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Subject:
From:
Alicia Dermer <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 26 Nov 1995 15:49:03 -0500
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Shelley:  You raise a very good point about the potential effects of oral
contraceptives on babies, short-term and long-term.  The issue has
actually been addressed, I believe a good reference is American Academy
of Pediatrics, Committee on Drugs.  Breast-feeding and contraception.
Pediatrics, 1981;Vol.68,pp138-40.  I don't have it handy, but I remember
that it stated that pills with less than 50 mcg of estrogen have lower
levels of estrogens in the mother's milk than are naturally present even
in a mother not on OC's.  Ruth Lawrence addresses the issue in her text
Breastfeeding: A Guide for the Medical Profession, Mosby, 1994.  Another
reference cited in Riordan and Auerbach's Breastfeeding and Human
Lactation (I haven't read the reference), is Nilsson S, Mellbin T,
Hofvander Y, et al.  Long-term followup of children breast-fed by mothers
using oral contraceptives.  Contraception, 1986; Vol.34, pp443-57.  The
concensus seems to be that any previously reported adverse effects were
with the higher dose estrogen pills.  Although we always need to be wary
of dismissing long-term effects, and we shouldn't recommend OC's as first
line contraception to all breastfeeding mothers (especially the combined
pills, since they do affect milk supply and have been associated with
slow weight gain), we shouldn't rule them out for women for whom other
methods are not feasible.  As for product inserts, just like the PDR
(Physician's Desk Reference, for those outside the USA), they are
basically useless for breastfeeding information, since they are written
by the drug company with a main purpose of protecting the company from
lawsuits.  Hope this helps.  Alicia.  [log in to unmask]

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