From Hale's MMM 12th edition, pages 551-552:

"The use of Depo-Provera in breastfeeding women is common but will probably
always be somewhat controversial. Depo-Provera has been documented to
significantly elevate prolactin levels in breastfeeding mothers and increase
milk production in some mothers.

It is well known that estrogens suppress milk production. With progestins,
it has been suggested that some women may experience a decline in milk
production or arrested early production, following an injection of DMPA
(Depo-Provera), particularly when the progestin is used early postpartum
(12-48 hours). At present there are no published data to support this, nor
is the relative incidence of this untoward effect known. Therefore, in some
instances, it might be advisable to recommend treatment with oral
progestin-only contraceptives postpartum rather than DMPA (Depo-Provera), so
that women who experience reduced milk supply could easily withdraw from the
medication without significant loss of breast milk supply. Progestins should
be avoided early postnatally, and perhaps longer.

Lactation Risk Category: L1, L4 if used first 3 days postpartum"   

Fleur Bickford BSc., RN, LLLL
Ontario, Canada

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