Can I use contraceptive pills while breastfeeding?

Have you recently had a baby? If so, you may be wondering what contraception can be used when breastfeeding. 

If you’re breastfeeding, you may have some questions about whether it’s safe to take contraceptive pills, whether breastfeeding is in itself a method of contraception, and whether the contraception will have any effect on milk production. Here are the facts about contraception and breastfeeding to help put your mind at ease.

It is possible to get pregnant as little as three weeks after giving birth, even if your period hasn’t returned and you are breastfeeding. 

Some people use the lactational amenorrhea method (LAM) as a natural method of birth control. If you are breastfeeding exclusively (which means nursing your baby at least every 4 hours during the day and every 6 hours at night, and feeding your child breastmilk exclusively rather than in combination with formula, solid foods or other liquids) then your body may naturally stop ovulating, which can prevent pregnancy. 

Pregnancy can occur if an egg is released during ovulation, fuses with sperm and successfully implants into the lining of your uterus – so if you don’t ovulate you won’t get pregnant.

When LAM is used perfectly about 2 out of 100 will get pregnant within 6 months, which makes it around 98% effective. The LAM method only works if you are breastfeeding exclusively, so it is not effective if you are also using formula or if intervals between feeds get longer – if your child starts eating solid foods or nurses less at night, for example. If your child has a dummy they may feed less, which could also mean the LAM method becomes less effective. Expressing milk without using it to feed the baby, or being separated from the baby for more than a few hours, can also reduce the contraceptive protection from the LAM method.

The LAM method becomes less effective after the first six months of breastfeeding, even if you are still breastfeeding regularly and your periods haven’t returned. If your periods return before the six months is up, this suggests you are ovulating again. At this point, you may wish to use a method of contraception to avoid pregnancy.

Please note, however, that some people may ovulate before their periods return, so even if you are not getting your period it doesn’t necessarily mean you can’t get pregnant. If you want to avoid getting pregnant, you may want to think about using an additional method of contraception.

If you want to use a contraceptive method to avoid pregnancy after giving birth whilst breastfeeding, it’s important to make sure you feel secure in the knowledge that your chosen option is safe for your baby. 

Some hormonal contraceptives are suitable for use while breastfeeding. These include the progestogen-only pill, the contraceptive implant, the contraceptive injection, and non-hormonal options like male and female condoms. You can also get an intrauterine device (IUD) or an intrauterine system (IUS) fitted within 48 hours of giving birth. If you don’t get it within 48 hours, you’ll usually be advised to wait around 4 weeks, so it’s worth thinking about whether this is a method of contraception you’re interested in getting beforehand.

“If you are breastfeeding and as long as you have no medical reasons not to, you can use the progestogen-only pill. If you want to know more about contraception and breastfeeding you can speak to your midwife, GP, health visitor or a pharmacist for advice,” says Deborah Evans, a pharmacist* with over 30 years of experience.

Progestogen-only pills (also known as mini pills) containing desogestrel, like Hana®, can be used when breastfeeding.  A small amount of desogestrel passes into the milk, but studies show no negative effects on the child. Desogestrel also does not appear likely to affect the quality or production of breast milk.

If you are breastfeeding, you will usually be advised not to use the combined contraceptive pill, the contraceptive patch or the vaginal ring. Please speak to a healthcare professional like a pharmacist or doctor if you have any queries.