From the Guidelines
Yes, you can safely breastfeed with a Mirena IUD, as the most recent and highest quality study suggests that it does not negatively influence lactation 1. The Mirena IUD releases a small amount of the hormone levonorgestrel locally in the uterus, with minimal amounts entering your bloodstream and even less transferring into breast milk. This makes it a safe contraceptive option for breastfeeding mothers.
Key Considerations
- You can have the Mirena inserted as early as 4-6 weeks after giving birth, though some providers may recommend waiting until your postpartum checkup (typically 6 weeks) 1.
- Breastfeeding itself won't affect the effectiveness of the Mirena, and the Mirena shouldn't affect your milk supply or quality.
- The Mirena IUD is actually considered a good contraceptive choice for breastfeeding mothers because it's highly effective, doesn't interfere with lactation, and provides long-term protection (up to 8 years) that you don't need to remember daily.
Important Recommendations
- If you notice any unusual symptoms after insertion, such as severe pain, heavy bleeding, or signs of infection, contact your healthcare provider.
- The Society for Maternal-Fetal Medicine recommends that women considering immediate postpartum LARC be encouraged to breastfeed, as current evidence suggests that these methods do not negatively influence lactation 1.
- It is essential to follow the guidelines and recommendations provided by reputable sources, such as the US Medical Eligibility Criteria for Contraceptive Use 1 and the Society for Maternal-Fetal Medicine 1, to ensure safe and effective use of the Mirena IUD during breastfeeding.
From the Research
Breastfeeding with Mirena IUD
- The Mirena IUD releases levonorgestrel, a form of progestin, which can affect breastfeeding 2, 3.
- A systematic review found that the risk of IUD perforation was 6-10 times higher among breastfeeding women compared to non-breastfeeding women, but the overall risk of adverse events was similar or lower for breastfeeding women 2.
- Another study found that the levonorgestrel-releasing intrauterine system (LNG-IUS) was effective in reducing painful periods and improving menstrual blood loss, but did not affect breastfeeding performance or infant growth 4.
- The biological basis of the mechanism of action of the copper-T intrauterine device and the levonorgestrel intrauterine system suggests that local effects, such as glandular atrophy and stromal decidualization, are dominant, and that systemic effects are minimal 5.
- There is no direct evidence to suggest that the use of the Mirena IUD affects breastfeeding, but it is recommended to consult with a healthcare provider to discuss individual circumstances and potential risks 2, 3, 4, 5.
Key Findings
- The Mirena IUD is a safe and effective form of contraception for breastfeeding women, but may increase the risk of uterine perforation 2.
- The levonorgestrel-releasing intrauterine system can reduce painful periods and improve menstrual blood loss, but may not affect breastfeeding performance or infant growth 4.
- Local effects of the Mirena IUD, such as glandular atrophy and stromal decidualization, are dominant, and systemic effects are minimal 5.
- There is limited evidence on the use of the Mirena IUD in breastfeeding women, and further studies are needed to fully understand its effects 2, 3, 4, 5.