Because I have a background with LLL and LC work most of my original exposure
to the birth control pill or depo-provera revolved around when mothers were
have difficulties with breastfeeding.  When I began working with a teen
population as a case manager I saw many who took the mini-pill or
depo-provera and had copius milk supplies and continued to breastfeed with no
problems.  When I went through training as a family planning counselor I saw
the studies and the stats.

While there is a percentage of the population that has milk supply problems
after beginning these methods of birth control, by far most women do not, for
them this may be a viable choice.

When I talk with women who are considering depo-provera and breastfeeding I
will suggest they do a couple of things to ensure breastfeeding is protected,
1) wait until breastfeeding is well established before beginning these
contraceptives 2) start with the mini-pill for one or two months so that if
there is a negative impact on milk supply they can stop taking the pills and
their milk supply usually rebounds within a day or so.  I point out that most
women will not experience a drop in milk supply and that many women notice an
increase.

I think when we give out information we need to remember that often the
population we encounter is the population that is having trouble with
breastfeeding.  Those who are not experiencing problems don't usually call
us.

Denise Parker, BA, IBCLC (La Crescenta, CA)