It's been a bad week.  All the messages about mothers' primary focus and
mothers who like to use gadgets and mothers who quit breastfeeding so easily
have been very timely.  Thank you all!

The most recent mini-disaster is the diabetic mother of a 10 day old baby,
delivered by C/Sec who started breastmilk-by-bottle as soon as she got home
from the hospital and then, predictably, phoned in tears the day before
yesterday to announce that she was exhausted and was thinking of abandoning
the whole thing.

The paediatrician, bless him, has made it clear that he would "prefer" the
baby to go on receiving breastmilk if at all possible, outlining some of the
possible consequences of a switch to formula, and the cost in $$$, and the
parents are having a re-think.  (Yeah!)

However, mom has also consulted her OB about how stressed she feels and the
OB has prescribed Cyclogest 400 vaginal pessaries to treat possible
postpartum depression.  My friendly pharmacist advises that these contain
400 mg natural progesterone, that they are indicated for pre-menstrual
syndrome, and that mental depression can be a side effect.  The pharmacist,
the paediatrician and I are all a little non-plussed.  "Progesterone" is not
listed in either Hale (98/99) nor in Briggs, Freeman & Yaffe (4th ed) except
under oral contraceptives where the information is mixed in with that on
estrogen.

Would anyone have any information on the likely effects of natural
progesterone on the quantity/quality of breastmilk, especially so early in
the course of lactation? And any consequences for the infant?  Many thanks
if you can help - one more set-back and this mom will quit altogether!

Pamela Morrison IBCLC, Zimbabwe