Effect of steroid contraceptives on lactation

Although steroid contraceptives have been in widespread use for many years, there still appears to be considerable uncertainty in the minds of many clinicians and family planning programme decision-makers regarding their prescription to nursing mothers. This uncertainty appears to be reflected in replies to a questionnaire sent by the Human Reproduction unit of WHO to scientists in its network of Collaborating Centres for Clinical Research in Human Reproduction regarding the current status of the use of steroid contraceptives by nursing mothers in different national settings. Although the information was, of necessity, in some cases imprecise, the following impressions were gained about eighteen countries: (Australia, Canada, Chile, Egypt, Holland, Hungary, India, Mexico, Nigeria, Philippines, Singapore, Sri Lanka, Sweden, Thailand, Turkey, United Kingdom, USA, Zambia).

Section: Influence Of Steroid Contraceptives On Lactational Performancementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Studies on lactation and contraception in WHO's research programme

Bernard

1977

“…Data on the effects of contraceptive pills on the mother, on the initiation of lactation, on the maintenance of established milk production and effects on the infant are particularly detailed by Chopra (1972), Vorherr (1973) and Buchanan (1975). Because the conditions of the tests vary considerably there are many contradictions in the literature.…”

Section: Effects Of Oral Contraceptive Steroids On Lactationmentioning

confidence: 99%

Side effects of steroid contraception

Gellén

1977

SummarySide effects of steroid contraception during lactation are discussed and followed by a review of the relevant literature. It appears that oestrogen has an inhibiting effect on lactation performance, but progestogen alone does not. Most of the undesirable systemic side effects of oral contraceptives on the mother are connected with the relative excess or deficiency of the oestrogen and/or the progestogen component. It is likely that a low oestrogen content preparation causes no dangerous side effects. There are few data about the appearance of contraceptive steroids in breast milk. Probably only a small proportion of the steroids are excreted into the milk. Any adverse effects, on the infant, such as slow weight gain, neonatal breast hypertrophy and breast milk jaundice, are dependent on the two preceding factors. It is doubtful whether the small amount of contraceptive steroids contained in modern pills exert any influence on the fetus. Although further examinations are necessary, the low dosage of progestogen and oestrogen combined contraceptives given at fully established lactation under close control seems to be advantageous to both mothers and their infants.

“…Although immediate side effects of steroidal contraceptives are important, it is the unforeseen long-term consequences that are of real concern (Catz & Giacoia, 1972). We need a contraceptive schedule which, while protecting the mother, is not detrimental to the infant (Chopra, 1972).…”

Section: Introductionmentioning

confidence: 99%

Appearance of contraceptive steroids in human milk: effects on the child

Harfouche

1977

The realization that steroidal contraceptives administered immediately after delivery to lactating women may be excreted into milk, and adversely affect the neonate, is a cause for concern. Most investigations on hormonal contraceptives have dealt with the efficacy of ovulation suppression, and systemic side effects, but little is known about the appearance of steroids or their metabolites in milk. Apart from the immediate side effects on the neonate, unforeseen long-term consequences require special consideration. Until research provides us with more information, women should use breast-feeding and I U D S instead of steroidal contraceptives during the first trimester post-partum.