Breastfeeding and Medication Question??

[annasmom]

Does anyone know whether it is o.k. to take progesterone and ortho-novum while breastfeeding?? I told my RE that I was still breastfeeding (although only at night), but I am not sure whether he "got it." I have a call into the office to double check, but I figured that I would check with you ladies as well. Someone is bound to have had some experience with these medications. TIA!!

Eileen

[SashaBear]

Oh gosh no! I can't believe a dr. would even prescribe you a combination pill while breastfeeding. Progesterone is guaranteed to destroy your milk supply! It is a major no-no! I'm not sure about ENing (I'm guessing you are ENing since you only nurse at night but you might be working too) but I know that it will when your supply isn't established. Drs should prescribe you a mini-pill which only contains estrogen (I think that is the right hormone). But even the mini-pill has significantly affected some women's supplies.

Find a new BC!

[annasmom]

Actually that is not correct, the minipill is progesterone not estrogen. I was on the minipill. You are right, estrogen can effect millk supply when someone is starting bfing. But it does not get into your milk supply in any significant way so as to effect the baby.

ETA: I want to clarify that I do not know what else is in the Minipill, but I do know that it has progesterone not estrogen.

[COElizabeth]

The mini-pill has only progestin (essentially the same as progesterone), not estrogen. It's estrogen that can definitely cause drying of milk supplies. But you're right that some women's supplies are also affected by progestin-only contraceptives.

Elizabeth, Mom to James, 9-20-02
and Charlotte, 11-04-04

[MaiseyDog]

My concern with this is, why are you taking both progestin and ortho-novum? Progestin is generally considered safe in lactation (that's the only think in the mini-pill). Ortho-novum is a combination brith control pill containing both estrogen and progestin, and estrogen will almost always adversely effect milk production to some extent (some women are able to continue breast feeding, but I will say they seem to be rare). The combination of progestin in addition to ortho-novum is a little strange, but not unheard of, but I wouldn't recommend it in a nursing mother without having some serious reasons. I would call your MD back and get clarification and make sure you two are both on the same page.

[annasmom]

Thanks for everybody's responses. This is pretty confusing isn't it?? I know why I am on both. I need the progesterone to bring on my menstrual cycle, and the ortho-novum for well, birth control. By the way, I am not taking progestin, but rather prometrium (I don't know if this makes a difference).

I am not concerned with supply issues because my ds lost interest in nursing during the daytime long ago. He only nurses during the night to get himself back to sleep. So you see, I really don't think I am producing much anymore anyway. My concern is whether there is anything in what I am taking that can harm my ds through the little breast milk that he is getting.

Anyway, I got the call from my RE (or rather, his colleague), he doesn't recommend that I continue nursing. On the other hand, I have done my own research, including a search of Dr. Hale's board, and from what I gather the only issues would be related to supply and there would be no danger that the estrogen or progesterone would seep into my milk at any level to cause concern.

If anyone knows/thinks differently, let me know. Thanks again!

[MaiseyDog]

In that case... there isn't any harm that should occur to your DC from these medications. I've attached some info from Micromedex (a drug database that I use I work- I'm a clinical pharmacist). Hope that helps.

"Estrogens are excreted into breast milk in small quantities (Nilsson et al, 1978) and have not been associated with adverse effects in the nursing infant. In the past, estrogens have been used to suppress postpartum lactation (Gilman et al, 1990; Nilsson et al, 1978). Estrogen use in the nursing mother may be associated with decreased milk production and decreased composition of nitrogen and protein content of the milk (Lonnerdal et al, 1980). These changes in milk production and composition are usually slight, however, they may be of nutritional importance when mothers are also malnourished. If breastfeeding is desired, the smallest possible estrogen dose should be used; the infant should be monitored for appropriate weight gain and the need for supplements."

"Progesterone is excreted in breast milk in detectable amounts. No adverse effects have been observed in breastfed infants of women using progesterone and it is considered compatible with breast feeding (Anon: Committee on Drugs & American Academy of Pediatrics, 1994)."

[o_mom]

I was taking Prometrium for the first trimester with DS2 while nursing DS1. OB said that was fine. No clue on the ortho-novum.