Effects of hormonal contraceptives on breast milk composition and infant growth
Anonymous
Studies in Family Planning 19(6): 361-369
1988
ISSN/ISBN: 0039-3665 DOI: 10.2307/1966630Document Number: 448620
Breast milk volume and composition and infant growth were measured at 3- and 4-week intervals, up to 6 months, in a multicentre randomized double-blind trial comparing a low-dose combined oral contraceptive (OC) with a progestogen-only OC. A non-random group using non-hormonal methods was also studied in the 3 centres: Szeged, Hungary; Bangkok, Thailand; and Khon Kaen, Thailand. A 4th group, users of depot-medroxyprogesterone acetate (DMPA) was included in the 3 Thai centres. Altogether, 341 women were recruited into the study. Combined OCs significantly decreased milk output and total energy content as well as widespread changes in milk constituents. In the DMPA group, no changes were seen in milk volume, and small changes occurred in milk composition, which varied between centres. No differences were found between the progestogen-only pill and DMPA. No hormonal contraceptive caused differences in infant weight or fat fold, or in the rate of discontinuation for failure to gain weight. This study reinforces the need to avoid combined OCs during the first few weeks or months of lactation. Both norgestrel and DMPA seem to be safe for use in developing and developed countries, at least when the nutritional state of the mother and infant are adequate, but further research is needed on the safety of these contraceptives in populations with malnutrition.