I seek your collective expert opinion on a drug called Utrogestan
(progesterone) manufactured by a French laboratory, Besins Ifcovesco.  My
client is a 47 year old woman who breastfed her now 5 year old daughter for
21 months.  She is planning to adopt a baby which is due at the end of June
and wishes to induce lactation.   For the last four months she has been
taking 100 mg Utrogestan (24 days on, break of 5 days) prescribed by her
gynaecologist to control severe and frequent menstrual bleeding.

As it is the *drop* in progesterone levels at delivery which triggers
Lactogenesis II (copious breastmilk production), my concern is that if she
continues to take this medication her efforts to induce lactation may be
hindered.  I have had so many anecdotal reports of the mini-pill apparently
having a negative effect on lactation even after a normal pregnancy and
delivery, and induced lactation can be expected to be far more difficult, so
it would be nice to make things as easy for this lady as possible.

Does anyone have any info/thoughts on this??  Or references I can share with
her doctor or gynae?  Gynae is currently away so she may consult her GP
about the possibilitiy of stopping the progesterone.  I see the possibility
of competing risks but I would like to provide the info so that she can make
the choices.
I have worked with an adoptive mom who continued to take estrogen
replacement therapy, and she was successful in partially breastfeeding her
baby, but I can see how progesterone might have a different impact.  What do
you think?

Thanks for any help.

Pamela Morrison IBCLC, Zimbabwe
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Thanks if you can help.

Regards

Pamela