Is It Safe for Women to Take Progestin While Breastfeeding?
If hormonal contraception is necessary or desired in women who are breastfeeding, the preferred option is progestin-only birth control. Progestin products are considered safe for women and children, and do not decrease breast milk production. Women can start taking these products safely six weeks after childbirth.
Progestin-only birth control options include:
- Intrauterine devices (IUD) that contain progestin (such as Mirena® or Skyla™): These are 99 percent effective at preventing pregnancy with typical use. Progestin IUDs may cause breakthrough bleeding or spotting (bleeding between periods) during the first six months of use or a lack of a period altogether.
IUDs do not protect against sexually transmitted diseases (STDs). Only a healthcare provider should implant and remove an IUD. These devices are safe to start using six weeks after childbirth.
- The progestin-only "mini-pill" (such as Ortho Micronor®, Nor-QD®, and others): Progestin works by increasing the thickness of the cervical lining, delaying sperm transport, and slowing down tubal motion. This type of birth control is a popular choice for many women who are breastfeeding, but it does not provide the same amount of protection as combined hormonal birth control pills (the traditional "pill").
Women using the "mini-pill" must take the tablet at the same time every day within a three-hour window. Failure to do this requires using a back-up method of contraception for the next 48 hours.
- Progestin injections (Depo-Provera®): This method can be used six weeks after childbirth and is considered safe for women who are breastfeeding. Injections are given into a muscle and are typically administered every three months to prevent ovulation. The long-term use of progestin injections is not usually recommended, as it can lead to a decrease in bone density.
- Progestin implants (Implanon®): These are small plastic implants that slowly release progestin into the bloodstream. The implants are placed in the upper arm and can prevent pregnancy for several years, or until removed. However, an implant might not be a good option for someone who is considering having another child soon or who is overweight.
- Emergency contraceptives: Emergency contraceptive medications are available that are safe for use in women who are breastfeeding. These include:
- Plan B® and Next Choice® contain either one or two high-dose progestin tablets that are to be taken as soon as possible after intercourse to help prevent pregnancy. Because these tablets are progestin-only, they are safe for use while breastfeeding.
- Ella® (ulipristal acetate) is a new form of emergency birth control. This medication works differently than progestin. However, it is currently not recommended for women to take Ella while breastfeeding.