. Ideal contraceptive for lactating mother is:
For newly married couples oral contraceptive pill is the method of choice provided there are no contraindications.
It has many noncontraceptive benefits along with effective contraception.
Barrier and Natural methods have high failure rate.
IUCD are not prescribed in nulliparous females due to increase risk of PID and infertility
In a couple who are living separately in two cities and meet only, occasionally contraception of choice is barrier method.
“Condom are suitable for use in old ager for couple who have infrequiuent coitus, during lactation, during holidays, subject who can not tolerate OCP, IUCD”.
In Breastfeeding Females
For lactating mothers, contraceptive should be chosen in such a way that in addition to providing effective contraception, they do not adversely affect the success of lactation or the health of the infant. Barriers have a high failure rate of 4–14% and not reliable for long-term control.
As estrogens decrease the quality and quantity of milk, COC pills are absolutely contraindicated in lactating mothers.
Lactation Amenorrhea Method (LAM)
• Excessive secretion of prolactin, which controls lactation, inhibits the pituitary. Prolactin inhibits luteinizing hormone (LH) but has no effect on follicle-stimulating hormone (FSH). However, it partially inhibits ovarian respons to both of these gonadotropins. As a result, while the prolactin level remains high, the ovary produces little estrogen and no progesterone. Hence, ovulation and menstruation are affected.
• LAM is effective only till 6 months postpartum. Beyond this, it is not a reliable method.
• Even for the 6 months, it is effective only if there is exclusive breastfeeding.
• It any time in the first 6 months the menses starts, then it cannot be used as birth control.
• POPs are safe with breastfeeding and very effective. They were mainly designed especially for lactating mothers.
Barrier method
Combined OCP
Lactational amenorrhoea
Progesterone only pill