I want to draw your attention to this study about associations between contraception use and breastfeeding at 4 months.1 In this study, all the women intended to breastfeed at least four months, and they reported at the 3 month check-in with researchers that they were using a contraceptive method.
As you look over the abstract you will quickly notice that women using progestin only pills were the most likely to be breastfeeding at 4 months, while women using combined hormonal contraception were the least likely. What I want you to see is that based on this study women using progestin have 97% probability of still breastfeeding at 4 months – in other words they have a tremendous success rate. In fact, they even had a higher success rate than women using non-hormonal contraceptive methods, and women using non-hormonal methods did very well with 90% probability of still breastfeeding at 4 months.
As we read this, we need to remember this was an observational study — which means there may be reasons outside the study that women using progestin only pills had the highest success rate. But, I’m not sure that matters for the point I want you to walk away with. My point — contraception does NOT need to end your breastfeeding plans. We have two categories of contraceptive methods with very high breastfeeding success rates — we should compare these to the women who do not use contraception post-partum who continue to 4 months.
So take another look a the family planing decision aid materials I posted two weeks ago and let your clients know they can be successful with breastfeeding while using contraception.