Can You Take Plan B While Breastfeeding?

Sometimes life (and sex) doesn't go as planned, which might prompt you to take emergency contraception. Maybe you had unprotected sex, or a condom broke, or you forgot to take your birth control pill. Regardless of how you got there, you may be in need of Plan B, a popular option for emergency contraception that is colloquially known as the "morning-after pill."

First of all, rest assured that this is an option. Despite the recent uptick in conversation surrounding bans on abortion, emergency contraception, and the like in the United States, Plan B currently remains legal and available in all 50 states. However, if you're a new parent and breastfeeding your baby, you likely have questions about the safety of using an emergency contraceptive.

If you're considering taking Plan B and wondering whether or not it's a safe option for you and your baby, keep reading for guidance from Mira medical advisor Katerina Shkodzik, MD, OB-GYN.

What is Plan B?

"Plan B is the brand name for a kind of emergency contraception pill with the active ingredient levonorgestrel. Levonorgestrel emergency contraception pills are progestin-only pills and work by inhibiting or delaying ovulation to prevent pregnancy," Shkodzik explains.

It's not uncommon for a person to get pregnant while they're still breastfeeding a child. "Pregnancy can occur as early as four to six weeks after giving birth," says Shkodzik, adding, "Ovulation can occur before your menstrual period returns." Considering some mothers breastfeed for years, an unplanned pregnancy during this time is a definite possibility.

Is it safe to take Plan B while breastfeeding?

The good news is Plan B is safe to use while nursing your baby, according to Shkodzik: "The progestin-only pills that contain levonorgestrel are safe while breastfeeding. They have no harmful effects on breastfeeding performance or the health, growth, or development of the infant. Plan B can be used safely with no changes to your breastfeeding schedule."

While she says levonorgestrel gets into breastmilk in small amounts, a person who takes it as emergency contraception can breastfeed three to four hours after the dose (or after each dose if the two-dose method is used). However, Shkodzik advises that you "be sure to talk to your healthcare provider about all of your breastfeeding questions. "

How do you take Plan B?

"The tablet should be taken as soon as possible after unprotected intercourse up to 72 hours after," says Shkodzik. "The longer the interval between intercourse and taking the tablet, the greater is the chance that it will not be effective."

If vomiting occurs soon after taking the tablet, Shkodzik recommends seeking out medical advice as soon as possible. "Emergency contraception is used to prevent pregnancy; it's not the 'abortion pill,'" Shkodzik cautions. "If you are already pregnant, emergency contraception will not work," adding that "no contraception has a 100% success rate."

Are there any side effects?

In general, Shkodzik says no harmful effects of progestin-only pills, like Plan B, have been found on breastfeeding performance or the health, growth, or development of the infant. "However, random cases of decreased (less) milk production in mothers have been reported," she elaborates. "The most common side effects on women are irregular bleeding or spotting, nausea, fatigue, vomiting, breast tenderness, headaches, dizziness and abdominal pain."

When can a mother start using Plan B again?

Shkodzik cautions Plan B or emergency contraception should not be used as a regular method of birth control.

"However, if you have already used Plan B, it can be safely used again after another instance of unprotected sex or birth control failure," she says, noting, "It will not affect a woman's future fertility. Plan B doesn't provide long-term protection against future pregnancy — it works to help prevent pregnancy after only one act of unprotected sex or birth control failure. It's recommended not to use emergency contraception more than once per cycle."

What are some alternatives?

"The alternative is the pill that contains ulipristal acetate (ellaOne®) that can be taken up to five days after unprotected intercourse," Shkodzik says. "If taken while breastfeeding, 'pump and dump' is required for 36 hours.

Additionally, a copper intrauterine contraceptive can be inserted up to five days after intercourse as an alternative method of emergency contraception pills. It prevents the sperm from meeting the egg and changes the acceptive properties of the uterine lining."

And, you guessed it, it's also safe while breastfeeding.