Hello, my name is Susanna Riley. I am a nursing student at the
University of North Dakota. For many years I have believed that
breastfeeding mothers should not take oral contraceptives at all. I
recently investigated this subject hoping to find information that would
support my view. Instead, what I found was information about the best
types of contraceptives to use at each stage of lactation. The following
is some of the information that I found.

     Even though the use of oral contraceptives during lactation may
cause decreased milk production, shortened lactation duration, and
decreased protein and nitrogen in breast milk, the AAP feels that
combination pills are "compatible" with breast feeding (Briggs, Freeman, &
Yaffe, 1994).

     Also, according to Paul Campbell Erwin (1994), use of the combined
pill can begin as soon as the milk supply is established. He also insists
that if women are forced to chose between this type of birth control and
breastfeeding, many will chose the pill (Erwin, 1994). It has also been
suggested that progestin only contraceptives be offered to the lactating
woman soon after delivery because progestin does not alter the production
or composition of breast milk (Kelsey, 1996).

     I still believe that the possible risks (known and unknown) of taking
oral contraceptives during lactation outweigh the benefits, but I
wonder why there is such a wide range of views on this subject. I have
reviewed the lactnet archives and realize this topic has been discussed
frequently in the past, but I would appreciate any recent updates,
experiences, and ideas. Thank you, Susanna Riley, College of Nursing
Student (University of North Dakota).

     Briggs, G.G., Freeman, R.K., & Yaffe, S.J. (1994). A reference guide
to fetal and neonatal risk: Drugs in pregnancy and lactation (4th ed.).
Baltimore: Williams & Wilkins.

     Erwin, P.C. (1994). To use or not use combined hormonal oral
contraceptives during lactation. Family Planning Perspective, (26)1, p.
26-30.

     Kelsey, J.J. (1996). The galactopharmacopedia: Hormonal contraception
and lactation. Journal of Human Lactation, (12)4, p. 315-317.