Hi all, this may be a redundant question (I am hopelessly disorganized in
keeping up with the digests and in filing the information, so please forgive
me).  I received a phone call today from a clinic mom who is exclusively
breastfeeding.  She was started on Ortho-Novum 777 (an estrogen-progesterone)
Birth control pill at 6 weeks post partum. She is currently finishing up her
first 4 week pack, so she must be 10 weeks postpartum.  She experienced
cracked, sore nipples for about 4 days out of the first week on the pill and
has been bleeding for the last 4 weeks.  She was told by another LC that the
pill will alter the milk composition and make it less nutritious.  She has
not had a supply problem.

Well, I ran into our nurse midwives who told me that they always prescribe
either the estrogen/progesterone combo pill (and tell the mom that she may
experience temporary supply problems) or the Depo shot.  They like to wait
for 6 weeks, but some of the docs are giving at 2 weeks.  One midwife
admitted that she does not usually see breastfeeding success with the pill,
but the other one says that she has seen women breastfeed with only transient
problems.  They state that their text books back them up.  I told them that
the only hormonal pill that I understood to be compatible with BF is the
progesterone only pill.  The one midwife told me that it has a high failure
rate if it is not taken exactly on time and the other one said that even
though that is true for non-breastfeeding women that the failure rate is not
so high if the mother is breastfeeding.

The mother's question is "Am I hurting my milk by taking this pill?"

On the way home from work, I was fantasizing about making a handout that
lists birth control options for breastfeeding mothers and summarizes the
pros, cons, effectiveness, effects on breastfeeding (and milk) and
responsibility of the woman (i.e. insert a barrier method at the proper
time).  Has this been done already?

You may e-mail me privately, if this has been thoroughly discussed (or if
anyone wants to let me know when it was discussed).

Also, a note in passing, the Dayton Daily News (the epitome of cosmopolitan
newspapers!) had an article today about "US uncovers widespread scam to sell
bogus goods" that mentions the fake formula, and adult nutritional products.
 Source was the NY Times, so there might be a bigger, better article there.

Thank you in advance,
Martha Brower  RD LD IBCLC Ohio (with a huge mental block about drugs)