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


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Is it allowed to take Mestranol + Norethynodrel 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 (Norethynodrel) for oral use. It was the first marketed contraceptive (1959).Currently withdrawn from market. 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. Norethynodrel is a progestin drug similar to Norethinondrone. It is excreted into 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. Currently, studies have not found differences on 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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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 + Norethynodrel:

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/11533352
  25. http://pediatrics.aappublications.org/content/108/3/776.full.pdf
  26. http://www.ncbi.nlm.nih.gov/pubmed/11172794
  27. http://www.ncbi.nlm.nih.gov/pubmed/10438999
  28. http://www.ncbi.nlm.nih.gov/pubmed/7924322
  29. http://www.ncbi.nlm.nih.gov/pubmed/7924321
  30. http://www.ncbi.nlm.nih.gov/pubmed/2892712
  31. http://www.ncbi.nlm.nih.gov/pubmed/7361700
  32. http://ajcn.nutrition.org/content/33/4/816.full.pdf
  33. http://www.ncbi.nlm.nih.gov/pubmed/20468683
  34. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2370008/pdf/canfamphys00378-0058.pdf
  35. http://www.ncbi.nlm.nih.gov/pubmed/4884828
  36. http://www.ncbi.nlm.nih.gov/pubmed/5814068
  37. http://www.ncbi.nlm.nih.gov/pubmed/4881421
  38. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1912881/pdf/brmedj02115-0073a.pdf
  39. http://www.ncbi.nlm.nih.gov/pubmed/5630224
  40. http://www.ncbi.nlm.nih.gov/pubmed/6012386
  41. http://www.ncbi.nlm.nih.gov/pubmed/5896477
  42. http://www.ncbi.nlm.nih.gov/pubmed/14117345

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