Does breastfeeding work as birth control?

The human body is a pretty amazing machine, and has adapted in some incredible ways. Too cold? Time to shiver. Too hot? Time to sweat!

Too soon after giving birth to get pregnant again? The body has that one covered too. Well, sort of.

The menstrual cycle pauses while exclusively breastfeeding

Women who are breastfeeding exclusively generally do not ovulate, or have their menstrual periods, within the first six months after giving birth. This pause in the menstrual cycle due to breastfeeding is known as lactational amenorrhea.

Ovulation is the process that produces an egg that is able to be fertilized, so if there’s no ovulation, there’s no egg, and no fertilization, and no pregnancy. Simple enough.

There are two big catches with the lactational amenorrhea method (LAM), however. First of all, LAM only works if you breastfeed exclusively. This means at least every four hours during the day, and every six hours at night. If you supplement your baby’s diet with formula, or even expressed (pumped) breast milk, ovulation may begin again. And because menstruation only happens after ovulation, you probably won’t know that ovulation has started again until a few weeks after it does.

Secondly, LAM only works for about six months, even if you continue to breastfeed exclusively beyond that. Everybody is different, so for some women ovulation might happen earlier, and for others later, but there’s no way to tell until after the fact.

When done perfectly, LAM is effective

If you are breastfeeding exclusively, and switch to a different form of contraception before your cycle starts again, LAM is believed to be about 98% effective. This puts it in “the pill” territory for effectiveness. However, the key word here is “perfect.” Going six months without pumping or supplementing isn’t easy, and in this case, “perfect” truly does mean perfect.

Pregnancies within 18 months of birth are linked to negative outcomes

According to the March of Dimes, pregnancies that start less than 18 months after delivering a baby are associated with higher rates of preterm birth, neonatal morbidity, low birthweight, developmental delays, asthma, and vision and hearing loss.

So what’s the verdict?

If you’re exclusively breastfeeding (perfectly!), and intend on starting a different contraceptive method after either six months, or when you first ovulate again, LAM may work. However, many health care providers recommend beginning a different birth control method shortly after delivery as a safety net.

Through your health plan, you’re likely covered for certain FDA-approved contraceptive methods, like IUDs and hormonal birth control pills.

If you would like to review or have questions about your health plan benefits, call the number on the back of your member ID card.

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