Dear Rachel Ask the mother with the sudden bf/production problem if she has recently started taking a contraceptive pill, including the mini-pill. I get so many of these stories (sudden unexplained drop in production or breast refusal) that I have given up exploring for other possible causes until I have asked this question. We know the combined pill can decrease supply, and I was so relieved last week to hear Miriam Labbok present a summary of her study if the literature on progesterone-only contraceptive methods and their effect on breastfeeding. She has isolated 13 studies that used a proper definition of real breastfeeding and 11 of them had a negative effect on breastfeeding under 8 weeks postpartum. The 2 that didn't were depot provera, not pills, which has lower blood levels. This is fantastic news. Not because they can stuff up breastfeeding, but because someone has finally validated what I have known clinically for a long time. Many, many of our mothers go onto the mini-pill t 6 weeks, quite a few come home from hospital already on it. Of course your mother is beyond 8 weeks, but I don't think that makes her safe from possible pill effects, we just don't have the studies. The other question I would ask is whether she is about to menstruate or resume menstruation? Keep us informed. Ros Escott ( Tasmania, Australia) [log in to unmask]