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I am still BF my 17 month old daughter approximately 3 times per day and sill have not gotten my 1st postpartum period. I'm not currently taking any form of birth control (just condoms). Before pregnancy, I used the Nuvaring and did ok on it. I've tried various BCPs and couldn't tolerate the side effects. My question is whether the NuvaRing is likely to have much impact on my supply at this point, or if I wait to use it whenever my period returns (assuming I'm still BF when it returns). I'm also considering Mirena or ParaGard, but the side effects make me a bit nervous. I also wasn't sure if Mirena is likely to affect my supply. Thanks for your input!
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Hi, thanks for your post.
Dr. Hale and I have discussed this question. Hormonal birth control (BCPs, Mirena, NuvaRing, etc) has the biggest impact on milk supply right at the beginning of lactation. Of these, the progestin-only birth control pill is generally recommended. We have reports from mothers concerning milk loss with Mirena, but one paper with a large number of women found no such response. NuvaRing has estrogens+progestin and is our least favorite.
By 6-8 weeks post-partum, the progesterone receptors have largely disappeared from the milk-producing cells and they become less responsive to the suppressing effects of progesterone. At 17 months, hormonal birth control products are unlikely to affect milk supply.
A healthy woman's milk production will naturally decline around 9 months post-partum, even if you continue breastfeeding after that. Be prepared for the possibility that your milk supply is already significantly less than when you started out.
ParaGaurd is not a drug-eluting device and will not affect your supply either. Choose the birth control method that is right for you.
Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519
-James Abbey, MD
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