Take a look in the archives Laura, a couple of months back. I had a battle royal about it here and it has ended up by being banned.
  Julie Taylor
  RN IBCLC

Laura Block <[log in to unmask]> wrote:
  Hi! I am a pharmacist just starting my IBCLC hours at my hospital, and I have already stepped in it!
We have an OB who sometimes likes to give Depo-Medrol to post-partum Moms before they leave the hospital. When I see this, I check to see if the are breastfeeding, and usually they are not. But last week, we had someone who was. I called the doctor and he said that this would not be a problem. But I had heard multiple LCs say that they had seen it harm milk supply, so I looked in my brand new book: Textbook of Human Lactation by Hale and Hartmann. (Loving this book, by the way)

It lists Progestins as one of the drugs that may reduce milk production. 
It goes on to say on page 482:
Even low-dose progestins may suppress milk production in some mothers if used too early postpartum. The most sensitive time for suppression is early postpartum before the mother’s milk supply is firmly established. Waiting as long as possible (weeks to months) prior to use is recommended. All mothers should be warned that in some cases a reduction in their milk supply may result, and they should be observant for such changes.

I am thinking the best way to handle this may be to create an informed consent form for the administration of Depo-Provera in nursing moms. Perhaps we should stipulate that either they are not nursing, or they understand that use of this medication in the first (six?) weeks after birth MAY adversely impact their ability to make milk. 

What do y'all think? And does anyone have an informed consent for this in their facility? If so, can you share? 

Thank you so very much, 
Laura Block, PharmD, CLC

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