Family Planning while breastfeeding

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Women who are breastfeeding have special needs when selecting a family planning method. Family planning counselors should be sure to inquire whether the client is breastfeeding and offer complete information about each method including any possible effects it may have on the quality and quantity of her breastmilk.  

Methods can be classified into three categories based on their effect on breastfeeding.  

1st Choice Methods 
These methods do not interfere with breastfeeding and are safe to use any time after birth: 

• Condoms (also the best protection against AIDS and sexually transmitted diseases)
• Diaphragm
• Spermicides
• IUD (non-hormonal)
• Natural Family Planning (breastfeeding disrupts the signs and symptoms of fertility, which may make charting difficult)
• Vasectomy
• Tubal Ligation

 

2nd Choice Methods 
Methods under this category contain the hormone progestin. In most cases, these methods do not affect a woman's milk supply. However, to avoid any risk, it is recommended to wait six weeks after delivery before using a progestin-only method, which include the following: 

• Mini-pill
• Injectables (such as Depo-Provera®)
• Implants (such as Norplant®)

 

3rd Choice Methods 
These methods contain the hormone estrogen which can reduce a woman's milk supply. Women should be informed of this risk and advised to delay the use of such methods until at least six months postpartum. However, if the breastfeeding woman chooses this method, she can continue breastfeeding and should be encouraged to do so for its numerous health benefits. 

• Combined oral contraceptives 
• Combined injectables

The client should be fully informed about all available methods and supported in her decision, regardless of which method she chooses.