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Breastfeeding Birth Control vs Vasectomy

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.
  • Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
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.
Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
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.

Vasectomy 99.85% typical use

Most effective: over 99 out of 100 people successfully prevent pregnancy per year.

CostBreastfeeding Birth Control $0 Vasectomy $0–$1,000 Insurance: Varies
DurationBreastfeeding Birth Control Up to 6 months postpartumVasectomy Permanent
ReversibilityBreastfeeding Birth Control ReversibleVasectomy Permanent
STI protectionBreastfeeding Birth Control NoVasectomy 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.

Vasectomy

A clinician cuts, seals, or blocks the vas deferens so sperm cannot mix with semen during ejaculation. The body absorbs the sperm, and the semen remains normal in appearance and volume.

PrescriptionBreastfeeding Birth Control Not required Self-DirectedVasectomy Required In-Person Procedure
Side effectsBreastfeeding Birth Control None reportedVasectomy
  • Mild pain or swelling for a few days
  • Bruising or bleeding at the site
  • Sperm granuloma (swelling from leaked sperm that usually goes away on its own)
  • Chronic post-vasectomy pain syndrome (5% in a 2020 meta-analysis)
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
Vasectomy
  • Uncertainty about future fertility desires
  • Known allergy or hypersensitivity to materials used in the procedure

Key differences

Breastfeeding Birth Control's effectiveness was measured in the first 6 months, not over a year, so it is not compared with Vasectomy's. How long it lasts: Breastfeeding Birth Control, up to 6 months postpartum; Vasectomy, permanent. Breastfeeding Birth Control: reversible. Vasectomy: permanent. A prescription is needed for Vasectomy, not for Breastfeeding Birth Control. Breastfeeding Birth Control: costs $0. Vasectomy: costs $0–$1,000.