Impact of early postpartum administration of progestin-only hormonal contraceptives compared with nonhormonal contraceptives on short-term breast-feeding patterns

Objective: The purpose of this study was to identify the impact on breast-feeding patterns of early postpartum initiation of progestin-only birth control methods compared with nonhormonal methods. Study Design: A prospective, nonrandomized trial was performed comparing progestin-only contraceptive methods administered before hospital discharge with nonhormonal methods on breast-feeding continuation rates, exclusive breast-feeding, and supplementation at 2, 4, and 6 weeks after delivery. Results: Three hundred nineteen women provided complete data until hospital discharge. The hormonal group had higher risk factors for not breast-feeding, but there was no difference among any of the subgroups in breast-feeding continuation rates except at week 4. Supplementation or perception of insufficient milk production did not differ between groups. By week 6, 23.5% of women discontinued breast-feeding, and 64.5% of those breast-feeding were supplementing. Conclusion: This study demonstrates that there is no detectable adverse impact on breast-feeding attributable to progestin-only contraceptive methods initiated within the first 3 days post partum. (Am J Obstet Gynecol 2002;186:1250-8.)