Is breastfeeding a natural method of contraception?

Breastfeeding and natural contraception: what is LAM, or exclusive breastfeeding?

Breastfeeding as contraception

Under certain conditions, breast-feeding can have a contraceptive effect for up to 6 months after childbirth. This method of natural contraception, called LAM (breastfeeding and amenorrhea method) is not 100% reliable, but it can operate for a few months provided that all these criteria are met to the letter. Its principle: under certain conditions, breastfeeding produces enough prolactin, a hormone that will block ovulation, making a new pregnancy impossible.

The LAM method, is it reliable?

Relying on exclusive breastfeeding as a means of contraception can be a tempting prospect … But keep in mind that it carries the risk … of being pregnant again. If you really do not want to start a new pregnancy, it is better to turn to the (re) taking of a reliable contraceptive means, which will be delivered to you by your midwife or doctor.

When should you take contraception after giving birth?

Which contraceptive during breastfeeding?

In general, after childbirth, ovulation resumes around the 4th week when you are not breastfeeding, and up to 6 months after birth depending on breastfeeding mode. It is therefore necessary to anticipate the return to contraception, if you do not want a new pregnancy immediately. Your midwife or doctor may prescribe a micro-dosed pill, compatible with breastfeeding, right out of the maternity ward. But it is usually during the postnatal consultation with the gynecologist that the method of contraception is decided. This appointment, a follow-up consultation, makes it possible to draw up a gynecological check-up postpartum. It takes place around the 6th week after your baby is born. Supported 100% by Social Security, it gives you the opportunity to take an overview of the different methods of contraception:

– the pills

– the contraceptive patch (this is not recommended when breastfeeding)

– the vaginal ring

– hormonal or copper intrauterine devices (IUD – or IUD),

– the diaphragm, the cervical cap

– or barrier methods, such as condoms and certain spermicides.

When to take the pill again after childbirth?

Breastfeeding and oral contraceptives

Periods and breastfeeding

After childbirth, the resumption of ovulation is not effective at least before the 21st day. Your period usually returns 6 to 8 weeks after giving birth. This is called the return of diapers. But when you breastfeed, it’s different! Infant feedings stimulate the secretion of prolactin, a hormone that slows down ovulation, and therefore the resumption of the menstrual cycle. That is why, your period often does not return until breastfeeding is over or within three months following childbirth. But beware of ovulation, which occurs 2 weeks before the onset of menstruation, and which it will be necessary to anticipate by a contraceptive method.

Can I get pregnant while breastfeeding?

LAM is not 100% reliable, because it is common that all the conditions it requires are not met. If you want to avoid a new pregnancy, it is better to turn to contraception prescribed by your doctor or midwife. Breastfeeding does not contraindicate the use of contraception.

What pill when you breastfeed?

How to avoid getting pregnant while breastfeeding?

There are two types of pills: combined pills et progestin-only pills. Your doctor, midwife or gynecologist is qualified to prescribe this contraceptive method. It takes into account: your breastfeeding, the risk of venous thromboembolism which is greater in the first weeks of the postpartum period, and any pathologies which have arisen during pregnancy (gestational diabetes, phlebitis, etc.).

There are two main categories of pills:

– the estrogen-progestogen pill (or combined pill) contains estrogen and progestin. Like the contraceptive patch and the vaginal ring, it is not recommended during breastfeeding and in the 6 months following childbirth when breastfeeding your baby, because it tends to decrease lactation. If afterwards it is prescribed by your doctor, he will take into account the risks of thrombosis, diabetes and possibly smoking and obesity.

– the progestin-only pill contains only a synthetic progestogen: desogestrel or levonorgestrel. When either of these two hormones is only present in small amounts, the pill is said to be microdosed. If you are breast-feeding, you can use this progestin-only pill from the 21st day after giving birth, on prescription from your midwife or doctor.

For either of these pills, only a healthcare professional is authorized to prescribe the best method of contraception if you are breast-feeding. The pills are available in pharmacies, only on prescription.

How to take the pill properly when breastfeeding?

Microprogestogen pills, like other pills, are taken every day at a fixed time. You should be careful not to be more than 3 hours late for levonorgestrel, and 12 hours for desogestrel. For information : there is no pause between the plates, one continues in a continuous way with another plate.

– In the event of menstrual disturbances, do not stop your contraceptive without the advice of a doctor, but talk to him / her about it.

– Diarrhea, vomiting and certain medicines can affect how well your pill works. If in doubt, do not hesitate to consult.

– Convenient: on presentation of a prescription for less than one year, you can renew your oral contraceptive once for an additional 1 months.

Remember to always anticipate well and plan several packets of your pill in advance in your medicine cabinet. The same if you go on a trip abroad.

Breastfeeding and emergency contraception

If you forget your pill or have unprotected sex, your pharmacist can give you a morning after pill. It is important to tell her that you are breast-feeding your baby, even if it is emergency contraceptive is not contraindicated in case of breastfeeding. On the other hand, quickly consult your doctor to take stock of your cycle and the normal resumption of your pill.

Implants and injections: how effective when breastfeeding?

Pill or implant?

Other contraceptive solutions may be offered to you, in the absence of contraindications, while you are breastfeeding.

— An etonogestrel implant, subcutaneously. It is generally effective for 3 years when one is not overweight or obese. However, this system is often the cause of menstrual disturbances and, in rare cases, the implant can migrate and create complications.

— L’injection contraceptive – hormone-based too – which is administered quarterly. But its use must be limited in time, because there are cases of vein thrombosis and weight gain.

When to put an IUD after childbirth?

IUD and breastfeeding

IUDs, also known as intrauterine devices (IUDs) can be of two types: copper IUD or hormonal IUD. Whether you are breastfeeding or not, we can ask for them to be installed as soon as possible. 4 weeks after vaginal birth, and 12 weeks after cesarean section. There is no contraindication to continuing breastfeeding after insertion of an IUD, or IUD.

These devices have a duration of action that varies from 4 to 10 years for the copper IUD, and up to 5 years for the hormonal IUD. However, as soon as your period returns, you may find that your flow is greater if you have a copper IUD inserted, or almost absent with a hormonal IUD. It is recommended to check the correct placement 1 to 3 months after implantation IUD, during a visit to the gynecologist, and to consult in case of unexplained pain, bleeding or fever.

Other methods of postpartum contraception: barrier methods

If you are not taking the pill or planning to have an IUD inserted, stay alert! Unless you want a second pregnancy very quickly or haven’t resumed sex, you can look to:

– male condoms which must be used at each intercourse and which can be reimbursed on medical prescription.

– the diaphragm or cervical cap, which can be used in combination with certain spermicides, but only from 42 days after childbirth,

If you were already using a diaphragm before your pregnancy, it is necessary to have its size reassessed by your gynecologist. Spermicides can be bought in pharmacies without a medical prescription. Consult your pharmacist.

Contraception: can we trust natural methods?

What means of natural contraception?

If you are ready to embark on a unplanned pregnancy, be aware that there are so-called natural methods of contraception, but with a high failure rate and which involve sometimes restrictive vigilance behaviors. You have to wait for the return of the rules (at least 3 cycles) if you really want to apply them.

Natural contraceptive methods:

– The Billings method : this is based on careful observation of the cervical mucus. Its appearance: fluid or elastic, can give indications on the period of ovulation. But beware, this perception is very random because the cervical mucus can change according to other factors such as a vaginal infection.

– The withdrawal method : we point to a failure rate of the withdrawal method quite high (22%) because the pre-seminal fluid can transport sperm and the partner does not always manage to control his ejaculation.

– The temperature method : it is also called symptothermal method, which claims to identify the period of ovulation according to variations in temperature and the consistency of the mucus. Very restrictive, it requires scrupulously check his temperature daily and at a fixed time. The moment when it rises from 0,2 to 0,4 ° C may indicate that of ovulation. But this method requires abstaining from intercourse before and after ovulation, since sperm can survive for several days in the genital tract. Temperature measurement therefore remains an unreliable method, and conditional on multiple factors.

– The Ogino-Knauss method : this consists of practicing periodic abstinence between the 10th and the 21st day of the cycle, which requires knowing your cycle perfectly. A risky bet since ovulation can sometimes be unpredictable.

In short, these natural contraceptive methods do not protect you from a new pregnancy, whether you are breastfeeding or not.

Source: Haute Autorité de Santé (HAS)