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Canadian Breastfeeding Foundation

Contraception and the Protocols

There are several adoptive or intended mothers who are fertile but for whom pregnancy is contraindicated due to medical reasons such as in the case of a “brittle diabetic” mother. If the mother is fertile and does not wish to become pregnant, it is recommended that she use an alternative method of contraception while on the protocols. Please note that oral contraceptives and domperidone are not recommended for use during pregnancy.

Because the birth control pill is started at any point in the woman’s cycle, and is taken non-stop for the duration of the protocol, it does not provide the usual contraceptive protection. Breakthrough bleeding is a common symptom of the protocols. Condoms, non-hormonal IUDs, spermicides, and the diaphragm are all acceptable alternatives to the birth control pill. It should be noted that use of the birth control pill, once lactation has been established, may significantly reduce milk supply. Therefore, alternative methods of birth control are preferable.

Once the baby is exclusively breastfeeding around the clock (no bottles, no supplementary feeding tube devices, no thumbsucking or blanket sucking) this should protect against pregnancy almost as effectively as the birth control pill. This is known as the Lactation Amenorrhea Method of contraception (LAM). Both the birth control pill and the Lactation Amenorrhea Method of birth control are 98-99% effective. However, neither method is foolproof. Once the baby has started on solids or supplements of any kind, the protection afforded by breastfeeding is reduced. Additionally, although breastfeeding significantly decreases fertility (if breastfeeding exclusively, the mother has not had a period, the baby is under 6 months of age), we still do not yet know if the protection afforded by breastfeeding following pregnancy is the same as for those who induce lactation.