Is it safe to use the pill while nursing a toddler?

My doctor prescribed birth control pills (Loestrin Fe 1.5/30) to treat my ovulation pain. However, I have a 25-month-old son who still nurses three times a day for about five minutes. The doctor doesn't think that oral contraceptives will be harmful to my son, but the package insert says breastfeeding is not recommended while taking oral contraceptives because of potential adverse effects. Is it safe to use the pill when nursing a toddler?


Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

The birth control pill you are taking, Loestrin Fe 1.5/30 (norethindrone acetate and ethinyl estradiol tablets, USP and ferrous fumarate tablets), contains primarily progestin and estrogen. The main concern with the use of birth control pills by nursing mothers is a possible decrease in milk supply, particularly when using pills containing estrogen, and when starting in the early months of lactation.

Nursing mothers using this method during the baby's first six months should monitor the baby's urinary output and weight gain to ensure they're adequate. However, you are at a different point in your breastfeeding relationship. A nursing toddler who breastfeeds only two or three times a day and eats a normal diet is not likely to suffer ill effects from a reduction in your milk supply. Also, he is receiving less of your milk and, consequently, less medication. Also, it is believed that with Loestrin, very little progestin or estrogen is transferred into breastmilk, or absorbed by the baby. There may be some change in your breastmilk's protein and fat content, but it is doubtful this would have a negative effect on a nursing toddler. Best wishes in making your decision!

References: Medications and Mothers' Milk, Thomas Hale, R.Ph., Ph.D., 1996
Breastfeeding and Human Lactation, Riordan and Auerbach, 1993.

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