Last update: Jan. 31, 2016
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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Birth control pill that contains the combination of an estrogen (Ethinyl estradiol) and a progestin (Etonogestrel) for use as a vaginal ring (for 3 weeks) or as a subcutaneous implant (for 3 months).
Ethinylestradiol is a synthetic estrogen with similar action than estradiol. Used in combination with progestogens for contraception.
Ethinylestradiol is excreted into the breast milk in no or small amount.
There is evidence (albeit inconsistent) that estrogen-containing pills may decrease milk production, especially during the first few weeks postpartum with a daily dose above 30 micrograms of ethinyl estradiol.
It may reduce the protein content of the milk.
No problems have been observed in infants whose mothers were treated, except some cases of transient gynecomastia in infants whose mothers were receiving a higher dose than usual.
Etonogestrel is the active metabolite of Desogestrel. It is used as a contraceptive, alone or in combination with Ethinyl estradiol. It is excreted into milk in small quantities. No problems have been observed in infants whose mothers were using it.
No differences were observed in the frequency of breastfeeding or the amount of milk produced or weight gain of infants nursed by mothers using mixed implants containing Ethinyl estradiol and Etonogestrel over other contraceptive methods (intrauterine devices, isolated progestogens). However, it would be advisable to avoid them until breastfeeding is well established (4-6 weeks).
During lactation, progestin-only contraceptive pills are preferred to Estrogen containing ones, otherwise, the lowest estrogen dose should be used.
During the first 6 postpartum weeks, non-hormonal methods are in the first line of choice.
Hormone containing contraceptives do not affect the composition of milk, minerals (Mg, Fe, Cu, Ca, P) fat, lactose and calories but only a few the proteins.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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