Contraceptive implants and lactation

Area of Science:

• Reproductive Health
• Contraception
• Lactation

Background:

• Postpartum contraception is crucial for family planning.
• Lactating women require safe and effective birth control methods.
• Concerns exist regarding hormonal contraceptive effects on breastfeeding infants.

Purpose of the Study:

• To evaluate the safety and efficacy of four progestin-only contraceptive implants in lactating postpartum women.
• To assess the impact of these implants on breastfeeding, infant growth, and development.
• To compare contraceptive implant use with other methods regarding amenorrhea and bleeding patterns.

Main Methods:

• Safety and efficacy of Norplant, Implanon, Nestorone, and Elcometrine implants were assessed in postpartum lactating women.
• Infant growth and development were monitored.
• Maternal milk steroid concentrations were measured to estimate infant steroid intake.
• Bone turnover and density were evaluated in women using Norplant.

Main Results:

• All four implants provided highly effective contraception with no adverse effects on breastfeeding or infant development.
• Norplant use in the second postpartum month led to longer amenorrhea periods compared to untreated or IUD users.
• Norplant did not negatively impact bone turnover or density during lactation.
• Implants releasing orally inactive progestins (Nestorone, Elcometrine) offer an advantage by minimizing infant steroid exposure.

Conclusions:

• Progestin-only contraceptive implants are safe and effective for lactating postpartum women.
• These implants do not negatively affect breastfeeding, infant growth, or development.
• Implants releasing orally inactive progestins are preferable for minimizing infant steroid exposure.
• Orally active steroid implants should be used cautiously after 6 weeks postpartum.