Korean J Prev Med. 1975; 8(1): 15-24.
The Effect of an Oral Contraceptive (Eugynon) Upon Lactation.
There are a number of published reports aimed at clarifying the effect of hormonal contracept -ives upon the quantity and quality of breast milk during postpartum and lactation periods. As to the volume of milk produced by breast feeding mothers, many authors seem to have agreed on a decrease as an established pattern in the periods following regular administration of oral contraceptives containing estrogen in varying dosage. The quality of milk following administration of hormonal contraceptives, however, remsins a controversial issue. Korea's experience in oral contraceptive is rather a brief one, but use of Eugynon has been widespread and frequent since this hormonal contraceptive was introduced into the national program in 1967. The authors have reviewed the potential significance of data concerning regular use of an oral contraceptive as affecting lactation, and have sought to clarify the interrelationship between the administration of Eugynon and quantity and quality of breast milk from mothers contracepting. with Eugynon in different periods following confinement. A total of 85 women, who were at different periods following deliveries, have been divided into, two groups, one comprising 28 women regularly taking oral pills and the other (57 women) not resorting to hormonal contraceptives if they were contracepting at all. 1. Milk Volume. In view of the possible influence of suckling on the amount of milk produced, efforts were made in this study to standardize the technique by extracting breastmilk by applying manual pressures on one side of the maw-nae, While the nipple on the other side was being sucked by the mother's own baby. The effetct of an exogenic ovarian hormone on the quantity as well as quality of breastmilk is generally understood to be inapparent until the drug is administered to women whose milk secreting function has been normalized. ") In the present study, it was observed that the decrease in the ammount of milk obtained from mothers in the periods following the 4th cycle of oral contraceptives or thereafter has turned out to be statistically insignificant. This result conforms i.u the findings by Tubari and others. It is assumed that it takes at lest 2 to 3 cycles of use before mammary glands are functionally adjusted to the use of exogenic hormonal contraceptives. 2. Specific Gravity and Composition of Milk There was no noticeable change in the protein and chloride content following continuous administration of ore.l contraceptives, while meaningful changes were observed in fat (increase) and calcium (decrease up to the 5th cycle use) contents. Also, there was a rather significant decrease in the specific gravity in the period following administration of the first cycle of the oral contraceptive. The findings from the present study partially conforms the results published by Ramadan and others, who reported that little change was noticed in the contents of total solids. ash, chlorides and lactose in the breast milk of women who had taken 4 cycles of ovosiston, although in our study lactose was not measured. Ramaden, however, reported that fat content did increase in the same milk, as in our study. A definitive conclusion, however, could not be made unless measures are taken to rule out the physiological changes of the maternal body affecting the composition of milks.