Levonorgestrel-Releasing Intrauterine System and Breastfeeding

The hormone in levonorgestrel-releasing intrauterine system does reach the bloodstream and will pass through breast milk. However, it is not likely to affect the quantity and quality of the milk. This device may increase the risk for uterine perforation in women who are nursing. If you are thinking about using levonorgestrel-releasing intrauterine system while breastfeeding, talk to your healthcare provider about the risks and benefits.


Can Breastfeeding Women Use Levonorgestrel-Releasing Intrauterine System?

Levonorgestrel-releasing intrauterine system (Mirena®, Skyla™) is an intrauterine device (IUD) approved to prevent pregnancy. It is a small, flexible, plastic system that slowly releases levonorgestrel (a progestin hormone) into the uterus for up to three to five years. In general, the device is safe to use while breastfeeding.

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Even though it is inserted into the uterus, where it produces the majority of its effects, the hormone in levonorgestrel-releasing intrauterine system does reach the bloodstream. Small amounts of it pass through breast milk and are detectable in a nursing infant's bloodstream. Still, progestin-only contraceptives such as this one have not been shown to cause problems on the health, growth, or development of a nursing infant.
If a breastfeeding woman is going to use a hormonal form of birth control, progestin-only products are generally preferred. These contraceptives are unlikely to affect the quality or amount of breast milk produced. However, there have been reports of decreased milk production in some women who used progestin-only birth control. 
Women who are breastfeeding may have a higher risk for uterine perforation (when the device tears the wall of the uterus) when levonorgestrel-releasing intrauterine device is inserted. Because of this, your healthcare provider may recommend you not breastfeed until the device has been safely inserted. The device can usually be inserted six weeks after childbirth, once the uterus has returned to its pre-pregnancy size and shape.

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Last reviewed by: Kristi Monson, PharmD
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