>I feel that if a woman wants a pill (usually because that is what she is used >to), the progestin-only pill can be started at 6 weeks postpartum when the >milk supply is well established......V. Nichols-Johnson, MD This seems to be the standard compromise between the medical and lactation communities. In light of the autocrine theory, however, I would like to propose that perhaps it might be more appropriate to forestall hormonal birthcontrol of any type until about three months postpartum. If hormones are most important during the first approximately three months, wouldn't such a policy seem more consistent if you want to slant the odds in favor of a mother not losing her milk supply? I have had some women with decreased milk supplies once they started on the mini-pill, and this was after the 6 week mark. In proposing this, I would like to have lactnetters examine this from the standpoint of the ideal physiological approach, and not from the viewpoint of mothers who might be at risk of inappropriate and early conception again. Let's try to nail things down from the physiological perspective first, then discuss risks vs benefits for individual maternal situations. -Lisa Marasco, BA, IBCLC