I’m Breastfeeding—Can I Take My Birth Control Pill?

New parents have a lot on their plate, to say the least: learning to live with a new roommate who’s totally dependent on you, juggling endless loads of laundry, and sneaking in naps whenever possible. And while most doctors recommend holding off on sex until after the six-week checkup, you probably want a contraceptive plan in place and ready to go (and be sure to be in contact with your OB-GYN within the first 3 weeks of postpartum!).

For many people, that birth control plan is an oral contraceptive, a.k.a. the pill. But if you’ve decided to breastfeed, can you do so safely while taking hormonal birth control? How does birth control affect your milk supply, and is it really true you can’t get pregnant while breastfeeding? Here’s what to know about breastfeeding and birth control.

Can you get pregnant while breastfeeding (and not on birth control)?

The odds are slim, but yes, there is a chance you can get pregnant while breastfeeding. However, people who exclusively breastfeed can consider it a temporary form of pretty effective birth control. This method even has a name—the Lactational Amenorrhea Method (LAM), which basically translates to producing milk and your period is absent. It works because when babies nurse, a hormone called prolactin is triggered to ensure milk is supplied to the baby, while simultaneously suppressing other hormones that lead to ovulation (and you can’t get pregnant if you don’t ovulate).

But you’ve got to be pretty careful in order to make the LAM work perfectly (and it is 98% effective when used perfectly for up to six months after giving birth). You have to exclusively breastfeed (no bottles or pumping), you can’t have a period or any spotting, and remember, it’s only considered effective until your infant turns six months. TBH, it’s probably best to use a backup method if you’re giving LAM a try—just in case.

How does taking birth control impact breastfeeding?

For total peace of mind, we’d recommend using some form of birth control while breastfeeding. But since the pill works by adding hormones into your body, you might have some questions about whether hormonal birth control impacts your breastfeeding. 

Remember, there are two types of the pill: the combination pill (with estrogen and progestin) and the minipill (with progestin only). Doctors typically recommend the minipill for anyone breastfeeding, especially in the first few weeks after giving birth. That’s because estrogen has been tenuously linked to a decreased milk supply, but more research still needs to be done on the connection. Meanwhile, breastfeeding people are less likely to have frequent or prolonged bleeding on the minipill, making it a popular option for doctors to prescribe. 

Note that the minipill is slightly less effective than the combination pill. However, you’re less fertile immediately after giving birth and while breastfeeding, so many people are willing to accept that tradeoff. When you stop breastfeeding, or when your period returns, some doctors suggest switching to combination oral contraceptives for that slightly higher effectiveness.

The hormones from your oral contraceptive do pass on to your baby through your milk supply. However, doctors agree this is nothing to worry about, because the amounts are so small. 

How soon after birth should I start taking birth control?

Well, you’re probably not going to get the green light for a roll in the hay until your six-week check up—so you have some time to plan your contraceptive method. However, with your doctor’s approval, you can probably start taking the progestin-only minipill right after giving birth.

In any case, your postpartum contraception plan should be something you and your doctor discuss before you give birth. That way, it’s one less thing you have to think about during those first few hazy weeks with your new baby. And if you can get that birth control delivered directly to your door and automatically refilled? That’s a new parent’s dream.