Maintenance of lactation by means of continuous low-dose progestogen given post-partum as a contraceptive

Zañartu, J; Aguilera, E; Muñoz-Pinto, Gloria

doi:10.1016/s0010-7824(76)80041-8

Cited by 19 publications

(5 citation statements)

References 4 publications

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“…Conservatively, articles with abstracts containing unclear presentation of either the exact timing of medroxyprogesterone administration or specific details regarding the measurements of breastfeeding outcomes were included in the formal evaluation; eight articles qualified. [22][23][24][25][26][27][28][29] For completeness, the literature represented in the U.S. MEC report was cross-checked with the PubMed literature search, and this produced an additional three articles. [30][31][32] Lastly, after we read those 11 documents and hand-searched references, an additional nine articles were identified that potentially met the study's inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Early Postpartum Medroxyprogesterone Receipt and Early Breastfeeding Cessation: Evaluating the Methodological Rigor of the Evidence

Brownell

Fernandez

Howard

et al. 2012

Breastfeeding Medicine

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Background: Breastfeeding has numerous maternal and infant benefits. Progesterone contraception after birth is frequently recommended, but because a decrease in progesterone is required to initiate lactation, early postpartum progesterone contraception use could inhibit lactation. The purpose of this article is to critically evaluate the scientific basis for conflicting clinical recommendations related to postpartum medroxyprogesterone use among breastfeeding women. Methods: Relevant peer-reviewed literature was identified through a comprehensive search of PubMed through December 2010. The search was restricted to clinical trials, randomized clinical trials, or comparative studies written in English and conducted among humans. The studies included in this review addressed the effect of medroxyprogesterone administration at < 6 weeks postpartum on breastfeeding exclusivity and/or duration and measured breastfeeding outcomes at ‡ 6 weeks postpartum. Results: Of the 20 articles identified, only three studies satisfied the inclusion criteria. However, all three studies were of low-quality methodological rigor, and none accounted for potential confounders. Conclusion: Current evidence is methodologically weak and provides an inadequate basis for inference about a possible causal relationship between early postpartum medroxyprogesterone use and poor breastfeeding outcomes. However, given the presence of a strong biological model describing the potential deleterious effect of postpartum medroxyprogesterone use on lactation, further research that improves on current literature is warranted. Meanwhile, we recommend that potential breastfeeding risks associated with early (<6 weeks) postpartum medroxyprogesterone use be disclosed to allow for a fully informed consent and decision-making process.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Early Postpartum Medroxyprogesterone Receipt and Early Breastfeeding Cessation: Evaluating the Methodological Rigor of the Evidence

Brownell

Fernandez

Howard

et al. 2012

Breastfeeding Medicine

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“…However, the same group of investigators later reported that this particular microdose progestogenonly pill had no adverse effect on lactation [4]. Another study has shown that taking chlormadinone diacetate 0.6 mg resulted in a longer duration of breast-feeding [42]. Of the three microdose progestogen-only pills which derive from 19-nortestosterone, two preparations (lynestrenol 0.50 mg and norgestrel 0.05 mg) did not show any adverse effects on lactation [ 13,211; the other one (norethisterone 0.35 mg) was found to decrease milk quantity, but this study involved only seven subjects [41] .…”

Section: Methodological Aspectsmentioning

confidence: 99%

The effects of contraceptive methods on the quality and quantity of breast milk

Koetsawang

1987

Intl J Gynecology & Obste

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“…In a nonrandomized trial, POP users initiated breastfeeding earlier than placebo users [43]. Other studies found no difference in breastfeeding duration for POP users compared with historical controls [37] or compared with nonhormonal users [39,44], while two found longer breastfeeding duration among POP users compared with historical controls [45] or IUD users [46]. Finally, two studies found less supplementation among POP users than nonhormonal users [47,48].…”

Section: Randomized Clinical Trialsmentioning

confidence: 99%

Progestogen-only contraceptive use among breastfeeding women: a systematic review

2010

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Background: Postpartum women need effective contraception. Concerns have been raised that use of progestogen-only contraceptives (POCs) may affect breastfeeding performance and infant health outcomes. Objectives: We investigated the clinical outcomes of breastfeeding duration, initiation of supplemental feeding and weaning, as well as infant outcomes including infant growth, health and development among breastfeeding women using POCs compared with breastfeeding women not using POCs. Search strategy: We searched the PubMed database for all articles published from database inception through December 2014. Selection criteria: We included primary research studies of breastfeeding women of any age or parity who received POCs, including progestogen-only pills, injectables, implants or hormonal intrauterine devices (IUDs). The main outcomes were breastfeeding performance (as measured by initiation, continuation, frequency and exclusivity of breastfeeding) and infant health (as measured by growth, development or adverse health effects). Results: Forty-nine articles reporting on 47 different studies were identified that investigated the use of POCs in breastfeeding women and reported clinically relevant outcomes of infant growth, health or breastfeeding performance. Studies ranged from poor to fair methodological quality and generally failed to show negative effects of the use of POCs on breastfeeding outcomes or on infant growth or development. One randomized controlled trial (RCT) raises concerns that immediate insertion of the levonorgestrel IUD postpartum may be associated with poorer breastfeeding performance when compared with delayed insertion, although two other RCTs evaluating early etonogestrel implants compared with delayed initiation of implants or depot medroxyprogesterone acetate failed to find such an association. Conclusion: The preponderance of evidence fails to demonstrate adverse breastfeeding outcomes or negative health outcomes in infants such as restricted growth, health problems or impaired development. Evidence newly added to this review was largely consistent with previous evidence.

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Maintenance of lactation by means of continuous low-dose progestogen given post-partum as a contraceptive

Cited by 19 publications

References 4 publications

A Systematic Review of Early Postpartum Medroxyprogesterone Receipt and Early Breastfeeding Cessation: Evaluating the Methodological Rigor of the Evidence

A Systematic Review of Early Postpartum Medroxyprogesterone Receipt and Early Breastfeeding Cessation: Evaluating the Methodological Rigor of the Evidence

The effects of contraceptive methods on the quality and quantity of breast milk

Progestogen-only contraceptive use among breastfeeding women: a systematic review

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