Hello!  This is my fist question to Lactnet, so I hope I mind my manners
and do this right! I have been reading for several months, and I, too,
appreciate the volumes of information I have gained.  I am currently
working with a faculty physician (in a private hospital) whose residents
have been in the habit of administering Depo Provera to breastfeeding
mothers prior to hospital discharge.  The LC's in our community believe
that the Depo is causing a reduction in milk supply for these moms.
This physician is very supportive of breastfeeding, and wants to teach
his residents to do the correct thing.  He is also very research based,
and has asked me for an good research article documenting this action.
I have checked Dr. Hale's recommendations, which state that Depo is not
contraindicated in breastfeeding.  The only information I have for this
physician about the milk supply reduction is anecdotal.  He feels it is
more efficient to give the Depo prior to discharge, as the mother is
here at the hospital.  He is concerned that the LC's are leaning on
their anecdotal experience, rather than utilizing evidence-based
practice.  He hypothesizes that perhaps we only see a few of the mothers
that are experiencing a reduction in their milk supply, and that the
vast majority do well- we just don't hear from them.  Can anyone give me
any advise on this?  I am also curious as to whether there is less of a
tendency to affect the milk supply if the Depo is given at six weeks, so
a good supply can be built, rather than 48 hours postpartum.  I would
appreciate the information and the help!  Thanks in advance!

Linda J. Tandy, MSN, RN, IBCLC
In Cedar Rapids, Iowa, where is is dark and rainy