Hi Linda, 2 of the MDs here have changed their practice too. They give the Depo before dischg. I argued the point with them. However looking for support statements I found there aren't any studies that prove that giving it TOO EARLY cuts milk production. However, they know that progesterone needs to drop before milk production starts. So the questions are when is too early and does introducing progesterone too early inhibit that drop? I tried to encourage the MDs to at least wait until the first well baby check (about 3-7 days post discharge, or 5-11 days post delivery). The reason the MDs want to give the Depo early is because at 6 weeks the women may already be pregnant-pretty unlikely but then if there is a possibility they need to do a pregnancy test BEFORE administering the Depo. Depo is listed as pregnancy category X: Giving it during a pregnancy shows "that it can cause fetal abnormalities or there is evidence of fetal risk based on human experience.." As far as doing this only with the Medicaid population that is discrimination. They should be doing this with private or HMO insurances carriers also as the cost of doing a pregnancy test effects insurance rates as well as taxes. For those of you that say these moms are bf and so they won't get pregnant correct if they are still bf but unfortunately many have already stopped by 6 weeks. And many of those have received cases of formula in the mail-from 3 different companies. The easily persuaded mother has been enticed into the formula trap. Mary Ann Krainz RN, IBCLC in central WI ----Original Message----- From: Janet Simpson, IBCLC [mailto:[log in to unmask]] Sent: Monday, August 19, 2002 5:41 PM To: [log in to unmask] Subject: Re: Depo shots... Hi Linda, I am sorry I don't have any specific references to give you for these Drs other than Tom Hale Medications and Mother's Milk 10th Ed. However, have they thought about reading the package insert that says wait 6 weeks?? How about asking the OB/GYN dept to give the LC dept proof that it is safe to give at discharge. And - hmmm - any particular reason they are giving it to ALL the medicaid patients?? grrr... In Hale 2002 10th Ed. (pg 444) there is a lot of information. Hale states that, re: Depo, waiting until 6 wks pp is preferrable. It also states: "With progestins, it has been suggested that some women may experience a decline in milk production, or arrested early production, following injection of DMPA <Depo Medroxyprogestrone>, particularly when the progestin is used in the early postpartum (12-48 hrs). ...snip... No progestin should be used before at least 3 days postpartum and perhaps longer." Hope this helps... Warmly, Jaye *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html