Last update: July 16, 2017
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.
Combined contraceptive with Estrogen (Estradiol hemihydrate) plus Progestin (Nomegestrol acetate) for daily oral administration.
ESTRADIOL is excreted in breast milk in clinically non-significant amount without problems having been observed in infants whose mothers have received it. Plasma levels of drug in those infants were undetectable or very low. There was higher excretion into milk when administered vaginally.
There is some evidence (though not definite) that estrogens may decrease milk production, especially if they are used during the first few days postpartum.
Estrogens may decrease the protein content of breastmilk.
No problems have been observed in infants whose mothers were on estrogens, except for rare cases of transient gynecomastia in infants whose mothers received higher doses than usual.
Exposure to estrogen in childhood or adolescence does not influence subsequent milk production.
NOMEGESTROL is a third generation synthetic progestogen which is structurally related to progesterone.
It has been used as a part of only-one-component contraceptives which have one year lasting effect in subdermal implants. Also orally used alone or associated to estrogen (see info on Estradiol + Nomegestrol).
In a study comparing effects on breastfeeding women (120 with a Nomegestrol implant and 120 with an intrauterine device (IUD), there were no significant differences on duration of breastfeeding nor somatic follow-up criteria nor health issues in infants (Abdel -Aleem 1996).
Differences on frequency of breastfeeding, amount of milk production and the weight gain of breastfed infants with similar combined contraceptives compared to other contraceptive methods (intrauterine devices, isolated progestogens) have not been observed. However, it would advisable to avoid them until breastfeeding is well established (4 to 6 weeks).
During lactation, progestogen-only contraceptives are preferred over those combined with estrogen. Otherwise, those with lower doses of estrogen should be used.
Within the first 6 weeks postpartum, non-hormonal contraceptive methods should be the first option.
Hormonal contraceptives do not change the milk composition whether minerals (Mg, Fe, Cu, Ca, P), fats, lactose or calories but a little protein.
We do not have alternatives for Estradiol + Nomegestrol.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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