Does anyone look at the purpose of contraceptives?  They work either to prevent implantation of a fertilized ovum OR to create a hormone profile that fools the ovaries into thinking that the body is already pregnant.  We know that the drop in progesterone is what triggers lactogensis II.  We know that progesterone builds breast tissue (I can testify that after briefly taking HRT with progesterone in it and experiencing breast fullness and tenderness).  We know that with pregnancy, milk volume tends to decrease under the influence of pregnancy hormones.  ERGO - does it not make sense that hormone contraceptives would decrease milk supply?  If a mother was already at risk for low volumes due to genetic situation, a prematurely ended pregnancy, poor milk removal with an inefficient baby or artificial baby, etc., why would we further compromise supply hormonally?  If a mother has an excess milk supply - she should not be affected as much.   When I read research showing that this or that is OK or not OK, I want to look at the population, the variables included, the documentation, etc.  Otherwise, it's just anecdotal information and no more valid (and probably less than) my grandmother's recommendations for treating a cold! 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of [log in to unmask]
Sent: Thursday, May 21, 2009 7:51 PM
Subject: New Contraceptive Guidelines

Have any of you read this proposal.  Dr. Hatcher of the CDC is no going to approve of early contraceptive usage.
We are talking about depo, micronor, etc at delivery!  There rationale: 
  women can ovulate in the first month postpartum and don't breastfeed exclusively!

Dr. Sperloff did some article in contraception 2008 that convinced Dr. 
Hatcher that this was OK!

I am incensed.  There are no studies that I am aware of that looks at preterm outcomes.  There is no study that I am aware of that specifically asks wether or not the mother noticed a significant drop within a couple weeks of initiation.  
There are no acceptable randomized controlled double blinded trials to support that there is no affect on lactation.

I want the USBC to write a letter.  I want the ABM to write and I am 
definitely going to write. Here is the article:    
http://www.obgynnews.com/article/PIIS0029743709701375/fulltext

I have taken care of mothers (as many of you have) that have lost their supply with 2 doses of micronor or how about the mother who's infant started losing weight 2 weeks after the initiation or how about the mother of a 27 weeker who was given (without any explanation or discussion with her MD) a shot of depo.  She initiated pumping got in a normal supply and mysteriously lost  her milk despite continued pumping and a trial of Reglan!


Christine M. Betzold NP CLC MSN

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