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pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.


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Is it allowed to take Ethinylestradiol + Drospirenone during lactation?
Is it safe for a nursing mother and a child?

Birth control pill that contains the combination of an estrogen (Ethinyl estradiol) and a progestin (Drospirenone) for oral use. 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. Drospirenone is an analogue of spironolactone which has the effects of progesterone. It is excreted into breast milk in clinically non-significant amount. With other similar combined contraceptives no differences have been observed in the frequency of breastfeeding or the amount of milk produced or weight gain of breastfed infants compared to 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.

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Types of risk

VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...

LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...

HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...

VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...

Scientific literature

The level of risk for breastfeeding is confirmed in these scientific publications:
  1. http://www.ncbi.nlm.nih.gov/pubmed/25551519
  2. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/13-contraception-and-breastfeeding-protocol-english.pdf
  3. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/13-contraception-and-breastfeeding-protocol-spanish.pdf
  4. http://www.ncbi.nlm.nih.gov/pubmed/26447268
  5. http://www.ncbi.nlm.nih.gov/books/NBK321151/pdf/Bookshelf_NBK321151.pdf
  6. http://www.ncbi.nlm.nih.gov/pubmed/23784109
  7. http://www.cdc.gov/mmwr/pdf/rr/rr6205.pdf
  8. http://whqlibdoc.who.int/hq/2002/55732.pdf
  9. http://www.ncbi.nlm.nih.gov/pubmed/11763981
  10. http://www.ncbi.nlm.nih.gov/pubmed/11044538
  11. http://www.ncbi.nlm.nih.gov/pubmed/10438999
  12. http://www.ncbi.nlm.nih.gov/pubmed/9853546
  13. http://www.ncbi.nlm.nih.gov/pubmed/1381897
  14. http://www.ncbi.nlm.nih.gov/pubmed/1935859
  15. http://www.ncbi.nlm.nih.gov/pubmed/3816229
  16. http://www.ncbi.nlm.nih.gov/pubmed/4085247
  17. http://www.ncbi.nlm.nih.gov/pubmed/6241559
  18. http://www.ncbi.nlm.nih.gov/pubmed/6681210
  19. http://www.ncbi.nlm.nih.gov/pubmed/6404597
  20. http://www.ncbi.nlm.nih.gov/pubmed/6404596
  21. http://www.ncbi.nlm.nih.gov/pubmed/6404595
  22. http://www.ncbi.nlm.nih.gov/pubmed/7234211
  23. http://www.ncbi.nlm.nih.gov/pubmed/7195545
  24. http://www.ncbi.nlm.nih.gov/pubmed/7361700
  25. http://ajcn.nutrition.org/content/33/4/816.full.pdf
  26. http://www.ncbi.nlm.nih.gov/pubmed/630883
  27. http://www.ncbi.nlm.nih.gov/pubmed/4128673
  28. http://www.ncbi.nlm.nih.gov/pubmed/4467130
  29. http://www.ncbi.nlm.nih.gov/pubmed/6038336
  30. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1842938/pdf/brmedj02152-0036.pdf

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