From the Guidelines
Depo-Provera can be safely used while breastfeeding, with the first injection given at any time postpartum, including immediately after childbirth, as long as it is reasonably certain that the woman is not pregnant 1. The typical dose is 150 mg administered as an intramuscular injection, given every 12 weeks (3 months). Depo-Provera does not affect milk production and only minimal amounts of the hormone pass into breast milk, posing no known risks to the nursing infant. This makes it a good contraceptive option for breastfeeding mothers who want reliable birth control without affecting lactation. The progestin-only formulation avoids the potential milk supply reduction sometimes associated with estrogen-containing contraceptives. Some key points to consider when using Depo-Provera while breastfeeding include:
- If the woman is less than 6 months postpartum, amenorrheic, and fully or nearly fully breastfeeding, no additional contraceptive protection is needed 1.
- Otherwise, a woman who is 21 days postpartum and has not experienced return of her menstrual cycle needs to abstain from sexual intercourse or use additional contraceptive protection for the next 7 days.
- Side effects for the mother may include irregular bleeding, weight gain, and mood changes.
- Fertility may take 6-12 months to return after stopping Depo-Provera, so this should be considered when planning future pregnancies.
- Regular calcium intake is also recommended while using this contraceptive to maintain bone health. It's worth noting that while other studies discuss various aspects of contraceptive use, including effectiveness and side effects 1, the most relevant and recent guidance on using Depo-Provera while breastfeeding is provided by the U.S. Selected Practice Recommendations for Contraceptive Use, 2013 1.
From the FDA Drug Label
Detectable amounts of drug have been identified in the milk of mothers receiving Medroxyprogesterone Acetate Injectable Suspension, USP In nursing mothers treated with Medroxyprogesterone Acetate Injectable Suspension, USP, milk composition, quality, and amount are not adversely affected. Neonates and infants exposed to medroxyprogesterone from breast milk have been studied for developmental and behavioral effects through puberty. No adverse effects have been noted.
The use of Depo Prevera (Medroxyprogesterone Acetate Injectable Suspension, USP) while breastfeeding is considered safe, as it does not affect milk composition, quality, or amount, and no adverse effects have been noted in neonates and infants exposed to medroxyprogesterone through breast milk 2.
From the Research
Depo Prevera and Breastfeeding
- Depo Prevera, also known as depot medroxyprogesterone acetate (DMPA), is a progestin-only method of contraception that can be used by breastfeeding women 3, 4.
- However, there are concerns that DMPA may affect breastfeeding, as a decrease in progesterone is required to initiate lactation 5.
- Studies have shown that there are no significant differences in lactogenesis, breastfeeding, and infant growth parameters between immediate postpartum and delayed insertion of DMPA 4.
- Some studies have reported a small but statistically significant increase in milk supply concerns among users of postpartum hormonal contraception, including DMPA 4.
- Despite these concerns, DMPA is considered a viable option for breastfeeding women, particularly if nonhormonal methods are not available or acceptable 3.
- It is essential to note that postpartum nurses and healthcare providers may have persistent erroneous beliefs about the safety of DMPA during breastfeeding, which can impact counseling and decision-making 4.
- Women who intend to breastfeed should be informed about the potential risks and benefits of DMPA and other contraceptive methods to make an informed decision 4, 5.