Contraception

Special Birth Control Pill

Check with your doctor before beginning any medication.

It is important to find a birth control pill that is at least equivalent to Ortho 1/35 (1 mg norethindrone + 0.035 mg ethinyl estradiol). But if a higher progesterone content is available, it would be preferable.

Acceptable birth control pills include:

  • Ortho Novum 1/35
  • Necon 1/35
  • Demulen 1/35
  • Norethin 1/35E
  • Norinyl 1 +35
  • Zovia 1/35
  • Microgestin

Note: It is extremely important that the mother’s doctor understand that the birth control pill is not being used to control menses but rather to develop the milk making apparatus of the breasts. This is why the birth control pill must contain at least 1 mg of progesterone (2-3 mg is better) and no more than 0.035 mg of estrogen. Many women have found that higher doses of estrogen to be ineffective. The birth control pill must be taken non-stop, only active pills, no sugar pills, for the duration of the protocol.

The longer the time a mother spends inducing lactation by taking the birth control pill together with the domperidone, the longer the milk making apparatus of her breasts will have time to prepare for milk production. It normally takes 9 months for a baby to gestate and during that time the milk making apparatus of the mother’s breasts are being prepared for lactation. For this reason, 6-9 months, on the combination of the birth control pill and domperidone, before baby is expected to arrive produces the best results.

For the Accelerated protocol and Menopause protocol it is highly recommended to use Microgestin 1/30 in place of the Ortho 1/35 because the Microgestin contains 1.5 mg of progesterone as opposed to the 1 mg of progesterone in the Ortho 1/35. The estrogen content is the same in the three medications. Many women have found that when the Microgestin is substituted for the Ortho 1/35, breast changes occur more rapidly and more effectively which is desirable when time is of the essence. Microgestin is available in the US and several other countries worldwide. It is sometimes marketed as Loestrin.

Several women have expressed concern about the hormones in the birth control pills. They have found it helpful when it is pointed out that the hormones that are contained in the birth control pills are minuscule compared to the hormone levels that a woman normally achieves during a pregnancy. The hormone levels necessary to achieve breast changes are minute compared to the levels necessary to support gestation.

Contraception and the Protocols

There are several adoptive or intended mothers who are fertile but for whom pregnancy is contraindicated due to medical reasons such as in the case of a "brittle diabetic" mother. If the mother is fertile and does not wish to become pregnant, it is recommended that she use an alternative method of contraception while on the protocols. Please note that oral contraceptives and domperidone are not recommended for use during pregnancy.

Because the birth control pill is started at any point in the woman’s cycle, and is taken non-stop for the duration of the protocol, it does not provide the usual contraceptive protection. Breakthrough bleeding is a common symptom of the protocols. Condoms, non-hormonal IUDs, spermicides, and the diaphragm are all acceptable alternatives to the birth control pill. It should be noted that use of the birth control pill, once lactation has been established, may significantly reduce milk supply. Therefore, alternative methods of birth control are preferable.

Once the baby is exclusively breastfeeding around the clock (no bottles, no supplementary feeding tube devices, no thumbsucking or blanket sucking) this should protect against pregnancy almost as effectively as the birth control pill. This is known as the Lactation Amenorrhea Method of contraception (LAM). Both the birth control pill and the Lactation Amenorrhea Method of birth control are 98-99% effective. However, neither method is foolproof. Once the baby has started on solids or supplements of any kind, the protection afforded by breastfeeding is reduced. Additionally, although breastfeeding significantly decreases fertility (if breastfeeding exclusively, the mother has not had a period, the baby is under 6 months of age), we still do not yet know if the protection afforded by breastfeeding following pregnancy is the same as for those who induce lactation.


Newman-Goldfarb Protocols for Induced Lactation © 2002-2016 
Jack Newman, MD, FRCPC and Lenore Goldfarb, Ph.D., CCC, IBCLC

Breastfeeding