I apologize: I meant to ask if anyone requires informed consent be signed for the administration of depo-provera. 
Thank you, 
Laura

Date:    Sun, 13 Apr 2008 23:40:12 -0400
From:    Laura Block <[log in to unmask]>
Subject: Depo-Medrol and informed consent?

Hi! I am a pharmacist just starting my IBCLC hours at my hospital, and I =
have already stepped in it!
We have an OB who sometimes likes to give Depo-Medrol to post-partum =
Moms before they leave the hospital. When I see this, I check to see if =
the are breastfeeding, and usually they are not. But last week, we had =
someone who was. I called the doctor and he said that this would not be =
a problem. But I had heard multiple LCs say that they had seen it harm =
milk supply, so I looked in my brand new book: Textbook of Human =
Lactation by Hale and Hartmann. (Loving this book, by the way)

It lists Progestins as one of the drugs that may reduce milk production. =
=20
It goes on to say on page 482:
Even low-dose progestins may suppress milk production in some mothers if =
used too early postpartum. The most sensitive time for suppression is =
early postpartum before the mother=92s milk supply is firmly =
established. Waiting as long as possible (weeks to months) prior to use =
is recommended. All mothers should be warned that in some cases a =
reduction in their milk supply may result, and they should be observant =
for such changes.

 I am thinking the best way to handle this may be to create an informed =
consent form for the administration of Depo-Provera in nursing moms. =
Perhaps we should stipulate that either they are not nursing, or they =
understand that use of this medication in the first (six?) weeks after =
birth MAY adversely impact their ability to make milk.=20

What do y'all think? And does anyone have an informed consent for this =
in their facility? If so, can you share?=20

Thank you so very much,=20
Laura Block, PharmD, CLC

  

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