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.