Patricia wrote:
<<the concern with depo is that if it is given in the immediate pp
period the
necessary drop in progesterone for lactogenesis will not occur and mom
will
not make milk/ at this point there is nothing that can be done to
reverse the
process.>>

Patrica,
I don't understand how this could be true because the way that Depo
Provera works is to release a high level of progestin into the body.
This unnaturally high level stops the natural production of both
progesterone and estrogen. So, I don't see how it can prevent the
natural decrease in progesterone when, in fact, it is causing an
unnatural one. If anyone has better information I would be interested.
However, it is generally felt that before using hormonal methods of
birth control that breastfeeding should be well established first before
use to ensure that they are not interfering with milk production.  I
think more studies in this area are needed but I think it makes sense to
delay the use of Depo or Norplant until at least the six week postpartum
visit.
There are newer methods of birth control and I don't know what the
recommendations are for those...anyone?
Karen Ianacone, RN, MA, CCE, CLC
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