I have done a review and those studies that show a lowering of milk
supply are more likely to have either a definition of exclusive
breastfeeding or tightly controlled supplementation, a normal control
group, non-commercial funding and more complete data like loss to
follow up rates. There are 3 well designed studies: 2 are progestin
only and 1 is a combination. These studies were done early on and 2 of
the researchers then were the main researchers for much of our current
literature. They never repeated their primary design. THey are
Shaaban and DIaz. Miller also did a well designed study but he didn't
do as much follow up work (Obstetrics and GYnecology 35 (1) 1970;
44-50). I defined a lowering of milk supply as any study that had some
statistical evidence that it lowered supply with out any evidence that
it increased it. Yes, there are studies that show both an increase and
a decrease. In the Cochrane reveiw three of the trials had a control
group tht did not have normal infant weight gain or milk supply.
Truitt ST, Fraser AB, Gallo ME, Lopez LM, Grimes DA. Schulz KE.
Combined hormonal versus nonhormonal versus progestin-only
contraception in lactation. Cochrane Database of Systematic reviews
2003, Issue 2. Art. No.: CD003988. DOI: 10.1002/14651858.CD003988
Diaz S, et al. Fertility regulation in nursing women: VII. Influence of
Norplant levonorgestrel implants upon lactation and infant growth.
Contraception 1985;32:53-74.
Shaaban N, Salem H, Abdullah K. Influence of Levonorgestrel
Contraceptive implants, Norplant, initiated early postpartum upon
lactation and infant growth. Contraception 1985;32:623-35.
Seth H, Yadava H, Aragwal N, Laumas K, Hingorani V. Contraception
1977;16:383398.
Parveen L, Chowdjury A, Chowdhury Z. Injectable contraception
(medroxyprogesterone acetate) in rural Bangladesh. Lancet 1977;
November 5: 946-948.
Kamal I, Hefnawi F, Ghonein M, Abdallah M, Abdel Razek A. Clinical,
biochemical, and experimental studies on lactation. Amer. J. Obstet.
Gynec. 1970; October 15:655-58.
Karim M, Ammar R, El Mahgoub s, Ganzoury B, Fikri F, Abdou I.
Onjected progestogens and lacation. British Medical Journal 1971;
1:200-03.
Guiloff E. Ibarra-Polo A, Zanartu J, Toscanini C, Mischler T,
Gomez-Rogers. Effect of contraception on lactation. Am.J. Obstet.
Gynecol. 1974;118:42-5.
World Health Organization (WHO). Task Force on Oral Contraception.
Effects of hormonal contraception on breast milk composition and infant
growth. Stud Fam Plann 1988;19:361-9.
Gellen J. Fertility regulation during human lactation: Side effects
of steroid contraception. J. biosoc. Sci. 1977;4:149-164.
Schippancasse V, Diaz S, Zepeda A, Alvar
ado R, Herrereos C. Health and growth of infants breastfed by Norplant
contraceptive implants users: a s
ix-year follow-up study. Contraception 2002;66:57-65
Peralta et al. Rertility Regulationin Nurisng Women. Contraception 27
(1), 1983Christine M. Betzold NP CLC MSN
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