Dear Colleagues,
In the last month I have heard from two WIC moms who wanted to breastfeed
but have ended up hardly breastfeeding at all after they began taking an
oral contraceptive (OC) called Camila. One began the pill at two weeks; the
other at six weeks. Both babies began to act hungry at the breast around the
time their moms began the pill. The 6-week-old had been refusing the
occasional formula bottle his mom was offering (because she wanted to have
the option of giving a relief bottle for her own needs). After she began the
pill he began taking the formula and refusing the breast.

I had not heard of this OC before, so I looked it up and found it's the same
active drug as Micronor. Women have taken Micronor for decades and it is
considered OK for nursing mothers. So what's up? Are these two moms just
unusual, or is there something about this formulation that is different?

I talked my questions over with a pediatrician friend, and we came up with
the idea that moms should be warned in advance that giving a baby bottles
may be especially risky around the time a mom starts taking oral
contraceptives. It would make more sense for mothers to begin and continue
exclusive breastfeeding until the milk supply is well established (while the
xbf would give them 98% protection from pregnancy anyway), THEN get started
on the OC, nursing frequently to offset any faltering in supply, and ONLY
THEN begin mixed feeding (if that is her preferred method of infant
feeding).

It just seems unwise for a mom to offer a baby an alternative choice during
a time when she needs the baby's best effort at the breast to maintain her
milk production.

How many of you feel that you know how to advise moms who want mixed
feeding? What evidence have you found showing how to do it successfully,
maintaining milk production and baby's interest?

Chris Mulford, RN, IBCLC
LLL Leader Reserve
working for WIC in South Jersey (Eastern USA)
Co-coordinator, Women & Work Task Force, WABA

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