title: Contraception and lactation.
abstract: Lactation worldwide is estimated to prevent more births than all organized family planning programs, and thus has a definite contraceptive action.  In addition, it contributes to better infant nutrition and well-being.  In some societies women do not cohabit while lactating and therefore need no contraception.  This situation is being eroded, and in any case does not apply generally.  The risk of pregnancy increases with the length of lactation, and thus some form of added contraception needs to be adopted during lactation.  Because of the nutritional value of lactation, the CMC deprecates the exploitative commercial advertising and promotion of bottlefeeding that exists in many parts of the world.  It recommends that the IPPF and its member associations should actively promote breastfeeding.  Since pregnancy can occur during lactation, additional contraception is desired.  It should be remembered that IUDs, spermicides, mechanical methods, depot medroxyprogesterone acetate, progestagen-only oral contraceptives (OCs), and sterilization have no adverse effects on lactation.  Evidence is accumulating that combined OCs have an adverse effect on the quantity and possibly the quality of breastmilk.  Therefore, much greater caution should be exercised in distributing combined OCs than previously.  Combined OCs should not be started until lactation is well established, and ideally not before 6 months or until the infant is weaned, whichever occurs 1st.  If, however, no alternative contraception is available then OCs may be used earlier.
mesh_terms: D001942:Breast Feeding; D003267:Contraception; D003268:Contraception Behavior; D003276:Contraceptives, Oral; D005193:Family Planning Services; D006262:Health; D007227:Infant Nutritional Physiological Phenomena; D007267:Injections; D007434:Intrauterine Devices; D007774:Lactation; D009747:Nutritional Physiological Phenomena; D013245:Sterilization, Reproductive
chemical_list: D003276:Contraceptives, Oral
keywords: Barrier Methods; Breast Feeding; Contraception; Contraceptive Usage; Family Planning; Health; Infant Nutrition; Injectables; Iud; Lactation; Nutrition; Oral Contraceptives; Sterilization, Sexual