Breastfeeding as Birth Control

Overview

Breastfeeding can be used as a method of birth control. This is called the lactational amenorrhea method (LAM). But three conditions must be met to make sure that it works:

• Your baby must be 6 months of age or younger. After your baby is 6 months old, you are much more likely to become pregnant. You'll need to use another method of birth control to prevent pregnancy.
• You must fully breastfeed your infant. This means that the baby receives only breast milk. You can't use formula or other supplements. And you have to breastfeed for both day and night feeding, with no long breaks between feedings. It's best if you don't go longer than 4 hours between feedings during the day and no more than 6 hours between feedings at night.
• You must not have a period (amenorrhea). When your periods start, use some other birth control method.

When these conditions are met, LAM has been shown to be about 98% effective.^{footnote 1} But many doctors recommend that you also use another method of birth control.

After 6 months, even if you breastfeed only and your period has not returned, you must use another form of birth control if you do not want to get pregnant. You can get pregnant before your first period. That's because you ovulate before you have your period.

Other birth control methods

At any point during breastfeeding, use a reliable method of birth control if you don't want to get pregnant. Many methods are safe to use if you breastfeed, but some work better than others. Talk to your doctor about which type is best for you.

Options include:

• Birth control pills, skin patches, and vaginal rings. But it's best to use progestin-only options in the first few weeks after giving birth.
• The shot, such as Depo-Provera.
• The hormonal implant, such as Nexplanon.
• Barrier methods, such as condoms or diaphragms. To make them more effective, use them with spermicide or foam. Diaphragms are not widely available in Canada. Buying the necessary spermicidal jelly to use with them is difficult.
• An intrauterine device (IUD). This is placed inside your uterus by a health professional.

Fertility awareness isn't recommended for birth control during breastfeeding. This method is less reliable and harder to manage than other forms of birth control, especially since ovulation may not be regular while you are breastfeeding.