SHARES
“I heard that when mothers breastfeed after childbirth, periods may not return for several months after birth. Is it true that breastfeeding help with birth control? Yet, I have also heard about mothers getting pregnant too soon despite breastfeeding their babies.”, Mariam, 28, a soon-to-be new mother
Can Breastfeeding be a birth control method? Yes. In fact, breastfeeding can be an effective contraceptive method but only under the right conditions. It is recommended for almost all women after childbirth. Moreover, breastfeeding benefits both the mother and the newborn baby a lot, physically and mentally. You may use other birth control methods together with breastfeeding to achieve better contraception.
What is Exclusive Breastfeeding?
You will need exclusive breastfeeding in order to achieve a contraceptive effect. This means that your newborn baby receives only your breast milk and no other source of food. Also, frequency of feeding matters. You need to feed your newborn baby before menstruation returns. Feeding at least every 4 hours during daytime and at least every 6 hours at night. This can be as early as when your baby is about 6 weeks old. When you follow closely these criteria, you can effectively avoid getting pregnant.
Generally, the contraceptive effect can last for about 6 months or until your baby starts taking food other than your breast milk such as supplement, formula milk, porridge etc.
In summary, exclusive breastfeeding is 98-99.5% effective in preventing pregnancy when all these conditions are met:
- Your baby is less than six months old
- Your menstrual periods have not yet returned
- Baby is breastfeeding on cue (both day & night), and gets nothing but breast milk or only token amounts of other foods.
How Does Exclusive Breastfeeding Help in Birth Control?
Prolactin And Contraception
During breastfeeding, the suckling and stretching of the nipples stimulate the release of a hormone, called prolactin. In return, this hormone causes more breast milk production. Then, you will have more breast milk to feed your baby longer and more frequently. As a result, you body produce more and more prolactin. When this hormone reaches a sufficiently high level, it effectively stops your ovulation and period.
Therefore, you can resume intimacy with your partner using this natural birth control method without worries of getting pregnant again too soon. Indeed, getting pregnant again too quickly gives no time for your body to recover and can cause more pregnancy-related and childbirth-related complications.
Reliability of Breastfeeding As a Method of Contraception
The downside to this method of birth control is that any decrease in breastfeeding frequency decreases your body prolactin level. This gives chance for your body to ovulate and you may get pregnant again with unprotected sex.
Furthermore, if your baby is feeding poorly or you have problem with low breast milk production, or improper feeding technique, etc, these may result in non-reliable contraception. Thus, it is not recommended to have sexual intercourse for at least six weeks after childbirth. You would most likely have post-delivery menstrual bleeding, irregular menses and may even ovulate. Your breast milk production is usually low initially. It takes time for you to establish breastfeeding and for your prolactin level to build up. More importantly, your wounds such as vaginal, cervical and perineum tears, and Cesarean scar, need time to heal. Early sexual activity may cause pain and discomfort and even open up your wounds.
Talk to your doctor early if you have any problem with breastfeeding.
Photo by Element Media by Igor Milicic’s photostream from Flickr
Are There Any Better Options For Birth Control?
Usually, your doctor will schedule a follow up visit six weeks after your childbirth, to review your recovery and counsel you on the birth control methods best suited for you. A few examples of commonly used contraceptive methods are described below:
1. Barrier Method
By using a female or male condom throughout sexual intercourse, you can have close to 100% contraceptive effect. This means that there is totally no genital or semen contact without barrier. With “typical” usage, the realistic number can be slightly lower (about 82%).
2. Hormonal Pills, Injections, and Implants
These contain either progesterone or a combination of both progesterone and oestrogen. Both can stop ovulation effectively. Generally, implants last longer than injections, whereas injections last longer than pills. For instance, you would need to take hormonal pill every single day without missing a dose; but only take injection once in every three months; or undergo an implant procedure that lasts for 4 years.
However, oestrogen containing pills can temporary lower your breast milk production. Some people may experience certain side effects such as headache, weight gain, vaginal dryness, less sex drive, irregular menses, spotting etc. Note that with the use of any hormonal contraceptive methods, it takes time for you to ovulate again after discontinuation. It takes about 1-3 months for pills and implants and 6 months to 2 years for injections.
3. Intrauterine Device (IUD)
This is the most effective contraceptive method available. Your doctor will insert a T-shaped device into your womb. This prevents any fertilised eggs from implanting into your womb. IUD can last for 3-5 years. Hormones coated IUD are also available. They have better contraceptive effect and can even lighten your menstrual flow. Having said so, some people may experience heavy menstrual flow and cramping with the use of non-hormonal IUD.
4. Sterilisation
This is a surgical procedure that ties up the tubes carrying your eggs or sperms. The contraceptive effect is permanent and cannot be reversed. After the procedure, you can have unprotected sex with your husband/wife for the rest of your life. This is only suitable for married couples who have completed their family planning or where any more pregnancy can be dangerous to the mother’s life. Usually, for pregnant women going for her 3rd Cesarean delivery, this procedure is recommended and can be done together in one operation. This is because pregnancy after the 3rd Cesarean surgery is very dangerous and may cost both the mother’s and foetus’s life.
Photo by rewireme58 from Flickr
Intimate Again – The Sixth Week Pressure
It is not recommended to have sexual activity for at least 6 weeks after childbirth. If your baby is exclusively breastfed and there are no issues with breast milk production, your period may stop as early as 6 weeks. However, this does not mean you should pressure yourself to resume sexual activity immediately simply because you’re told by your doctor that you can. Many couples feel stressed to have sexual intercourse on the sixth week.
All the wounds, baby cries, responsibilities, leaking breast milk, and lack of sleep can take its toll on your body and mind. Your wounds can be very sensitive and sexual intercourse may cause pain. It takes time. The duration differs from person to person. More importantly, it takes a lot of understanding and communication with your loved one to walk through this wonderful phase of life.
Conclusion:
Exclusive Breastfeeding method of birth control can be very effective as a form of birth control, provided the perfect match of all conditions are met. However there could be variables that could not be predicted or controllable, hence couples would be wise to consider other methods of contraception instead.
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References:
1. Marcin A. Which forms of birth control are safe to use while breastfeeding [healthline]? Healthline Media. (Available from: https://www.healthline.com/health/birth-control/birth-control-while-breastfeeding; last updated on 2019 Dec 19; last accessed on 2020 June 23)
2. Galan N. Which birth control options are best while breastfeeding [MedicalNewsToday]? (Available from: medicalnewstoday.com/articles/319424; last updated on 2017 Sept 15; last accessed on 2020 June 23)
by Chang Xian
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