each and did get pregnant, while
nursing with the mini pill.
momto4
I had an IUD, and was pretty happy overall with the idea of it
because it isn't a chemical form of birth control, and I could
remove it at any time if my husband and I wanted to start working
on the family again.
I had mine put in 8 months postpartum, before my period returned.
The first period I had was HUGE - so much blood I genuinely
thought there was something very wrong. So huge that it dislodged
the IUD and it ultimately needed to be removed.
While I wanted to share my experience with you, I need to stress:
I am a very tiny statistic. Very seldom does something like this
happen, and while it was a bit scary at the time, my OB was very
comforting and explained everything to me, and reassured me that
no damage has been done.
I am now pregnant with my second, and am planning on getting a
new IUD afterwards, although based on my experience with my
gigantic first period, I will wait until I've had it at least
once before putting the IUD in.
IUD experienced
I use the mirena IUD (the plastic one with progesterone, and have been
very happy with
it. It hurts alot when they put it in and then I had pretty bad cramps
for the next 2
days, and finally no cramps at all after a week and a half. Before
having my baby (now
one year old) I suffered from horrible cramps and pretty heavy bleeding
when I got my
periods and this IUD tends to make those things better. I've had it in
for 8 months
now and no probs. One thing to know is that it can cause menstrual
irregularities,
anywhere from random spotting to no periods at all. Now, here's the
catch. I
recommended it to my sister and she had it put in, too. After 2 months
of cramps and
bleeding she got it removed. She's fine now but what a drag. Good luck
in your
decision making!
No more babies for now
I chose the copper IUD, no hormones, since I'm still breastfeeding my 14
month old
and seem to be very sensitive to hormones. I got it when he was 11
months old. Don't
believe the drama you'll read about insertion on the web - i took 800 mg
of advil
before I went in and barely felt it. I love the fact that it is
hormone-free birth control,
but the the first couple periods were rough. Cramping and HEAVY
bleeding, longer
periods. Still, it's worth it, b/c the rest of the month everything is
great. And now, 4
months or so into it, my periods are more normal. I think you will get
those rough
couple of first months even with Mirena, which eventually takes your
period away. You
just have to weigh the pros and cons of the hormone, a little of which
will get into the
milk.
Fan of Paragard
Honey, just make your husband wrap it up for awhile. you've been
through enough!
anon
I got the IUS at 6 months after birth. I noticed a slight dip in
milk supply, but nothing a little fenugreek wouldn't help. Other
than that (at least in terms of breastfeeding), no issues. It did
come with lots of other side effects, but they are so different
from person to person that it would hardly be worth relating.
I will say that you might check with your health insurance before
going with the IUS. I've known a number of women to get them;
some insurances cover, some don't, and doctors don't seem to be
too concerned about it before recommending, inserting, and
charging for them!
I highly recommend the non-hormonal (copper, or paraguard) IUD.
It lasts for 10 years and provides the same effective birth
control as a tubal ligation. I had one placed after each of my
pregnancies (after the third, my husband had a vasectomy). I was
able to remove the IUD and easily conceive because my hormones
weren't altered. Because there are no hormones, it doesn't alter
your milk supply at all. The potential downside to the
non-hormonal IUD is that some women have increased bleeding and
cramping with their periods--these symptoms usually ease up after
a few months. If they don't you can just have it easily removed.
I found that because I had my IUDs put in post-partum, my uterus
was already accustomed to a ''foreign object'' and because I was
breastfeeding I didn't have a period for almost a year--allowing
my uterus plenty of time to adjust to having the IUD in place
before I started having periods again (I had normal, light periods).
The hormonal (Mirena) IUD is also a good option, but it does
release hormones into your system. You will stop having periods
(a plus for many women). It only lasts for 5 years. It is safe to
use while breastfeeding, but there is theoretical risk that the
hormones can reduce your breastmilk--less likely if you are
solo-breastfeeding for the first few months.
Finally, I am offering this advise up as a fellow mother, but I'm
also a doctor and I feel comfortable recommending IUDs to my
patients. In the past, there was some concern that sexually
transmitted diseases could travel up the IUD strings and into the
uterus, but this is not the case. The data is showing they are
safe and IUDs are gaining a resurgence in popularity among
doctors and women. There is a very minimal risk that the uterus
could be perforated when the IUD is inserted, but it is a simple
procedure and that risk is very small when done by an experienced
practitioner. Without the hormones, there's no increased risk of
breast cancer, blood clots, etc. It's all a balancing act.
Good luck with your decision!
anon
After I had my baby, my doctor recommended the ''mini pill''
while I was breastfeeding. It is a birth control pill but it
only has progestin. I believe that it is slightly less
effective and you have to much more diligent about taking it at
the same time every day, but my doctor told me that it is safe
for breastfeeding mothers.
Happy on the mini-pill
I tried the IDU and didn't work for me (very long and very heavy
periods!). I went back to the pill. While breastfeeding, I used
a low dose pill that was OK, but you really have to be on top of
it on terms of taking it at the same time everyday and not
missing ANY pill.
back on the pill
After I had my son, I requested an IUD, but was pushed to go on the
shot. I did three
rounds of the shot and experienced blinding headaches before going and
finding a
new doctor. I now have the Mirena, which I guess is considered an IUS.
I've had it for
four years, it comes out next year, and I will be requesting a new one.
I feel great with
it, it contains a small fraction of the hormones in other birth control
methods, and you
dont even notice it's there. The appointment to get it is mildly
painful, you'll
experience a cramping sensation in the pelvic region while they are
inserting, but that
aside, it's the greatest birth control method I have ever had.
anon
I used the ParaGard IUD (copper) for a few months. Like it says,
and as people told me, it gave me heavier periods. They lasted
for 10 or 11 days, and for the first couple of days, I could go
through 1 super plus tampon every hour. My PMS, usually not too
bad in the past, was completely out of control. I felt, ok, I
can handle this for a few months, because it is such a reliable
type of birth control, and hopefully these side effects will
subside. What I didn't consider is why these long periods
happen. Is it because the copper IUD causes a huge surge in
one's own hormones? What else can this sort of surge to this
degree cause to happen? I did lose some hair, right at the
widows peak (I found out on some message boards that I wasn't the
only one). But, more disturbingly, I feel that the copper IUD
caused my onset to Crohn's disease, which I was diagnosed with
less than a year later. I didn't know that I was predisposed to
Crohn's (I had a cousin who had it), but now here it is. I can't
prove the connection; it just makes sense to me. I recently read
that if you have an autoimmune disease, you should not use
ParaGard. Wish I had explored that further at the time.
I've been using a diaphragm. Kind of old-fashioned, but it works.
anon
I had a Mirena IUD put in after my first two children were born
(10 weeks after the births) and will have another one put in soon
(I just gave birth to my third a few weeks ago). The Mirena
worked really well for me and had no effect on breastfeeding
whatsoever. I've heard that some people have a lot of spotting
between periods with the Mirena, but that was not the case with
me. I did have pretty light periods, which was an added benefit
in my opinion.
Kara
First of all, not all women who have IUD's have good reactions to it.
Secondly, don't let
anyone tell you that it's drama - IUD's CAN very much cause pain upon
insertion. Not
all women feel it, but some do, and it can be extremely uncomfortable.
And then there
are some of us whose bodies can't handle having a foreign object inside
them, and
develop severe pelvic inflammatory disease (PID), causing infection and
subsequent
scarring of the fallopian tubes, ovaries, uterus, and in my case,
blowing out of the area
into the diaphragm and liver quadrant. I could only have one child
because of so much
scarring, and I was a lucky one, and I'm alive. Most women have no
trouble with the
IUD, but some do and it's no joke, it's a statistic worth looking into.
Feeling pain upon
insertion might be the only thing that is troublesome for some, and
worth it for the
benefits this birth control offers. But think long and hard about
possible risks of the
IUD. I, if I'd had a daughter, would categorically dissuade her from
ever using one,
given the damage it did me. There are other, safer forms of birth
control.
Lisa
I breastfed both of my kids until they were 3 years-old, and
both times I was very happy on the Depo Provera injection. You
get it every three months and forget about taking pills or
anything. I did not notice any changes in my milk supply, and
the best part for me was that I did not get a period while I
was on the Depo. I absolutely loved it and highly recommend it
for people who do not want the IUD for any reason (my reason
being that I got pregnant with in IUD, but that is very rare if
properly placed). When I was ready for baby #2, i suspended the
Depo, my period resumed in 6 months and I got pregnant right
after.
Loved the Depo
diaphragm (w/spermicide) works for us (over 20 years now, no
accidents)
anon
April 2004
I was encouraged by my midwife at my 6 week postpartum check up
last week to decide on a birth control method as soon as
possible if we didn't want to risk getting pregnant again. This
is not to imply that we are having sex but was wondering what
other folks have chosen to do while breastfeeding.
new mom
I used the minipill and was very happy with it. It was an
obvious choice for someone who'd used and liked the regular pill
for many years! It's more important to take the minipill at
about the same time every day than with the regular pill, and
you don't get a withdrawal bleed every month because there's no
placebo week, but otherwise it's similar.
I have friends who've used diaphragms and liked that, but you'll
need to pay close attention to the fit; you can't use the same
one after giving birth that you did before!
And if you are breastfeeding around the clock, including at
least one or two nighttime feeds, with NO supplements or solid
foods, and you have not yet had a period, you're actually quite
safe until your baby is 6 months old. (If I recall correctly,
the ''lactational amenhorrea method'' or LAM is about as reliable
as the best barrier methods, under those conditions. But as
soon as you have a period, your baby reaches 6 months, or your
baby begins sleeping through the night, (or if you begin using
formula or introduce solid foods) another method is advised.)
anon
If you don't want to unexpectedly have another child soon, by
all means use birth control (but it sounds like you know this
already!). I have more than a few friends who thought that,
since it took more than a year in some cases to get pregnant
the first time, then it would take that long the second time,
particularly since they were breastfeeding exclusively. Boy
were they all surprised when they learned they were pregnant
without even having had one period yet! As for me, I chose to
use a diaphragm for intercourse while breastfeeding,
particularly since we weren't very sexually active the first
year or so and it therefore isn't that hard to pull a diaphragm
out of a drawer once in awhile. [On the other hand, I did wish
occasionally that there were something that did not involve
doing *one more thing* in my stupefied and tired state of being
a new parent in order to have intercourse. But I just don't
like any of the alternatives, particularly taking hormones,
that I've tried throughout my life for me.]
anon
I had an IUD inserted about 12 weeks postpartum. That was
going on five years ago (they last up to ten years), and all is
still well. I breastfed until my daughter was 2. It means
ABSOLUTELY NO HASSLE for sex, unlike the daily pill or any
barrier method. You're supposed to check the position of
the ''strings'' every month, but that is way too difficult for me
and with my GYN's blessing I just have her check when I have my
annual exam.
My periods are much heavier, and somewhat crampier, than before
my pregnancy, which is probably due to the IUD, but being over
35 and the daughter of a breast cancer (of the estrogen
sensitivity variety) survivor, there was no way I was going to
take the pill; and as for the diagphragm, well--been there done
that, NO THANK YOU. IUDs are generally recommended for women
who have given birth and are MUCH safer than old kind which
caused significant problems and gave them a bad rap, and nearly
100% effective in preventing pregnancy.
Happy IUD Mom Loves Sex
I started taking the mini-pill when my son was 8 weeks old. For
the first 10 months of his life his diet consisted entirely of
breast milk, he simply refused to eat any solids. He will be
two years old next week and I am still nursing. The
progesterone-only pill that I was, and still am, taking did not
affect my milk supply in the least. My son’s weight has always
been in the 50’s percentile. Originally I was taking Nor-QD,
but now I have switched to a less expensive generic substitute
NORA-BE. Prior to going on the pill, I tried to get information
on whether the pill would have any effect on my child’s health,
but unfortunately was unable to find anything.
Try the Mirena IUD. I have one and just LOVE it. I have gone
from a postpartum period that was irregular and heavy (7 days
long twice a month some months, 10 days long other months) to
minimal spotting two days a month. It does have hormones in it
which reduce the thickness of the uterine lining, but not a
significant amount so it doesn't effect breast milk production.
And I don't remember if this was supposed to be a side effect,
but my libido has improved too. If only it would allow me to eat
as much as I want without weight gain... then it would really be
perfect!!!
happy mom
I had an IUD inserted about 8 weeks after my son was born 3 1/2
years ago. I guess there are several kinds out there; I got
the kind without hormones as I was concerned about the effect
of hormones on breastfeeding. Here's my experience:
Pros: After insertion, you don't have to do anything. They
last for a long time. (I think you can use the same IUD for
something like 10 years.) It's very effective. There's no ''lag-
time'' in returning to fertility after you get it removed. (In
fact, I had mine removed in July, and never got another period
because I got pregnant right away -- I'm due with baby #2 any
day now!)
Cons: The insertion is a bit uncomfortable. (Though very
manageable-- especially if you take ibuprofin beforehand.) I
found the ''string'' to be a bit poke-y at first, so I would have
to move it to a comfortable place. My husband also noticed it
during intercourse at first. (But there were lots of things to
get used to in the postpartum love-making department, so it
wasn't that big of a deal.) After time, I think the string
softened a bit and we both got used to it. Neither of us
noticed it after a couple of months. My periods were perhaps a
bit heavier-- but it was hard to tell how much of that was just
from having a baby.
All in all, it worked very well for us and we'll probably use
it again at some point.
Good luck!
Loved the IUD
1999
I recently had my postpartum checkup and the nurse practicioner gave me a
prescription for the pill, saying that it was okay to use while
breastfeeding. However, the blurb that came with the pill said that you
should not use it while breastfeeding because it can decrease the amount of
milk. I'm confused. Has anyone taken the pill while breastfeeding? Has it
caused any problems concerning milk supply? Your help would be greatly
appreciated!
Angela
I was wondering if anyone has experienced any problems with taking a
low estrogen birth control pill while breastfeeding 6 months
post-partum or beyond. My ob/gyn says I should not have any problems,
but I still feel concerned. The particular pill she prescribed is
called LOESTRIN FE 1/20. Thank You.
I have an 8-month old baby and have been taking the pill (Micronor)
since the doctor first prescribed it post-partum. I have not noticed
any problems with it at all.
I used a low estrogen pill while nursing my first child, over 5 years
ago. I, too, had been told not to worry, but had continual problems
with my child not getting enough milk. I ended up quitting the pill
after 4 months, while at the same time supplementing with formula so
my daughter would get enough nourishment (she was in the bottom 5th
percentile). My milk never came in very well. The second child, born 3
years ago, nursed very well, had plenty of milk (he's always been in
the 95th percentile, which may be genetic--he was 9lbs.13oz. at
birth!), and although I did supplement later with formula (for
convenience), I never felt he wasn't getting enough milk. He was able
to nurse quickly and fully, usually getting his fill within 15-20
mins., whereas my daughter would nurse for an hour or more (sore
nipples!). I never used the mini-pill while nursing my second child.
I recommend against the mini-pill; I felt that the Kaiser GYN depts.
don't really get the feedback about whether it's affecting nursing or
not--this shows up later in the Pediatrics dept., and unless you have
to go to your GYN regularly after birth, there's no way this info gets
passed back down to them. I don't care what the studies show--I think
it makes sense that your body would, if on the pill, believe itself to
be pregnant and be less likely to produce milk as a result. We have
successfully used foam with condoms (except for a several years when I
had an IUD, which has since been removed--another story!). Best of
luck.
I took a very light pill while nursing and also had concerns about it.
Two different ob/gyns assured me it was safe. I also looked up the
studies myself to make sure the doctors weren't just being glib (a pet
peeve of mine). We were in something of a bind because other birth
control methods weren't an option. I'm glad I did it because being on
the pill gave us peace of mind about not getting pregnant again too
soon.
I, too, was prescribed a low-estrogen pill in the months after my
daughter was born, since I was breastfeeding. I was given Micronor
(not what you have) but I suspect they are similar. Anyway, they
seemed to be effective (no unwanted pregnancy!) and it didn't seem to
have any negative effect on nursing, but they really affected my mood.
I wasn't really aware of how depressed I was, and how wildly my moods
would swing, until I stopped taking them after 10 months. I don't
think I will ever take them again, it was that bad, and I'm quite sure
that it was the pills that were causing the problems. Indeed, in the
first few months I'm sure that other things like normal hormone
imbalances, stress of a new baby, nursing issues, etc., contributed to
my depression. But after 6 months or so I had really found a nice
balance of dealing with the new stuff, finding other mothers to talk
with and getting back to the work I love part-time. But my mood
didn't improve until almost immediately after stopping the mini-pill.
You didn't mention what it is you are concerned about with the pills
you are taking, but if it's emotional I'd see your OB or nurse
practitioner about other birth control options. Hope this helps, for
what it's worth!
I am confused by this topic thread. So if my post doesn't address the
original concern I am sorry, but here are my thoughts.
The mini pill is a progesterone only pill. There is no estrogen in it. It is
commonly prescribed for nursing women because it is not supposed to have any
effect on milk supply. However, I know at least one lactation consultant who
says that she has occasionally seen women who have experienced a supply
decrease while taking this pill. This decrease was easily remedied by
ceasing to use the medication. (She has also seen some women who thought it
helped their supply, so it is definitely one of those things that varies
from woman to woman.)
This same LC doesn't recommend that women start birth control pills of any
kind until they are 6-8 weeks post partum so that they will have enough time
to start building a good milk supply. After this time, she says, that there
is rarely any risk to milk supply, and if there is a decrease, it will
resolve when you stop using the pill (I guess I already said that). By the
way, Depo Provera and Norplant are not recommended by this LC because if
there is a decrease in supply, there is no way to "quit" them to get your
supply back.
Birth control pills that contain estrogen are more likely to have an effect
on milk supply, but the later in your nursing career you use them, the less
likely they will have an effect. (At least that is what I have been
reading.) However, you are never going to find any dr. or pharmacist who
will give you a guarantee that there will be no effect on your supply. It
will just be one of those things you have to discover on your own. The good
news is that just like the progesterone pills, if you see a supply dip, you
can quit them, and it should go right back up.
I hope that helps someone out there.
There is a pill called Micronor which is supposedly safe to use while
breastfeeding. In fact, it is only effective while you are breastfeeding.
I used it while breastfeeding both my sons with no known side effects.
Virginia
I took the pill while breastfeeding with no problems, but it was the "mini"
pill - one hormone instead of two. The Dr. said that it was about as
effective as the regular pill as long as I was nursing and was unlikely to
affect the milk supply. Ask about it.
Robin
I was given a mini-pill while still breastfeeding. It does not have
estrogen (right?) and can be used, per my doctor, until the baby is
weaned or as my doctor put it, just doing social nursing (i.e. for
comfort and not really nutrition). Then he switched me back to the
regular pill. I would double check with the practioner or talk to the
pharmicist.
Janette
Don't do it! If it is a regular pill (estrogen & progesterone) it is
*guaranteed* to cause problems with your breastfeeding (& it's not safe for
your baby). If it is the mini-pill (progesterone only), the doctors will
tell you it's OK, but my experience, and the experience of MANY women I
have talked to through La Leche League, is that it still causes a drop in
your milk supply. I was absolutely FINE on my milk supply till I started
to take the mini-pill. I took it for about 8 months, from the time my baby
was about 4 mos till about her 1 year birthday. It's very hard to sort out
what exactly was the cause of my problems, since at the same time I started
the pill I also went back to work and started pumping, but I can tell you
that it was nothing but misery trying to get enough milk for my baby after
that. I ended up having to supplement her, which I was not happy about. I
think that the doctors are more concerned about you not getting pregnant
again than they are about your continued breastfeeding, so they like to err
on the side of pregnancy prevention. And for some women, the mini-pill may
not cause a problem (the type of woman who leaks a lot, and gets engorged
easily). But for those of us with a precariously-balanced milk supply
(never leak after the first couple weeks, rarely get engorged), it can
spell disaster. My sister-in law concluded that she just didn't have
enough milk, and quit nursing after only a few weeks because of this.
Think VERY carefully before you take those pills. (And remember that you
can't take the shots, implants, or some of the IUD's either, since they are
all hormonal methods.) My 2 cents: You won't be nursing forever. Use a
barrier method till you're done, and give your baby the best you have to
offer while you're in this special phase.
Feel free to contact me if you want to discuss this in more detail; I'm
glad to share my experience. (We're still nursing, by the way, at 16 mos
and counting).
Dawn
I recently nursed my daughter who is now one for 10 1/2 months and I took a
low estrogen pill for most of the time. My milk production was fine. I
did not notice any change in production after I started taking the pill.
Good Luck!
Tamara
Regarding the pill and breastfeeding, my doctor prescribed a pill called
Micronor. I took this pill for approximately 7 months (until I stopped
breastfeeding) and did not notice any negative side effects. It is tough to
know whether it reduced my milk supply, since I returned to work when my
daughter was 2 months old and pumped during the day. It did not seem to
have any effect on it, and I felt great, better than with traditional pills.
Hope that this helps.
Lori
I would like to reply to the person who stated that Micronor - the
mini-pill aka the progesterone only pill - only works while
breastfeeding. This is not true. I have used it very successfully
for 2 years until I decided to stop using it so I could get pregnant.
It is slightly less effective than the traditional pill which means
that if you miss even one day's dose you have to rely on some other
method of birth control for a while after. Because of my latex
allergy (which basically rules out almost all barrier methods of birth
control), I have used the mini-pill since my son, now 7-months, was 2
months, and have not had any problems with my milk supply. I would
like to add that I switched to the mini-pill originally because of
problems with too many side- effects while using the regular pill. I
found the mini-pill much better than the regular pill, giving me
almost no side-effects.
Pia
I feel I have to respond to the comment, "I think that doctors are more
concerned about you not getting pregnant again than they are about your
continued breastfeeding." My response: and well they should be! I got
pregnant by accident when my second child was five months old. I still
don't know how it could have happened. I hope all women considering their
birth control options imagine themselves in that situation before they make
a choice. I felt my new son needed all the attention and energy I could
spare for him and could not imagine a way to share that with a third child
that wouldn't have sacrificed the baby already in my arms. So I sacrificed
the unborn child instead. Everytime I look at my son, I know I made the
right decision. But I have a permanent hole in my heart and soul that
pains me every single day. (I have tried for five years to conceive
another baby and am now 46: it's not going to happen.) My advice?
Consider the bigger picture, credit the doctors for having your well-being
in mind, and don't take a risky approach to birth control unless you're
willing to pay the price.
Anonymous
I recently asked my OB/GYN about taking Birth Control while nursing. Her
response was that there haven't been conclusive studies, but personally she
wouldn't use the pill because of hormones the kid might be getting. I know
some people don't have much choice, but I just thought I would mention this
aspect of the pill and nursing. I've decided not to take the pill for
awhile. My son is 2.6 years old and will probably be weaning him soon,
although I'm not in a hurry.
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