Depo is viewed as a way to protect women from an early unplanned pregnancy, especially since so many women do not keep their postpartum visit. This is especially the case at clinics serving low-income women. With current recommendations to space pregnancy at least two years apart, practitioners think this is an effective way to go.
I have had conversations with local OBs and federal OB planners about the use of Depo and its effect on breastfeeding. They admitted that they really had not thought about this, but then added "those women (poor women of color studied in the research project) don't breastfeed any way". Then it goes to "well, are they educated and supported prenatally to choose BF?..."well, no". and so it goes.
A common perception among the public and health care professional communities is that middle class educated women are the women that breastfeed. Look at all the journal articles and media reports about who breastfeeds? White middle class women. When asked by a reporter "what are the BF rates" WE often quote stats that supports that belief that poor women, women of color and teens don't breastfeed. We need a different response to that question, like "the demographics are changing, improving, especially among ....., thanks to efforts by WIC". We need to publicize to OBs that poor women and teens are bf candidates and that they are getting information before birth, so join the BF team!
You are right the mothers and practitioners need more and more education, about choosing a different form of birth control or information about exclusive breastfeeding. Mothers need appropriate and accessible services ...However, there a few well done studies that show a negative impact on milk supply. A review of Depo in Hale does not state that Depo is the cause of decreased milk supply, says that Depo after 6 weeks is "preferable".Our argument about Depo's negative impact on supply comes from observation...and often several weeks poor nursing, support, and use of formula. To me, this is a problem because we have little research that they (HCP) can read to support our claim. If there is good research out there, please share it so we can all read it and give it to HCP.
I am not in support of using Depo, just think that the if LCs are going to try and change the practice regarding the use of Depo, we need to be on solid ground, with facts and figures. Anne Andrianos
Of course it is not.
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