From the Guidelines
Most birth control pills are safe to use while breastfeeding, with progestin-only pills being the safest option and combined hormonal contraceptives typically safe to use after 6 weeks postpartum. When considering the safety of birth control pills during breastfeeding, it's essential to weigh the benefits and risks. According to a study published in Diabetes Care 1, combination oral contraceptives containing the lowest doses can be prescribed and started 6 – 8 weeks after delivery if the woman is breastfeeding. However, progestin-only agents should be used with caution during breastfeeding, especially in certain populations.
Key Considerations
- Progestin-only pills are generally considered the safest option for breastfeeding mothers as they don't contain estrogen, which can potentially reduce milk supply in some women.
- Combined hormonal contraceptives are typically safe to use after milk supply is well established, usually around 6 weeks postpartum.
- The hormones in birth control pills pass into breast milk in very small amounts that are not harmful to the baby.
- Other safe contraceptive options while breastfeeding include IUDs, implants, injections, condoms, and diaphragms.
- Exclusive breastfeeding itself can provide some contraceptive effect in the first 6 months postpartum if your periods haven't returned and you're nursing frequently, but this method (lactational amenorrhea) is not completely reliable. It's crucial to consult with a healthcare provider to determine the best contraceptive option for individual circumstances, taking into account factors such as medical history, lifestyle, and personal preferences, as recommended by the study 1.
From the FDA Drug Label
Small amounts of progestin pass into the breast milk, resulting in steroid levels in infant plasma of 1 to 6% of the levels of maternal plasma. However, isolated post-market cases of decreased milk production have been reported in POPs. Very rarely, adverse effects in the infant/child have been reported, including jaundice.
Birth control pills are not entirely safe with breastfeeding. While small amounts of progestin pass into breast milk, there have been reports of decreased milk production and rare adverse effects in infants, such as jaundice 2.
From the Research
Safety of Birth Control Pills with Breastfeeding
- There are no research papers provided that directly address the safety of birth control pills with breastfeeding 3, 4.
- The studies available discuss the effectiveness and risks associated with oral contraceptive pills in general, but do not specifically mention their use during breastfeeding.
- One study mentions that oral contraceptive pills can increase the risk of venous thrombosis, but does not provide information on how this risk may be affected by breastfeeding 3.
- Another study discusses the effect of oral contraceptive progestins on serum copper concentration, but does not address the safety of these contraceptives during breastfeeding 4.
- Overall, there is a lack of direct evidence in the provided studies to assist in answering the question of whether birth control pills are safe with breastfeeding.