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Breastfeeding Birth Control vs Diaphragm

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

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Side-by-side comparison

  • Breastfeeding Birth Control A natural postpartum method (lactational amenorrhea method, LAM) that relies on exclusive breastfeeding to suppress ovulation, effective for up to 6 months.
  • Diaphragm A reusable silicone dome that covers the cervix to block sperm, used with spermicide each time you have sex.
Method
Breastfeeding Birth Control A natural postpartum method (lactational amenorrhea method, LAM) that relies on exclusive breastfeeding to suppress ovulation, effective for up to 6 months.
Diaphragm A reusable silicone dome that covers the cervix to block sperm, used with spermicide each time you have sex.
EfficacyBreastfeeding Birth Control 98% typical use, in the first 6 months

Measured in the first 6 months, not over a year, so it cannot be compared directly with first-year rates.

Diaphragm 83% typical use

Least effective: under 90 out of 100 people successfully prevent pregnancy per year.

CostBreastfeeding Birth Control $0 Diaphragm $0–$250 Insurance: Usually
DurationBreastfeeding Birth Control Up to 6 months postpartumDiaphragm Reusable for up to 2 years (replace sooner if damaged)
ReversibilityBreastfeeding Birth Control ReversibleDiaphragm Reversible
STI protectionBreastfeeding Birth Control NoDiaphragm No
How it worksBreastfeeding Birth Control

Full or nearly full breastfeeding prevents the ovaries from releasing eggs. Frequent suckling suppresses the brain's pulses of GnRH and LH, the hormones that drive ovulation.

Diaphragm

A reusable silicone dome covers the cervix to block sperm from reaching an egg. Used with spermicide for added effectiveness.

PrescriptionBreastfeeding Birth Control Not required Self-DirectedDiaphragm Required Hybrid (Fitting or Ship)
Side effectsBreastfeeding Birth Control None reportedDiaphragm
  • Increased risk of urinary tract infection
  • Vaginal irritation from spermicide
  • Toxic shock syndrome risk (rare)
Who shouldn't use thisBreastfeeding Birth Control
  • Baby over 6 months old
  • Periods have returned
  • Not exclusively or nearly exclusively breastfeeding
  • Use of supplemental formula or solid foods
Diaphragm
  • Uterine or cervical anomaly preventing fit
  • Sensitivity to silicone or spermicide
  • Inability to insert or remove reliably
  • History of toxic shock syndrome
  • High risk of HIV exposure (because of the spermicide)

Key differences

Breastfeeding Birth Control's effectiveness was measured in the first 6 months, not over a year, so it is not compared with Diaphragm's. How long it lasts: Breastfeeding Birth Control, up to 6 months postpartum; Diaphragm, reusable for up to 2 years (replace sooner if damaged). A prescription is needed for Diaphragm, not for Breastfeeding Birth Control. Breastfeeding Birth Control: costs $0. Diaphragm: costs $0–$250.