Emergency contraception, or the “morning after pill,” offers a time-sensitive option to prevent pregnancy after unprotected intercourse. For nursing mothers, a common concern revolves around the safety of these medications for their breastfed infants and potential impacts on milk production. This article clarifies emergency contraception use for breastfeeding individuals, distinguishing types and providing practical guidance for maternal and infant well-being.
Types of Emergency Contraception and Their Action
Two main types of emergency contraception pills are available: levonorgestrel-based pills and ulipristal acetate. Levonorgestrel-based pills, such as Plan B One-Step, primarily work by delaying or inhibiting ovulation, the release of an egg. This prevents the egg and sperm from meeting, preventing fertilization. These pills are most effective when taken as soon as possible after unprotected intercourse, typically within 72 hours, though some efficacy may extend up to 96 hours.
Ulipristal acetate, often marketed as ella, functions similarly by modulating progesterone receptors to delay or inhibit ovulation. This medication can be effective for a longer window, up to 120 hours (five days) after unprotected sex. Both types prevent pregnancy and do not terminate an existing one.
Safety Considerations While Breastfeeding
Levonorgestrel is compatible with breastfeeding. Studies indicate that only minimal quantities of levonorgestrel pass into breast milk, approximately 0.1% of the maternal dose over three days. Major health organizations support its safe use during lactation without interruption. No adverse effects have been reported in breastfed infants.
For ulipristal acetate, guidance has evolved. While earlier recommendations sometimes suggested temporarily interrupting breastfeeding, more recent clinical guidance indicates that the amount transferred into breast milk is very low. The manufacturer’s data show that the mean concentration of ulipristal and its metabolite in milk is low, with a relative infant dose of about 0.8% in the first 24 hours, which is well below the 10% level generally considered safe. Many expert sources now state no interruption of breastfeeding is necessary after a single dose of ulipristal acetate. However, some older guidelines may still advise a temporary interruption, such as 24 hours.
Practical Guidance for Nursing Mothers
Taking emergency contraception as soon as possible after unprotected intercourse increases its effectiveness, regardless of the type chosen. Levonorgestrel can be purchased over-the-counter, while ulipristal acetate may require a prescription. Rapid access is important for optimal results.
If a mother chooses ulipristal acetate and wishes to minimize infant exposure, despite updated guidance suggesting it may not be necessary, some might still opt to express and discard breast milk for a period. For instance, some older recommendations suggested a 24-hour interruption. Maintain milk supply during any temporary interruption by regularly pumping. After taking either type, observe your infant for unusual changes in behavior, feeding, or health, and seek medical advice if concerns arise.
Potential Effects on Milk Supply and the Mother
Levonorgestrel-based emergency contraception has minimal effect on milk supply. Studies show no decrease in milk production. Breast milk composition is also not significantly altered.
Temporary side effects may occur, including nausea, abdominal pain, fatigue, headache, and changes in menstrual bleeding patterns. These effects are generally mild and resolve without intervention. If vomiting occurs within a few hours, seek medical advice as a repeat dose might be necessary.