Sarah asks about the use of Lunelle in a teen breastfeeding mom:

Trade: Lunelle
Can/Aus/UK:
Uses: Once-a-month birth control injection.
AAP: Not reviewed

Lunelle is a new once-a-month injectable birth control product.  It contains
medroxyprogesterone acetate (25 mg ) which is the active ingredient in
Depo-Provera,  and it also contains 5 mg estradiol cypionate,  which is a
repository form of estrogen that is slowly released from the injection site
over 30 days.

The amount of medroxyprogesterone for this one month injection is 25 mg. The
amount of Depo-Provera providing 3 months coverage is 150 mg.   Because this
injection  contains estrogen,  it may potentially reduce the production of
milk and caution is recommended.1   Although small amounts of estrogens and
progestins may pass into breastmilk,  the effects of these hormones on an
infant appear minimal.  Use of estrogen containing products, particularly
early postpartum, may dramatically reduce the volume of milk produced.
Mothers should attempt to delay use of these products for as long as possible
postpartum (at least 6-8 weeks), if at all.

References:

1. Booker DE, Pahyl IR. Control of postpartum breast engorgement with oral
contraceptives. Am J Obstet Gynecol 98:1099-1101, 1967.

The above info is from Tom Hale's Red Book, Australian version, 2001.

Sarah, I'd really wonder about a teen mom using this -- injections have to be
every 30 days -- no longer than 33.  Is she able to comply with that?  How
old is the baby?  There are the usual caveats to giving any kind of
contraceptive to mothers while milk production is being established.  Early
on the doc could give the drug and she WILL be breastfeeding half time
whether she wants to or not!

By the way, I have a new best friend when it comes to getting updated info
about drugs.  While I'm impatiently waiting for the 2002 edition of
Medication & Mothers Milk to arrive, I've been using Google.com.  Generally,
put in the name of the drug (generic) + breastfeeding  (Google doesn't like
Breast Feeding or Breast-feeding, it likes breastfeeding -- just like we
do!!) and you'll probably get some hits.  Some good, some not so good, but
you can at least read abstracts of the articles that have been published for
yourselves.  So if it is something that isn't in Hale, or you need it between
now and the end of February -- have at it!

 Jan Barger, RN, MA, IBCLC -- Wheaton IL
Lactation Education Consultants
www.lactationeducationconsultants.com

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