We've had 2 moms of NICU babies in the last 4 months get Depo-Provera before being discharged from the hospital (day 2-3 after delivery). These women state they were not told that this could affect their milk supply. These women were both very upset and crying when told it was probably due to Depo. When the L.C.'s do a history on these moms, birth control plans are discussed. 

One mom didn't speak English so the L.C.'s probably didn't do as complete of an interview on her. Her OB is fluent in her language but I don't know the specifics of her situation except what the mom said. ONe of our Neonatologists is working on this problem of ordering Depo from the MD end. Everyone at our facility (just about) really encourages moms of NICU babies to pump even if they don't want to breastfeed so it seems as if all our care should support lactation.

There seems to be a problem with people understanding that Depo being compatible with breastfeeding does not mean it can't cause problems like low milk supply. The nurses who get the order to give Depo are uncomfortable with the situation. They don't mind giving the mom the right information but they feel they are supposed to get her to refuse it. I don't know if they have to call the OB and tell him if a mom refuses the Depo or not. They like everything black and white and just want to give the meds that are ordered. 

We were first thinking that a consent form for Depo, giving all the facts would be good. Then realized that it would be easier and more successful if there was a handout that discusses all forms of birth control. I'm sure there's one out there.

Does anyone out there have such a handout they would share or know where we could get one? Seems like Planned Parenthood (if they are still around) may have something.

Kris Wiedman RN IBCLC
East Tennessee


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