Which contraceptive methods can be considered while breastfeeding, what is lactational amenorrhoea, and when to start protection? Balanced information.
Contraception while breastfeeding is a family planning subject that covers when the risk of becoming pregnant again begins after birth and which methods can generally be considered while you are breastfeeding. The right method is determined together with your doctor according to your breastfeeding situation, your health history and your personal preference.
When does the risk of becoming pregnant again begin after birth?
Ovulation can happen before your periods return; for this reason not having had a period does not on its own mean you are protected from pregnancy.
Does breastfeeding really provide contraception? What is the Lactational Amenorrhoea Method (LAM)?
The Lactational Amenorrhoea Method (LAM) relies on the temporary fertility-suppressing effect of breastfeeding, and this effect applies only when certain conditions are met together: periods not yet having returned, the baby still being small, and full or nearly full breastfeeding. If one of the conditions is not met, protection is reduced and an additional method should be considered. Breastfeeding does not provide this protection by itself; LAM is a limited method that depends on conditions.
Which contraceptive methods can generally be considered while breastfeeding?
According to current classifications, methods containing oestrogen (combined methods) are generally not recommended in the early postnatal period; methods that do not contain oestrogen can be considered during breastfeeding too. Which method is suitable at which time is determined according to your mode of birth and your health history.
Why are some methods avoided in the early postnatal period?
The reason methods containing oestrogen are generally not recommended in the early postnatal period is that they are linked with the risk of venous blockage (thrombosis) in this period. This risk context means that your general health history needs to be assessed in choosing a method, as well as your breastfeeding situation.
Does contraception affect milk production?
In choosing a method compatible with breastfeeding, an important criterion is that the method does not affect milk production. The effect of methods containing hormones on milk production varies from person to person; it is recommended that you assess this with your doctor.
When should postnatal family planning be talked about?
It is recommended that you talk about postnatal family planning early, in pregnancy or in the early period after birth. Your contraception preference is also discussed at your postnatal check-up.
What can you ask your doctor before choosing a method?
- Which methods may be suitable for me according to my breastfeeding situation?
- Which conditions must be met together for me to regard LAM as reliable?
- Could the method I choose affect my milk production?
- When should I start protection again after birth?
- When does each class of method become an option for me?
Frequently Asked Questions
If I cut down breastfeeding or start giving my baby extra food or formula, do I need to change my method?
LAM relies on full or nearly full breastfeeding. When you stop breastfeeding or it becomes less frequent, or when extra food or formula starts to take the place of breastfeeding, this condition may not be met; in this case an additional or different method may be needed. It is recommended that you share changes in your breastfeeding pattern with your doctor.
If I have another health condition, does my choice of method change?
Current classifications assess the suitability of each method separately, not only according to breastfeeding but also according to the health conditions the person has. For this reason, telling your doctor about your existing health conditions and the medicines you use makes it easier to determine the class of method that suits you.
Can I become pregnant before my periods return?
Yes. Ovulation can happen before periods return. Not having had a period does not on its own mean you are protected.
Is breastfeeding alone enough for protection?
No. Breastfeeding does not provide this protection by itself; LAM is a limited method that depends on conditions.
Do the LAM conditions need to be met together?
Yes. The conditions of periods not having returned, the baby still being small, and full or nearly full breastfeeding need to be met together.
If one of the LAM conditions is not met, is an additional method considered?
Yes. If one of the conditions is not met, protection is reduced; an additional method should be considered.
Can methods without oestrogen be considered while breastfeeding?
Yes. Methods without oestrogen can be considered during breastfeeding too. When they are suitable is determined according to your mode of birth and your health history.
Why are methods containing oestrogen generally not recommended in the early period?
They are generally not recommended because they are linked with the risk of venous blockage in the early postnatal period. Your general health history is also assessed when choosing a method.
Is milk production taken into account when choosing a method?
Yes. It is important that the method does not affect milk production. The effect of methods containing hormones may vary from person to person; you can assess this with your doctor.
Should I wait for the postnatal check-up to talk about family planning?
It is recommended that you talk about it early, in pregnancy or in the early period after birth. Your preference is also discussed at the postnatal check-up.
Is my personal preference also taken into account in the method I will use?
Yes. The suitable method is determined with your doctor together with your breastfeeding situation, your health history and your personal preference.
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