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Letter to the editor
Breastfeeding and postpartum contraception: dual priorities in the immediate postnatal period
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  1. Annette Thwaites1,2,*
  1. ↵  *Corresponding author.
  1. Lesley Bacon
  1. Jane Dickson
  1. 1ST2 in Sexual and Reproductive Health, Contraception and Sexual Health, Oxleas NHS Foundation Trust, Market Street Health Centre, London, UK; annettethwaites@doctors.org.uk
  2. 2ST2 in Sexual and Reproductive Health, Contraception and Sexual Health, Lewisham and Greenwich NHS Trust, Waldron Health Centre, London, UK
  3. Retired Consultant, Contraception and Sexual Health, Lewisham and Greenwich NHS Trust, Waldron Health Centre, London, UK; lesleybacon30@gmail.com
  4. Consultant, Contraception and Sexual Health, Sexual and Reproductive Health, Oxleas NHS Foundation Trust, Market Street Health Centre, London UK; jane.dickson@nhs.net

https://doi.org/10.1136/jfprhc-2016-101623

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    In a letter1 published in the July 2016 issue of this journal, the Breastfeeding Network's approach to postpartum contraception was advocated and described as: (i) avoidance of all hormonal contraception in the first 21 days postpartum; (ii) after that, a month's trial of the “mini-pill” to check milk supply is unaffected; and (iii) initiation of hormonal long-acting reversible contraception (LARC) methods (e.g. the subdermal implant), after this and only if breastfeeding is going well. The letter expresses concern among breastfeeding counsellors, based solely on anecdotal reports, regarding “the impact of hormonal contraception on milk supply” (including progestogen-only methods). The Breastfeeding Network's ‘Breastfeeding and Contraception’ factsheet2 asserts that initiation too early after delivery “may interfere with priming of prolactin receptors” and refers to anecdotal reports …

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