All emphasis below is mine–dw

New Rochelle, NY, May 28 –
New CDC birth control guidelines http://www.cdc.gov/mmwr/preview/mmwrhtml/rr59e0528a1.htm )
could undermine mothers who want to breastfeed.

The new guidelines
advise that the benefits of immediate progesterone
contraception outweigh the
risks, and that by 4 weeks, there is no
risk. Previously, progesterone birth
control was not recommended for
nursing mothers until at least 6 weeks after
birth, and combined
hormonal methods were not recommended for 6 months. In
the new
guidelines, combined pills are rated as “generally acceptable” from
4
weeks.

“The new guidelines ignore basic facts about how
breastfeeding works,”
says Dr. Jerry Calnen, president of the Academy of
Breastfeeding
Medicine. “Mothers start making milk due to the natural fall
in
progesterone after birth. An injection of artificial progesterone
could
completely derail this process.”

Clinically, breastfeeding support
providers report a negative impact
on breastfeeding when these methods are
introduced too early, and one
preliminary study found dramatically lower
breastfeeding rates at 6
months among mothers who underwent early insertion
of progesterone-
containing IUDs, compared with insertion at 6-8 weeks
postpartum.

“The data are limited,” says Calnen, “but for now, the state
of the
science suggests that early progesterone exposure
undermines
breastfeeding.“

The ABM wrote to CDC Director Thomas Frieden in
January urging
reconsideration of the guidelines. In his reply, Dr. Frieden
described
the new recommendations as “the best interpretation of the
existing
evidence.”

Calnen is less confident. “Physicians and mothers
should proceed with
caution,” he says. “There are plenty of birth control
methods that are
proven to be safe for breastfeeding. Early progesterone is
not one of
them.”