Breastfeeding and Birth Control Pills

Ask Anne…

Question: I have been taking Micronor while breastfeeding my 12 month old. I know that this method has been known to suppress having one’s period, but for how long? I am only nursing 2-3 times a day at this point. Also, since she is nursing less frequently do I need a “stronger” birth control pill?

Answer: You don’t need a ‘stronger’ pill when your baby cuts back to nursing only a few times a  day, but you do need to know that you are more likely to start ovulating and to become fertile again as your breasts receive less sucking stimulation.

Micronor is a progesterone-only pill that is often prescribed for nursing mothers. Because it contains no estrogen, it is less likely to reduce the milk supply than pills that contain both estrogen and progesterone.

One common side effect of progesterone-only methods of birth control is that menstrual bleeding is often irregular. The amount and duration of flow vary, as does the length of the cycle. Some women using progesterone only methods of birth control notice no difference in their cycles, some find that their cycles are irregular, and some will stop having periods altogether.

Injectable progesterone methods such as Depo-Provera cause higher levels to circulate in the body than either pills or implants, and so are more likely to cause dramatic changes in the menstrual cycle like total cessation of menstruation. There is no way to predict exactly how an individual woman will respond to the progesterone-only pills. You just have to try it and see what happens.

Progesterone pills are slightly less effective than pills containing both progesterone and estrogen, but are still very effective when taken consistently and correctly. Progesterone has not been shown to adversely affect milk production when begun after the first six weeks postpartum, and in some mothers, is actually believed to increase milk supply. You don’t need to take a stronger pill just because your baby is nursing less often. If you take the pills as directed, you will have enough progesterone in your system to have the same contraceptive effect as a non-nursing mother. For more information about fertility, menstrual cycles, ovulation, and breastfeeding, see Breastfeeding and Birth Control.

Anne Smith, IBCLC
Breastfeeding Basics