What contraception can I use if I’m breastfeeding?

Dr Shazia Malik, consultant gynaecologist and obstetrician at The Portland Hospital, answers our question on contraception

Our bodies become fertile again as early as 21 days after childbirth. For this reason, unless you are intending to have another child immediately, it is recommended that you discuss your options with your health visitor or GP around a week after having your baby.

Don’t assume that because you’re breastfeeding, that in itself is an effective contraceptive, even if you’re not having periods. Ovulation takes place two weeks before a period happens, so you will be unaware of when there is a risk of pregnancy.

Some methods can impact upon breast milk supply. This applies mainly to those that contain oestrogen, such as the combined oral contraceptive pill, the vaginal ring or combined skin patch. Apart from these, you can use most other methods. The most common are either condoms or the mini-pill – the progesterone-only pill.

Most women do not have any major side effects when taking contraception shortly after having a baby, especially if you make an informed choice with your GP. As you are breastfeeding, then you may have no periods, especially while taking the mini-pill.

You can also take emergency contraception while breastfeeding. The coil must be inserted within five days of unprotected intercourse, but may not be suitable if you have had a caesarean section. The emergency pill contains progesterone only, so can also be taken. Levonelle can be taken while breastfeeding, too. Although small amounts of the hormones contained in the pill may pass into your breast milk, it’s not thought to be harmful to your baby.

If you want to have another baby next year or not too much of an age gap, I’d recommend using something that doesn’t affect your cycles too much, such as condoms or a coil.