A client of mine suffers from terrible acne.  The only treatment that she
has found to be effective is Diane (cyproterone and ethinyl estradiol) which
she was taking for 10 years before falling pregnant.  She is now 36 weeks
pregnant and has set her heart on breastfeeding.  During her pregnancy her
skin has been worse than ever.  She has broken out on her face, back, chest,
breasts and even has "boils" on her stomach which are spreading.  These
pimples are inflamed and painful.

The composition of Diane is cyproterone acetate 2mg and ethinlyestradiol
0.0035mg.  According to Hale 2002, estrogen-estradiol is AAP approved for
breastfeeding mothers.  Hale states: "If oral contraceptives are used during
lactation, the transfer of estradiol to human milk will be low and will not
exceed the transfer during physiologic conditions when the mother has
resumed ovulation."

The real concern of course is re milk production.  Hale suggests waiting
until lactation is firmly established (6-8 weeks).  Does anyone have
experience with breastfeeding mothers taking Diane?  Many thanks.

Jean Ridler  RN  RM  IBCLC
Cape Town,  South Africa
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