Dolores and Colleagues,

None of us is going to be able to help you very much - I am speaking on the
basis of what Lactmed, The National Institutes of Health website, has for
info and references. (You can easily access this at
http://toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~toR6lt:1

 One paragraph (which will be one you will be quoted I'm sure) says

In a nonrandomized, nonblinded study comparing women who were breastfeeding
at discharge, 102 postpartum women received depot medroxyprogesterone
acetate (dosage not stated) in the early postpartum period (average 51.9
hours postpartum; range 6.25 to 132 hours), 181 received another
progestin-only contraceptive and 138 used nonhormonal contraception. No
differences in breastfeeding rates were seen at 2 and 6 weeks, but women
receiving any hormonal contraceptive were breastfeeding at a lower rate
(72.1% vs 77.6%) at 4 weeks postpartum. The authors concluded that
progestin-only contraception initiated in the early postpartum period had
no adverse effects on breastfeeding rates.[31]

I don't have my Hale book here in my office (we use it lots on the floor)
-- Dr. Hale's website is also a good place to look at things. There is a
search feature on his site, which I used to look up Depo. He discusses this
here
http://www.infantrisk.com/content/safe-use-birth-control-while-breastfeeding
and it looks like he has some questions.

The problem is - if we are seeing the problem WE should be doing a study.
(In our spare time, right?) But if you have ANY students in your facility
who need a project - this would be a place to direct them.

I can't very well say "I hope this is helpful" because it won't be - but it
may help us all to see where the confidence of midwives and doctors is
coming from when they prescribe Depo early on.

Dawn Kersula in Vermont

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