a1 Department of Community Health Practice, School of Public Health, American University, Beirut, Lebanon
The realization that steroidal contraceptives administered immediately after delivery to lactating women may be excreted into milk, and adversely affect the neonate, is a cause for concern. Most investigations on hormonal contraceptives have dealt with the efficacy of ovulation suppression, and systemic side effects, but little is known about the appearance of steroids or their metabolites in milk. Apart from the immediate side effects on the neonate, unforeseen long-term consequences require special consideration. Until research provides us with more information, women should use breast-feeding and IUDs instead of steroidal contraceptives during the first trimester post-partum.