I have had great success just talking to moms during my lactation rounds about contraception. One of the topics I cover, prior to hospital discharge, is "diet, meds, illness." So we talk briefly about mom being able to eat whatever she wants, that it's ok to bf thru most illnesses, that moms usually don't have to stop bf to treat most common illnesses, to tell their doctors they are bf and would like to be on a med that is compatible, etc. I ask "what method of birth control are you going to be using?'  I let them know that "from a bf point of view, I don't recommend the depo shot. I've seen it dry up the milk in some mothers, and once it's inside of you, it's there for several months, and there's no way of getting it out." I go on with giving some brief info if they are favoring hormonal methods, waiting for supply to establish (6 wiks or so) and reporting if supply goes down when the pill is started. Also to prevent if relations resume before the 6wks. I also give some info on meds that can decrease their supply like psuedofed and other "cold medicines." I tell them that if they can to avoid that category of meds. The mothers are very receptive to this information and generally opt for another method of contraception. Sometimes pregnancy prevention and logistics of using the shot vs the pills are more important than a risk of a possible lower supply, and mother will want the shot, it is her choice.

Laurie Wheeler, IBCLC, MN, RN
Mississippi, s.e. USA

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