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


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

Birth control pill that contains the combination of an estrogen (Mestranol) and a progestin (Noretindrone) for oral use. Mestranol is a synthetic estrogen that is metabolized to Ethinylestradiol with similar actions as estradiol. A latest update no published data on excretion in breast milk, found were found. However, it is known that its metabolite Ethinylestradiol is excreted into 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 one isolated case of transient gynecomastia. Norethindrone or Norethisterone is a progestin derivative of 19-nortestosterone. It is excreted in breast milk in clinically non-significant amount and no problems have been observed in infants whose mothers were treated with it. Its plasma levels in these infants were undetectable or very low. 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.Within 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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Would you like to ask something else about Mestranol + Norethindrone ?
Ask your question through the form below.

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...

Trade Names

The main trade names in different countries containing in its composition Mestranol + Norethindrone:

Scientific literature

The level of risk for breastfeeding is confirmed in these scientific publications:
  1. http://www.ncbi.nlm.nih.gov/pubmed/25793657
  2. http://www.ncbi.nlm.nih.gov/pubmed/26002804
  3. http://www.ncbi.nlm.nih.gov/pubmed/26390248
  4. http://www.ncbi.nlm.nih.gov/pubmed/25551519
  5. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/13-contraception-and-breastfeeding-protocol-english.pdf
  6. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/13-contraception-and-breastfeeding-protocol-spanish.pdf
  7. http://www.ncbi.nlm.nih.gov/pubmed/26447268
  8. http://www.ncbi.nlm.nih.gov/books/NBK321151/pdf/Bookshelf_NBK321151.pdf
  9. http://www.ncbi.nlm.nih.gov/pubmed/26447268
  10. http://www.ncbi.nlm.nih.gov/pubmed/23623474
  11. http://www.fertstert.org/article/S0015-0282(13)00455-X/pdf
  12. http://www.ncbi.nlm.nih.gov/pubmed/23635040
  13. http://www.ncbi.nlm.nih.gov/pubmed/23784109
  14. http://www.cdc.gov/mmwr/pdf/rr/rr6205.pdf
  15. http://www.ncbi.nlm.nih.gov/pubmed/24491602
  16. http://www.ncbi.nlm.nih.gov/pubmed/22682722
  17. http://www.ncbi.nlm.nih.gov/pubmed/22143258
  18. http://www.ncbi.nlm.nih.gov/pubmed/20559203
  19. http://www.cdc.gov/mmwr/pdf/rr/rr5904.pdf
  20. http://www.ncbi.nlm.nih.gov/pubmed/21080791
  21. http://www.ncbi.nlm.nih.gov/pubmed/19637436
  22. http://www.ncbi.nlm.nih.gov/pubmed/16531169
  23. http://www.ncbi.nlm.nih.gov/pubmed/11861054
  24. http://www.ncbi.nlm.nih.gov/pubmed/11172794
  25. http://www.ncbi.nlm.nih.gov/pubmed/9800931
  26. http://www.ncbi.nlm.nih.gov/pubmed/7924322
  27. http://www.ncbi.nlm.nih.gov/pubmed/7924321
  28. http://www.ncbi.nlm.nih.gov/pubmed/1835650
  29. http://www.ncbi.nlm.nih.gov/pubmed/2624954
  30. http://www.ncbi.nlm.nih.gov/pubmed/3117488
  31. http://www.ncbi.nlm.nih.gov/pubmed/4042659
  32. http://www.ncbi.nlm.nih.gov/pubmed/6617204
  33. http://www.ncbi.nlm.nih.gov/pubmed/6673900
  34. http://www.ncbi.nlm.nih.gov/pubmed/6213373
  35. http://www.ncbi.nlm.nih.gov/pubmed/6781816
  36. http://www.ncbi.nlm.nih.gov/pubmed/7361700
  37. http://ajcn.nutrition.org/content/33/4/816.full.pdf
  38. http://www.ncbi.nlm.nih.gov/pubmed/7389350
  39. http://www.ncbi.nlm.nih.gov/pubmed/606500
  40. http://www.ncbi.nlm.nih.gov/pubmed/923249
  41. http://www.ncbi.nlm.nih.gov/pubmed/780215
  42. http://www.ncbi.nlm.nih.gov/pubmed/4120298
  43. http://www.ncbi.nlm.nih.gov/pubmed/5099971
  44. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1794828/pdf/brmedj02243-0028.pdf
  45. http://www.ncbi.nlm.nih.gov/pubmed/20468683
  46. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2370008/pdf/canfamphys00378-0058.pdf
  47. http://www.ncbi.nlm.nih.gov/pubmed/4918514
  48. http://www.ncbi.nlm.nih.gov/pubmed/4884828
  49. http://www.ncbi.nlm.nih.gov/pubmed/5814068
  50. http://www.ncbi.nlm.nih.gov/pubmed/4881421
  51. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1912881/pdf/brmedj02115-0073a.pdf
  52. http://www.ncbi.nlm.nih.gov/pubmed/6038336
  53. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1842938/pdf/brmedj02152-0036.pdf
  54. http://www.ncbi.nlm.nih.gov/pubmed/6044157

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