The Effects of Birth Control on Breastfeeding

Some of you might remember this article, but I feel compelled to run it again as I had two instances of this last month. A mom will start the mini-pill and quickly watch it affect her milk supply, sometimes with a very dramatic decrease. I wanted to remind everyone of what I see clinically in some of my patients who take the mini-pill, so I can prevent other mothers from going through the same thing!  Please remember that this is my anecdotal experience, not at all backed by research, and is different from what the pharmaceutical companies and many doctors and midwives believe. Also, I see moms with issues, so my population is skewed!  There are many who have no problems with the mini-pill at all. But it is something for all moms to be aware of, especially if they have concerns about their supply. 

So much of my work is about asking the right question at the right time. I had a perfect reminder of this over the summer. I was sitting by the pool watching my boys play with some of their cousins. My sister’s sister-in-law was sitting next to me and we were talking about her beautiful little boy who was 9 months at the time. He is happy, chubby and very well nourished by his mom who has been nursing him. And he has rock star hair to boot! She was lamenting the difficulty she has had with maintaining her milk supply for this baby. It was an experience much different than her first child, for whom she felt she had an abundant supply. And of course, we had been in contact regarding this since the baby was born. She was doing all the right things: eating and drinking well, pumping when necessary, nursing on demand and trying to get adequate rest. But she really felt she had to stay on top of this with this baby and couldn’t figure out why. And frankly, neither could I.

Then our conversation went on to other things and we eventually got talking about plans for the future. Nosey me asked if and when this little boy would have a younger sibling. And his mom replied that she would love to have another one someday, but was on the pill now and they were waiting a little bit longer for all the usual reasons. “You’re on the pill?” I asked. “Yes, since he was 6 weeks old,” she replied. “Wasn’t that when you started having problems with your supply?” I asked.

She went on to say that she was assured by her MD that it was safe to take this mini pill while nursing. I told her that she received correct information. It is considered perfectly safe for babies  to nurse when their mothers take the mini pill. What she wasn’t told though, was that in the fine print of the drug literature, it clearly states that it can cause a decrease in your supply. In fact in light of this new information, I was absolutely amazed that she had nursed this baby as well as she had! Many mothers that I work with in this situation lose their milk supply significantly within about 2 weeks. It is usually a very sad situation, as they were told it was safe for the baby, but not told that the side effect is a significant reduction in milk supply. They had no intention of weaning, but it happened dramatically and much sooner than they would have liked.

How did I miss this in someone who is essentially part of my family? It’s all in the questions I ask and I honestly am learning new stuff every day. I will never make that mistake again, but will probably make a new different one! In the meantime, I hope everyone reading this has learned a little something about birth control pills and nursing. And also, please tell me or any other health care provider you deal with everything you think they might need to know, even if you think it is inconsequential.

It just might be the one thing they need to know!