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


woomen

Is it allowed to take Methylacetoxyprogesterone during lactation?
Is it safe for a nursing mother and a child?

Synthetic progestin similar to progesterone that is used in uterine bleeding, dysmenorrhea, infertility and contraception.For contraception is used as a single drug or in combination with estrogen (e.g. Estradiol + Medroxyprogesterone).For oral use or long-acting injectable administration (Intramuscular or subcutaneous). It is excreted into breast milk in clinically non-significant amount, and, no problems have been observed in infants whose mothers who were treated with this medication. Plasma levels of these infants were undetectable or very low.There may be increased prolactin and milk production in women who receive medroxyprogesterone. Although it has not been shown effects on production and duration of breastfeeding when administered at any time postpartum, it is still controversial on if it really decreases milk production when progestins are used before a fully establishment of breastfeeding has occurred. Therefore, experts’ protocols by WHO and ABM advise to avoiding it until breastfeeding is fully developed (4-6 weeks). During lactation progestin-only drugs are preferred or in combination with estrogen for birth control, but whatever, the ones with the lower doses of estrogen should be used.For the first 6 weeks postpartum, non-hormonal methods are of choise. 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. WHO List of Essential Medicines 2002: rates it as compatible with breastfeeding after the 6th postnatal week.

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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. http://www.ncbi.nlm.nih.gov/pubmed/26410174
  4. http://www.contraceptionjournal.org/article/S0010-7824(15)00585-5/pdf
  5. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/13-contraception-and-breastfeeding-protocol-spanish.pdf
  6. http://www.ncbi.nlm.nih.gov/pubmed/26447268
  7. http://www.ncbi.nlm.nih.gov/books/NBK321151/pdf/Bookshelf_NBK321151.pdf
  8. http://www.ncbi.nlm.nih.gov/pubmed/24996766
  9. http://www.bestpracticeobgyn.com/article/S1521-6934(14)00103-5/pdf
  10. http://www.ncbi.nlm.nih.gov/pubmed/24783085
  11. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003690/pdf/jcdr-8-69.pdf
  12. http://www.ncbi.nlm.nih.gov/pubmed/23153897
  13. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038903/pdf/nihms582570.pdf
  14. http://www.ncbi.nlm.nih.gov/pubmed/23784109
  15. http://www.cdc.gov/mmwr/pdf/rr/rr6205.pdf
  16. http://www.ncbi.nlm.nih.gov/pubmed/23304918
  17. http://www.ncbi.nlm.nih.gov/pubmed/22085201
  18. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270056/pdf/bfm.2011.0105.pdf
  19. http://www.ncbi.nlm.nih.gov/pubmed/20816003
  20. http://ejournals.library.ualberta.ca/index.php/JPPS/article/download/6663/7429
  21. http://www.ncbi.nlm.nih.gov/pubmed/19501209
  22. http://www.ncbi.nlm.nih.gov/pubmed/16680366
  23. http://downloads.hindawi.com/journals/tswj/2006/804987.pdf
  24. http://www.ncbi.nlm.nih.gov/pubmed/15964288
  25. http://www.ncbi.nlm.nih.gov/pubmed/15222930
  26. http://jfprhc.bmj.com/content/30/3/181.long
  27. http://www.ncbi.nlm.nih.gov/pubmed/12804497
  28. http://whqlibdoc.who.int/hq/2002/55732.pdf
  29. http://www.ncbi.nlm.nih.gov/pubmed/12066106
  30. http://www.ncbi.nlm.nih.gov/pubmed/11533352
  31. http://pediatrics.aappublications.org/content/108/3/776.full.pdf
  32. http://www.ncbi.nlm.nih.gov/pubmed/11084179
  33. http://www.ncbi.nlm.nih.gov/pubmed/11024223
  34. http://www.ncbi.nlm.nih.gov/pubmed/9609206
  35. http://www.ncbi.nlm.nih.gov/pubmed/9025449
  36. http://www.ncbi.nlm.nih.gov/pubmed/7924322
  37. http://www.ncbi.nlm.nih.gov/pubmed/2906764
  38. http://www.ncbi.nlm.nih.gov/pubmed/6456130
  39. http://www.ncbi.nlm.nih.gov/pubmed/5099971
  40. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1794828/pdf/brmedj02243-0028.pdf
  41. http://www.ncbi.nlm.nih.gov/pubmed/20468683
  42. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2370008/pdf/canfamphys00378-0058.pdf

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