Nexplanon

[elflactation]

MDs where I work are on a crusade to implant the Nexplanon in as many of our low income, young primips and multips as possible prior to hospital discharge. The docs are placing the device anywhere between 12 and 90 hours postpartum.

Does this pose a threat to these mom's milk supply?

[admin]

Elflactation: The manufacturer recommends it use in breastfeeding mothers ONLY after 4 weeks postpartum. There data is pretty good that it does not affect milk production, but who knows if this is correct when used in the first few days.

I'd suggest it might cause a threat to the mothers milk supply, but we do not have data to really confirm this. I'd suggest you do a study and follow up with these moms to see what their milk production is after 2 weeks.

Tom Hale Ph.D.

[elflactation]

Tom,
Can you look at the pharmacokinetics of the Nexplanon. I find it very concerning...the implant provides a peak dose at 3 days post insertion of the device...so for my paitents they are getting a huge dose of progestin on day 4, 5,6 or 7. What do you think?

I would love to do a study. I don't have never done one and I wonder what kind of data I need. How many moms do I need as a sample, do I have to have a control group? I don't know if I should follow only exclusively BF moms or if I should include those who supplement regularly and for how long I should follow the subjects and what kind of consent I would need?

Eve

[admin]

elflactation:

Doing a research study is a major undertaking and would require assistance from experienced people. I'd suggest you find a clinical research unit in your university and discuss this issue. As for the kinetics, it is interesting that levels at 3 days are 2.5 times higher than at 3 months. But to construe that it is interrupting breastfeeding is another proposition, that requires confirming experimentally, not emotionally. I'd suggest you get busy and do this study. But its going to be a problem on how to manage the pregnancy risk.

Tom Hale Ph.D.