PREMATURE INTRODUCTION OF PROGESTIN-ONLY CONTRACEPTIVE METHODS DURINGLACTATION

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.