Breastfeeding is as good as combined contraceptive pills (about 2% failure rate) if all the following conditions apply (no exceptions):
1. the baby is younger than 6 months
2. the mother has not yet had a normal menstrual period
3. the baby is exclusively breastfeeding (or near exclusively)
4. there is no prolonged period (greater than 6 hours?) when the baby does not nurse
For those of little faith, breastfeeding can be combined with other contraceptive methods. However, the "other methods" do not have to be the pill.
When to start contraception?
If there is no option to the pill:
Progestin only pills
If the mother is to be given medroxyprogesterone injections:
1. do not give injection on discharge from hospital
2. start progestin only pill at 6 weeks
1. WHO task force on oral contraceptives. Effects of hormonal contraceptives on breastmilk composition and infant growth. Studies in Family Planning. 1988;19:361-9
2. Fraser IS. A review of the use of progesteron-only minipills for contraception during lactation. Reprod Fertil Dev 1991;3;245-54
3. Visness CM, Rivera R. Progestin only pill use and pill switching during breastfeeding. Contraception 1995;51:279-81
4. Labbok M, Cooney K, Coly S. Guidlines: Breastfeeding, Family Planning and the Lactation Amenorrhea Method. Washington, DC: Institute for Reproductive Health, 1994
About the Author:
JACK NEWMAN, MD, FRCPC is a pediatrician, a graduate of the University of Toronto medical school. He started the first hospital-based breastfeeding clinic in Canada in 1984. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa. Dr. Newman has practiced as a physician in Canada, New Zealand, and South Africa.
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