Contraception
Volume 82, Issue 1 , Pages 10-16, July 2010

Combined oral contraceptive use among breastfeeding women: a systematic review☆☆☆

  • Nathalie Kapp

      Affiliations

    • Department of Reproductive Health and Research, World Health Organization, CH-1211 Geneva 27, Switzerland
    • Corresponding Author InformationCorresponding author.
    • ,
  • Kathryn M. Curtis

      Affiliations

    • Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA

Received 1 February 2010; accepted 2 February 2010. published online 11 March 2010.

Abstract 

Background

Postpartum women need effective contraception, but using hormonal contraceptives may affect breastfeeding performance and infant health outcomes.

Study design

We searched the MEDLINE and Cochrane databases for all articles published through May 2009 for primary research studies that investigated clinical outcomes among breastfeeding women who used hormonal contraception or their infants.

Results

Three randomized controlled trials reported decreased mean duration of breastfeeding and higher rates of supplemental feeding among combined oral contraceptive (COC) users than among nonusers, while one multicountry trial found no differences in these parameters. Only one study demonstrated lower average weights during the first year of life for infants whose mothers used COCs while breastfeeding. None of the eight studies, four of which were observational, included in this review documented adverse infant health outcomes.

Conclusions

Limited evidence demonstrates an inconsistent effect of COC on breastfeeding duration and success. The evidence is inadequate to determine whether a mother's use of these drugs affects breastfeeding duration or the infant's health.

Keywords: Breastfeeding, Breast milk, Combined hormonal contraception, Lactation, Postpartum, Puerperium

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☆ The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the World Health Organization or the Centers for Disease Control and Prevention.

☆☆ This review was supported by resources from the Department of Reproductive Health and Research at the World Health Organization, the Centers for Disease Control and Prevention, the US Agency for International Development and the National Institute of Child Health and Human Development in the USA.

PII: S0010-7824(10)00045-4

doi:10.1016/j.contraception.2010.02.001

Contraception
Volume 82, Issue 1 , Pages 10-16, July 2010

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