Experts on contraceptive technology concur that progestin-only methods
can be used safely during lactation. However, very Jew studies exist
of the effects on lactation of the introduction of progestin-only meth
ods prior to the sixth postpartum week. Since progesterone withdrawal
is the likely stimulus that initiates lactogenesis, it appears necessa
ry for natural progesterone levels to decline to baseline before a pro
gestin-only contraceptive is initiated. Therefore, the use of such con
traceptive methods should be delayed for at least 3 days after the bir
th. Non-hormonal methods remain the first choice category of contracep
tive methods for breastfeeding women, since there is no possibility th
at they will interfere with lactation. Progestin-only methods comprise
a viable and often desirable next choice category, although the timin
g of their commencement must be determined with care in order to suppo
rt lactation. (C) 1997 Elsevier Science Inc. All rights reserved.