I wish I had the reference. Dr. Thomas Hale gave a session at the LLL
comference, in Chicago, in July 2001, which addressed this issue. His
research seemed to support the neccesity of a precipitous drop in
Progeterone immediately following childbirth, for lactogenesis to occur.
This explains why placental fragments have such an impact on supply (they
are still secreting progesterone,) and also why so many see failure of
lactogenesis when Depo is given in the early weeks after childbirth.

Dr. Hale even broached the subject of using mifepriston (sp?) in ecases of
difficult suspected retained placenta, or other conditions which may cause
high levels of progesterone in the early days. This would not only empty
the uterus post partum without surgery, but help with the neccesary drop in
progesterone. (Much to the gasping of a few of in the audience.) He seemed
to be of the opinion that Depo, given too soon after delivery, would
obviously prevent the rapid decrease in progeterone, this seriously
impacting lactation.

Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice

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