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Breastfeeding As Contraception: Lactational Amenorrhea

Breastfeeding is the most effective natural contraception method. It involves breastfeeding your newborn exclusively during the first six months postpartum.


This article is part of our Contraception Series!

 

What we're covering


What is it?

How does it work?

How effective is it?

What side-effects could I get?

When can't I use it?

Does it work immediately?

What happens to my fertility if I stop?

Does it protect against STDs?

 

Note: the information below was sourced from references (1-5), unless stated otherwise.


What is it?

Also called “lactational amenorrhea", breastfeeding as a contraception method is the most effective natural method. It involves breastfeeding your newborn exclusively (meaning, you breastfeed for every feed, never using formula or donated breastmilk) during the first six months postpartum. This method is only useful for you if you don’t menstruate during those six months. The moment you do, you’re no longer protected against pregnancy. After six months, breastfeeding doesn’t protect against pregnancy anymore regardless.


How does it work?

Person breastfeeding child
© Timothy Meinberg

During breastfeeding, you produce the hormone prolactin. This hormone stimulates the production of breastmilk and also prevents ovulation. Because the levels of this hormone drop after three to four hours after breastfeeding, you need to breastfeed your child frequently to prevent ovulation. This only works relatively reliably in the first six months following delivery, and only if you’re not menstruating yet. Note, however, that you’ll typically ovulate before you start your first postpartum menstruation. This means you might already be fertile before you start your first postpartum period.


In order to use the lactational amenorrhea reliably, you need to receive high-quality counselling. Ask your doctor or midwife whether they can provide this to you, or perhaps refer you to an expert.


How effective is it?

This method is quite effective in many people. With perfect use, it’s about 99% effective, meaning it leads to about 1 pregnancy per 100 people* per 6 months. With typical use, effectives is about 98%, meaning it leads to about 2 pregnancies per 100 people* per 6 months.


What are possible side-effects?

There are no side-effects for this method.


When can't I use it?

When you’ve started menstruating again, when you’re more than six months postpartum, or when you’re not exclusively breastfeeding (meaning you’re breastfeeding in combination with formula or donor milk) or not breastfeeding frequently enough (every 3-4 hours).


Does it work immediately?

Yes, you don’t have to wait or prepare anything to use this method.


What happens to my fertility if I stop using it?

Since nothing in your body changes when using this method, nothing’s different when you stop using this method. You have a higher risk of pregnancy if you’re not breastfeeding consistently and not using other contraception.


Does it protect against sexually transmitted diseases (STDs)?

No, this method does not protect against STDs. If you’re having sex with someone new or untested, use a barrier method as well.



*People, here, means anyone who is able to become pregnant, including girls, women, and non-binary people and transgender men who still have their uterus, vagina, and ovaries.



Are you curious about other methods to protect yourself from an unwanted pregnancy? Read about other birth control options here!



This article is pending medical review.

Contributors

Written by Juliëtte Gossens

Reviewed by Sophie Oppelt and Selina Voßen

Edited by Juliëtte Gossens

 

References


  1. McFarlane I (ed.). Seeing the unseen: The case for action in the neglected crisis of unintended pregnancy. United Nations Population Fund. 2022. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/EN_SWP22%20report_0.pdf

  2. Hacker NF, Gambone JC, Hobel CJ (eds.). Hacker & Moore’s Essentials of Obstetrics & Gynecology. 6th ed. Philadelphia: Elsevier; 2016.

  3. Hoffman BL, Schorge JO, Halvorson LM, Hamid CA, Corton MM, Schaffer JI (eds.). William’s Gynecology. 4th ed. New York: McGraw-Hill Education; 2020.

  4. Centers for Disease Control and Prevention. The United States Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html

  5. Centers for Disease Control and Prevention. 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html


Please note: the information we provide to you here is for educational purposes only. If you’re experiencing any discomfort or have any complaints or questions about your health, please contact your doctor or other relevant health professional. We don’t provide medical advice.