As I am the coordinator for our hospital's Childbirth and Parent Education
program the following complaint was recently forwarded to me.  A doc claimed
one of my instructors was saying Micronor (progestin only BCP's) could
decrease milk supply and she said she had documentation that it doesn't and
wanted this instructor to quit saying it does.  I wanted to investigate
before I spoke to the instructor about it and checked Hale first -- which
says the contraceptives can decrease milk supply, but Briggs seemed to
contradict that.  I called the University drug line to find out what the lit.
says and they sent me a couple unimpressive articles that basically say they
don't decrease milk supply.  What I ended up telling the instructor and what
I've always told people myself is that the studies indicate these type of
contraceptives don't decrease supply, but I also have spoken with a lot of
women who report a decrease in supply shortly after they start taking them.
My question is: what is the consensus on this?  There seems to be an
astonishing lack of research on this, or at least what I can find.  Do
progestin only oral contraceptives decrease milk supply (including Norplant
and Depo).  If you can direct me to some well done, fairly recent studies I
would be most grateful.
Along another line, my partner at work and I (she has 10 years of experience
and I have 5 years as lactation specialists) are going to apply to sit for
the IBCLC exam nest July.  We have both taken the UCLA CLA course and she has
done an additional preceptorship program.  How do we study for the exam?  We
don't really want to take an expensive course, are there any study manuals
available, or maybe on-line study courses? TIA.
Andrea Tran, RN, ICCE, CLE

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