>  I'm not trying to be a pain in the tookus but point out that these
>  events in and of themselves can lead a mom to believe she has a drop in
>  supply.  It doesn't necessarily have to mean the depo brought it on.  I
>  do believe for some women the depo is enough to make a drop happen just
>  not every or even most moms.
>
I agree, but if I were discussing using BCP's  with a mom who's BF
relationship had some or all of these characteristics I would be quite
concerned with her supply.  I would probably recommend that she use an
alternative method of  Birth control for at least a few months. ( I realize
that in and of themselves these characterisitcs can lead to poor supply-it
just seems to me that I am getting the calls within a few weeks of the start
of the BCP's.)

Alternatively,  if she still wanted to use the pills,  I would cautiously
prescribe them and I  would  certainly discuss how to increase her supply in
preparation for a possible drop and/or how to restore  her nursing supply
should there be a decrease.
 Encouraging providers to make an assessment of BF characteristics BEFORE
giving BCP's and to provide anticipatory guidance beforehand was the only
intent of this posting.   This is not something that I am finding is done,
when I mention that the BCP' s could affect supply I typically get a response
such as, "Oh, they can!? or Oh, but they are not supposed to!"
        Chris Betzold MSN NP CLE

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