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From:
Pamela Morrison <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 24 Jan 2003 21:21:42 +0200
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I'm wondering if anyone has had experience with reduced breastmilk supply
with the mini-pill Exluton (containing lynestrenol).  I haven't had one of
these for a while, but have just seen a mom who wants to persuade her 11
week old to take EBM in bottle so she can take a break from the baby.  Baby
is exclusively breastfed, looks great, refuses dummy (pacifier) and
refusing EBM in a bottle. Mom is very devoted to her but a little
depressed, and it turns out that she does little more than breastfeed the
baby, hourly by day and 3-hourly at night.  Baby was born at 38 weeks
weighing 2350g, discharged at 3 days at 2250g (loss of only 4.3% so things
obviously went well from the beginning).  At 42 days she weighed 3640g (an
average gain of 35.6g/day) when mom was prescribed, and started taking
Exluton (lynestrenol).  37 days later baby weighs 4260g, an average gain
from 42 days of only 16.7g/day - ie less than half!  I know this might
probably be interpreted as okay-ish, but I think the difference is fairly
dramatic, and combined with the very frequent feeding, no supplements, no
dummy, would indicate that something is going on.

Exluton is a progestin-only contraceptive pill which is subsidized by
USAID.  Consequently it's cheap to the consumer.  I believe it replaces
another mini-pill which we used to receive courtesy of USAID called
Ovrette, on which I collected 15 case histories of low supply, fussy
babies, low weight gain and breast refusal, many of which resolved within
about 5 days if the mother stopped taking the Ovrette (0.075mg
norgestrel).  This case now is the third one I've collected of similar
symptoms in a mom taking Exluton.  I don't hear these stories about other
un-subsidized, much more expensive mini-pills, such as Microval (30 mcg
levonorgestrel) or Micronor (0.35 mg norethisterone).

Is this a coincidence?   Does anyone else in the world use Exluton and what
do you find??

Pamela Morrison IBCLC, Zimbabwe
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