Q: I'm breastfeeding. What type of birth control should I use?
A: Since you're breastfeeding, you should steer clear of all forms of birth control that contain estrogen, as it can reduce your milk supply. These include the combined-hormone pill, NuvaRing (a flexible ring that you insert into your vagina and keep there for three weeks) and Ortho Evra (the patch). If you prefer a hormone-based method, your better bets are progestin-only birth-control pills or Depo-Provera (shots given every 12 weeks), as they contain no estrogen.Barrier methods (male/female condom, IUD, cervical cap or diaphragm) also are an option. Of these, the IUD has the highest effectiveness rate, though there is an increased risk of cramping and heavy periods with its use and of uterine infection for four weeks after insertion.If you prefer to use breastfeeding as birth control, this method has an effectiveness rate of up to 98 percent as long as you meet three criteria: You are nursing at least six times a day on both breasts, including at night (and that means no pacifiers, formula or bottles of pumped milk); you have not resumed menstruating; and you are no more than six months postpartum.