Cheryl,

Having just researched the original articles as well as spoken to the folks
of Pharmacia who make depo, I can give you a detailed biblio. that i have at
the hospital. You may want to contact acog as i did via email. They will mail
you an article they put in the July 2000 issue of their OB/GYN journal. This
11 page paper included 3 1/2 pages devoted to the complicated issues around
birthcontrol and breastfeeding. They ackowledge that "some practicitioners
recommend waiting for various lengths of time due to 2 theoretical concerns".
(ie hormones to a newborn and potential impact on supply). In light of the
fact that there is no published research that says it definitely adversely
effects supply, I felt gratified that they expounded on the theoretical
concerns. In other words they gave it enough credibility to give their
collegues reason to pause. Also, their was one study done (in 1982) where the
depo was given at 4 different times, the author also indicated that, a 5th
subgroup received depo at 48 hours, however he did not publish data on this
group, nor did he say how many. He only made an overall statement that all
groups of women had enough milk for their babies. (These women did not put
their babies to breast during the 3 month study - they pumped.)  I wrote down
his address, with the thought than in a free moment i would draft a letter.
(Mind you my free moments come about once a month.) Pharmacia has strict
guidelines by the fda that require that they reco giving depo at 3 wks for a
partially b/f mom and 6 wks for an exclusively b/f mom, and while their
literature doesn't say it, he repeated to me several times it is up to a
physician to weigh risk:benefit. Acog says up the the dr. and the patient. A
very important and... There was also a very good article in an ob journal in
the past few months that specifically addressed medico-legal implications
around birth control issues.  Informed consent was highly emphasized. It also
reco that they specifically discuss, with progestin only  that long delays in
return onset of ovulation may occur and that break through bleeding is common.
Detailed bib to follow!
Chris

             ***********************************************
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