How is the combined pill different while breastfeeding?

The combined pill contains oestrogen and progestogen. Soon after birth, the body is already in a period when blood clots can be more likely, and oestrogen can add to that concern. Oestrogen may also reduce milk production for some breastfeeding parents. The decision depends on time since delivery, feeding pattern, medical history and other clot risks; it is not made from breastfeeding alone.

A clinician can compare the combined pill with a progestogen-only method, a non-hormonal option or another method that fits your feeding plans. Do not rely on the combined pill for contraception until a clinician confirms when it is appropriate for you.

Tell the prescriber when you gave birth, whether you are fully or partly breastfeeding, and whether your periods have returned. Mention migraine with aura, high blood pressure, smoking, previous clots, surgery, medicines and any pregnancy complications. Ask when protection begins and what to use in the meantime. If you start the pill, watch for a noticeable drop in milk supply and discuss it promptly rather than changing the schedule yourself.

Get urgent medical help for sudden chest pain, trouble breathing, coughing blood, one-sided leg swelling or pain, severe headache, weakness or vision changes. Contact your maternity or contraception team about a marked change in milk supply, heavy bleeding or concerns about pregnancy. A missed pill may need specific advice depending on when it was missed and whether sex occurred.

Ask when the combined pill is suitable after birth, how it may affect milk supply, which alternative fits breastfeeding, when contraceptive protection starts, and what to do after a missed pill or vomiting.