Choosing the right form of birth control after having a baby is an important step in protecting your health, supporting your breastfeeding goals, and planning the timing of future pregnancies. The World Health Organization (WHO) encourages families to consider health benefits and risk factors, age, fertility goals, access to health care, and personal support when making family planning decisions.

The Importance of Pregnancy Spacing

The time between pregnancies—known as the interpregnancy interval—plays a big role in both your and your baby's health. The American College of Obstetricians and Gynecologists (ACOG) notes that this time gives your body a chance to heal and helps you feel ready, both physically and emotionally, for another pregnancy. Experts recommend waiting at least 6 months after giving birth before becoming pregnant again. Waiting at least 18 months offers even more benefits, such as lowering the chances of complications during pregnancy and birth.

Spacing pregnancies also supports infant growth and gives families time to adjust to life with a new baby. Large research studies, including one with nearly 47 million pregnancies, show that waiting at least 18 months, but no longer than 60 months, lowers the risk of preterm birth, low birth weight, and early newborn challenges. Beyond medical benefits, spacing also gives parents more time to focus on older children, restore physical and emotional energy, and feel more prepared for the next stage of growth.

Which Birth Control Methods are Breastfeeding-Friendly?

There are many different birth control options, but not all are ideal during breastfeeding. This guide highlights forms of birth control that are compatible with breastfeeding, so you can feel confident discussing your preferences with your healthcare provider. Together, you can choose an approach that supports your breastfeeding goals, family planning needs, and the timing that feels right for you.

Lactational Amenorrhea Method (LAM)

You might be surprised to learn that this natural method of contraception can be up to 98% effective for the first 6 months postpartum if all the following conditions are met:

  • Your baby is under 6 months old

  • Your menstrual period has NOT returned

  • You’re exclusively or nearly exclusively breastfeeding

When all of these conditions are in place, LAM can be as effective as many other methods of birth control, with no side effects for you or your baby. However, once your baby reaches 6 months of age, your period returns, or breastfeeding becomes less frequent, the effectiveness of LAM decreases. At that point, it’s a good idea to consider another method of birth control.

Barrier Methods

Barrier methods, such as condoms, diaphragms, cervical caps, or spermicides, are a reliable option for many families. They have the advantage of being low cost, have few side effects, and, when used correctly, are effective at preventing pregnancy. Condoms also provide the added benefit of protection against sexually transmitted infections.

On the other hand, they can be less effective if not used consistently, and some people may experience allergic reactions to the materials or spermicide. In addition, diaphragms and cervical caps require a proper fitting from a healthcare provider. Barrier methods have no effect on breast milk or milk production.

Natural Family Planning/Fertility Awareness

Some families prefer natural family planning, which involves tracking cycles, body temperature, and cervical mucus to identify fertile days. This method does not use hormones and has no effect on milk production. However, it requires careful monitoring, periodic abstinence, and can be less reliable if cycles are irregular, especially while breastfeeding.

Progestin-Only Hormonal Contraceptives

These hormonal methods use only progestin and come in several forms:

  • a daily oral contraceptive (often called the “mini pill”)

  • a shot every 3 months

  • a hormonal IUD

  • a vaginal ring

  • or a small implant placed under the skin of your arm, about the size of a matchstick

Progestin-only methods are highly effective, especially the longer-term options like the implant or IUD.

Possible side effects include irregular bleeding, headaches, acne, weight gain, bloating, or mood changes. Pills must be taken consistently, while shots, implants, and IUDs require a provider for placement and removal. Fertility may take longer to return after stopping the shot.

Progestin-only methods can sometimes lower milk supply, especially if started in the first month after birth. If milk supply decreases with the shot, it cannot be reversed until the medication wears off. Implants or IUDs placed immediately after delivery may be linked with a shorter duration of breastfeeding, but when placed 6 weeks postpartum or later, they usually do not affect milk supply.

Estrogen-Containing Hormonal Birth Control

These options combine the hormone estrogen with progestin. They include daily pills (often called “the pill”), a weekly patch, and a monthly vaginal ring. These can be managed at home and often help regulate menstrual cycles. However, they require remembering to use them on schedule, can increase the risk of blood clots, and may interact with certain medications. They are also not safe for some medical conditions.

Caution should be used when breastfeeding, since estrogen is well known to lower milk supply. Because of this, it’s best to avoid these options until breastfeeding is well established. If used, the lowest dose should be started as late as possible, once your supply is stable.

Intrauterine Devices (IUD)

There are two main types of IUDs:

  • Copper IUD (non-hormonal)

  • Hormonal IUD (releases progestin)

Both are small, T-shaped devices placed inside the uterus by a healthcare provider. IUDs are highly effective birth control methods, reversible, and can last for 5-10 years, depending on type. Drawbacks include a small risk of infection during insertion and the need for a provider for both placement and removal. The copper IUD should not be used by people with Wilson’s disease or a copper allergy. While the initial cost is high, IUDs are very cost-effective long term.

The copper IUD has no known effects on milk supply. Hormonal IUDs placed immediately after birth may slightly shorten breastfeeding duration, but when inserted 6 weeks postpartum or later, they generally do not affect milk production.

Emergency Contraception

Emergency contraception can be used after unprotected sex or contraceptive failure to lower the risk of pregnancy. Options include pills with both estrogen and progestin, progestin-only pills, ulipristal, and mifepristone.

It is most effective when taken as soon as possible, ideally within 72 hours. Progestin-only pills are usually more effective and have fewer side effects than estrogen-containing pills. Mifepristone may work as well as, or better than, progestin-only pills.

Estrogen-containing pills are more likely to cause nausea and vomiting. Research on the safety of ulipristal and mifepristone during breastfeeding is still limited. For breastfeeding mothers, progestin-only emergency contraception is preferred because estrogen can lower milk supply.

Sterilization

Sterilization is a permanent form of contraception. For males, this is done with a vasectomy, usually a simple outpatient procedure with a quick recovery. For females, it may involve blocking or removing the fallopian tubes through surgery. Female procedures carry risks, costs, and a small chance of ectopic pregnancy afterward.

Sterilization does not affect milk supply. However, if a female sterilization procedure is done soon after birth, it may mean a short separation from your baby and could require stronger pain medicine during recovery.

Choosing the best birth control option while breastfeeding is a personal decision that only you can make. Talking openly with your healthcare provider can help you find the method that protects your health, supports your breastfeeding goals, and fits your family planning needs.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare and/or lactation provider.