Not being able to wait for N. America to wake up, I looked around myself.
Lovenox (not Lovenex) is a low molecular weight heparin that is only
absorbed if given parenterally.  Thus, even if present in breastmilk, it has
no consequence for the consumer of such milk, as it can not be absorbed
through the gut.  It is also given to newborns who need anticoagulant
therapy, apparently, but that is beside the point.  A child being breastfed
by a mother who is on any kind of heparin will not have any effects of the
heparin unless they are being fed the breastmilk by injection.

Prometrium is progesterone.  The one website I looked at, drugs.com (!)
stated it was contraindicated in pregnancy.  In the Norwegian formulary,
which lists indications for the use of progesterone, pregnancy is nowhere to
be found.  It does mention that for women needing assisted conception, it
may be used to promote the luteal phase of the menstrual cycle to ACHIEVE
conception, but is unnecessary once the pregnancy is underway.  Progesterone
also increases the risk of thrombotic complications in users, regardless of
pregnancy status, so the Lovenox would seem to be indicated as prophylaxis
against this side effect.

From my training (midwifery) it makes no sense to give progesterone to
someone who conceived spontaneously while breastfeeding - like, where is the
fertility problem?  Unless this mother has some other risk factor for
thrombotic complications in pregnancy, she may not need the Lovenox either,
but even if she does, she can certainly keep right on breastfeeding.  

Like so many other cases recounted on Lactnet, I'd say this woman would
benefit from a second opinion at the very least, but that is based on the
extremely sketchy details given in the post about her.  It also sounds like
her clinician might find Tom Hale's book a useful addition to her/his
library.

Rachel Myr
Kristiansand, Norway

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