What to know about the combined pill while breastfeeding

The combined pill contains oestrogen and progestogen. After birth, oestrogen-containing contraception may be unsuitable for a period because blood-clot risk is higher during the postnatal recovery phase. In some people, oestrogen may also reduce milk production. The decision depends on time since birth, feeding pattern, medical history, migraine history, smoking, blood pressure, and previous clots. Breastfeeding alone is not a reliable contraceptive plan unless specific conditions are met.

Tell the prescriber that you are breastfeeding, when you gave birth, and whether feeding is exclusive or mixed. Share your medicines and any history of clotting, high blood pressure, migraine with aura, liver disease, or breast cancer. Ask about a progestogen-only method or non-hormonal option if the combined pill is not suitable at this stage. If prescribed, take it consistently and follow the instructions for missed pills. Report a noticeable drop in milk supply or concerns about your baby’s feeding.

Get urgent medical help for sudden chest pain, trouble breathing, coughing blood, one-sided leg swelling or pain, sudden weakness, or a severe new headache with vision or speech changes. Contact your clinician about heavy or persistent bleeding, a positive pregnancy test, or a marked change in milk supply. Do not restart or share contraceptive pills without an individual review.

Ask: Is the combined pill appropriate at this point after birth? Could it affect my milk supply? Which method fits my clot and migraine history? What should I do after a missed pill, vomiting, or diarrhoea? When should I return for a review?