Breastfeeding Birth ControlvsFertility Awareness

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

Side-by-side comparison

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.	Fertility Awareness Tracking body signs like temperature and cervical mucus to identify fertile days and avoid unprotected sex then.
Efficacy	98% typical use Moderately effective: over 90 out of 100 people successfully prevent pregnancy per year.	Least effective see details Least effective: under 90 out of 100 people successfully prevent pregnancy per year.
Cost	$0–$300 Insurance: Varies	$0–$100 /monthly Insurance: Varies
Duration	Up to 6 months postpartum	Ongoing daily tracking
Reversibility	Reversible	Reversible
STI Protection	No	No
How it works	Exclusive breastfeeding suppresses the hormones that trigger ovulation. High prolactin from frequent nursing keeps estrogen and progesterone low, preventing the return of menstrual cycles.	Track basal body temperature, cervical mucus, and cycle length to identify the fertile window. Avoid unprotected sex or use backup contraception on fertile days.
Prescription	OTC No prescription / OTC	OTC No prescription / OTC
Who shouldn't use this	Baby over 6 months old Periods have returned Not exclusively or nearly exclusively breastfeeding Use of supplemental formula or solid foods	Irregular cycles that make fertile window prediction unreliable Inability to track consistently Recent childbirth, breastfeeding, or perimenopause (cycles unstable)

Key differences

Breastfeeding Birth Control duration: Up to 6 months postpartum. Fertility Awareness duration: Ongoing daily tracking. Breastfeeding Birth Control: costs $0–$300. Fertility Awareness: costs $0–$100 monthly.