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Q&A: Breastfeeding and Contraceptives

Jerri Colonero, RN, BS


Q. When I went for my 6-week postpartum check up and discussed my contraceptive options as a breastfeeding mom with my ob-gyn. She said that I had to have a period before she would prescribe either the mini-pill or an IUD. Of course, because I am breastfeeding I had not had a period, nor have I had one yet and my baby is now 4 months old!

I feel like I'm in a Catch-22: I can't go on the mini-pill or IUD until I have a period, but I probably won't have a period until I stop breastfeeding, at which point I could just go on the regular pill! Can you explain to me why I my doctor requires me to have a period before I can get the mini-pill or IUD?

A. It is a bit of a Catch 22.

However, condoms, diaphragms and vaginal creams with Nonoxynol-9 can be used separately, or in combination, to provide contraception. Research on the mini-pill (progestin only) has not shown the negative results on quantity or composition of breastmilk that the combined oral contraceptives (containing estrogen), have shown.

However, because the hormones are passed on to the baby through your milk, some practitioners are concerned about the long-term effects on the baby. Your doctor is being cautious.

Your practitioner may not want to insert an IUD until your period proves that you are not pregnant. You cannot rely on breastfeeding as a method of birth control. There are several types of IUDS, however. Chemically treated IUDs contain some of the same hormones as the birth control pill, and are not recommended for breastfeeding mothers.

He/she may feel that condoms, diaphragms and vaginal creams offer adequate protection while nursing. Don't hesitate to discuss your frustration and "Catch 22" feelings further with your care provider.

Jerri Colonero RN

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