ABM updates protocol on contraception and breastfeeding
The long awaited protocol revision on Contraception and Breastfeeding by Drs. Pamela Berens and Miriam Labbok is out. This revision on a crucial topic has useful information for those counseling mothers regarding contraceptive choices. One to two times a month I encounter a mother in my consultative breastfeeding practice who has been placed on some type of hormonal contraceptive and now she is struggling to make milk. In this revision there are a few new tables and a section describing in depth the individual contraceptives choices, summarizing the evidence and the associated studies. The bottom line remains: “Until more extensive well designed research exists , it would be prudent to consider hormonal contraceptive methods as potentially having some risk of decreasing the mother’s milk supply.” Options such as Lactational Amenorrhea Methods (LAM) and Natural Family Planning (NFP) and emergency contraception are discussed and associated management issues are also addressed. As with all ABM protocols, this protocol benefitted from formal feedback from our expert board members and reviewers, ensuring that it not only has practical information but also has an international approach. Share it with your colleagues and leave a copy at a work station!
Maya Bunik, MD , MSPH, is Co-Chair of the ABM Protocol Committee and a Fellow of the Academy of Breastfeeding Medicine. She is an Associate Professor of Pediatrics at University of Colorado, Children’s Hospital Colorado. She sees patients in both primary care and breastfeeding consultation and has published a book Breastfeeding Telephone Triage and Advice.
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