I got a call from a mom last week  with a 7 month old.  She said her supply
had dimished and then told me she had begun birth control pills 3 months ago.
 I asked her what kind she was taking, explaining that pills containing
estrogen usually caused a decline in supply.  I went on to explain that while
we used to think the progestin only pills were ok, we were seeing an
occasional mothers who had a dip in their supply with even this one.  I
suggested that she find out which pill she was taking.  She called back a
couple of days ago and said her doctor told her it was a low dose combination
and that all the obs in his area freely prescribe it for their bf mothers
with no problems. (I wonder if some of these docs would draw conclusions that
it was the pill if some of their patients weaned early due to low milk
supply!) I feed really bad for this mom because she felt she had done her
homework and was doing the right thing  since her doctor assured her that it
would not cause a problem.T. Hale's  book suggests that the low-dose pill and
the progestin only pill are appropriate.  I mistakenly thought that if it
were a combination pill, it would automatically be a problem; I wasn't aware
that a low dose combination could be a possibility for a nursing  mom.
    Anyone out there think it would help her milk supply at all to switch to
the progestin only pill ?  She has three little ones (two were surprises from
contraception failures); another baby at this time would be a real problem
for her.  My thought was to go off all orals until her supply reestablishes
and then try the progestin only pill.  I'm afraid that if she goes directly
to another type she'll not be able to recoup. She has only 4 pills left and
needs to decide right away if she is going to make a change. Anyone got any
bright ideas for this mom?
Judy Eastburn, BS,IBCLC
private practice, Dallas, Tx.