Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Pill while nursing

17 May, 2006

Question:

I had a baby girl 4 weeks ago and have a little boy that is 2 yrs old. I am currently nursing full time and wanted some information on contraception.

With my son I took the mini pill and I became pregnant on it when my son was 15 months old. I was wondering if it would be safe to take a "regular" birth control pill and continue nursing my daughter, because I want to make sure that the contraception would be more effective.

Secondly, if the "regular" contraceptive is indeed ok, would I get my period during the 7 days of placebo pills?


Answer:

The minipill is recommended while breastfeeding as it is less likely to impact on milk supply. While combination pills are not dangerous for the infant, they can reduce the milk supply and thus are really not a first choice, especially in the early months of nursing.

As your chances of getting pregnant while fully nursing are markedly reduced in the first six months as long as you have not resumed menses, we would really recommend that you at least start with this progesterone only method of contraception – making sure to take at a consistent time each day. As we understand your concern about the mini pill not working the last time, you can then consider changing over to combination pills at about age six months. At this point your baby is ready for solids and thus, if you have reduced milk supply, solid food can help fill the gap.

An additional disadvantage of the combination pill is that you will most likely have withdrawal bleeding that starts during the placebo pills. Therefore, if you wait a few months until starting this method, you can take advantage of the lack of bleeding that generally accompanies the first number of months of nursing. Please do not hesitate to get back to us with further questions.


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