Obstetrics & Gynecology>>>>>The Puerperium, Lactation, and Immediate Care of the Newborn
Question 7#

A 30-year-old G5P3 has undergone a repeat cesarean delivery. She wants to breastfeed. Her past medical history is significant for hepatitis B infection, hypothyroidism, depression, and breast reduction. She is receiving intravenous antibiotics for endometritis. The baby latches on appropriately and begins to suckle. 

The patient returns to see you in 6 weeks for a routine postpartum visit. She has been nursing her baby without any major problems, and wants to continue to do so for at least 9 months. She is ready to resume sexual activity and wants to know what her options are for contraception. She is a nonsmoker, and her only other medication is a prenatal vitamin.

Which of the following methods may decrease her milk supply?

A) Intrauterine device (IUD)
B) Progestin only pill
C) Depo-Provera
D) Combination oral contraceptive
E) Condoms and spermicide

Correct Answer is D

Comment:

The use of an IUD, barrier methods, and hormonal contraceptive agents containing only progestins are all appropriate methods of birth control for breastfeeding women. It is best for nursing mothers to avoid estrogen-containing contraceptives because estrogen preparations can inhibit lactation or decrease milk supply.