Anticoncepción

Anticonceptivos y su nivel de protección en orden que va de los más compatibles a los menos compatibles con la lactancia

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MELA                                               98 - 99.5% 

Condones                                        85 - 98%

Diafragma con espermicida            84 - 94% 

Espermicidas                                  71 - 82%

Planificación natural                        80-97%

DIU cobre                                        99.2-99.4%

DIU progestina                                99.8

Vasectomia                                      99.85-99.9%

Ligación tubal                                   99.5%

Mini-píldora                                       92-99.7%

Inyectables                                       97-99.7%

Implantes                                          99.95%

Anillo vaginal con progesterona       92-99.7%

Contraceptivos orales/inyectables  92-99.7%

Inyectables combinables                 99.7%

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El método de la lactancia y la amenorrea (MELA) debe cumplir estas tres condiciones:

  1. la menstruación no ha regresado pasados los primeros 56 días
  2. bebé mama dia y noche sin otros alimentos o agua o bobos 
  3. el bebé tiene menos de 6 meses

La menstruación no causa cambios significativos en la composición de la leche pero si en el sabor y puede causar que el bebé se inquiete o rechace el pecho

Referencias:

Protocolo 13 de la Academia de Medicina y Lactancia (Academy of Breastfeeding Medicine)

Barras-Kubski T. Lactancia y fertilidad. LLLI. 2006

En inglés:

ABM Clinical Protocol #13 Contraception during Breastfeeding, BREASTFEEDING MEDICINE Volume 1, Number 1, 2006 Mary Ann Liebert, Inc.

Bjarnadóttir, R. I., Gottfredsdóttir, H., Sigurdardóttir, K., Geirsson, R. T. and Dieben, T. O. M. (2001), Comparative study of the effects of a progestogen-only pill containing desogestrel and an intrauterine contraceptive device in lactating women. BJOG: An International Journal of Obstetrics & Gynaecology, 108: 1174–1180. 

Danli S, Qingxiang S, Guowei S. A multicentered clinical trial of the long-acting injectable contraceptive Depo Provera in Chinese women. Contraception. 2000 Jul;62(1):15-8.

Díaz S, Cárdenas H, Brandeis A, Miranda P, Salvatierra AM, Croxatto HB. Relative contributions of anovulation and luteal phase defect to the reduced pregnancy rate of breastfeeding women. Fertil Steril. 1992 Sep;58(3):498-503.

Díaz S, Cárdenas H, Brandeis A, Miranda P, Schiappacasse V, Salvatierra AM, Herreros C, Serón-Ferré M, Croxatto HB. Early difference in the endocrine profile of long and short lactational amenorrhea J Clin Endocrinol Metab. 1991 Jan;72(1):196-201.

Epigee Birth Control Methods Considerations & Limitations

Espey E, Ogburn T, Leeman L, Singh R, Ostrom K, Schrader R. Effect of progestin compared with combined oral contraceptive pills on lactation: a randomized controlled trial. Obstet Gynecol. 2012 Jan;119(1):5-13. doi: 10.1097/AOG.0b013e31823dc015.

Gellén JJ. The feasibility of suppressing ovarian activity following the end of amenorrhoea by increasing the frequency of suckling. Int J Gynaecol Obstet. 1992 Dec;39(4):321-5.

Kelsey JJ. Hormonal contraception and lactation. J Hum Lact. 1996 Dec;12(4):315-8.

Kennedy K, et al. Users’ understanding of the lactational amenorrhea method and the occurrence of pregnancy. J Hum Lact. 1998;14:209-218.

Kippley S. The Seven Standards of Ecological Breastfeeding 

Kippley SK, Kippley JF., The Relation Between Breastfeeding and Amenorrhea: Report of a Survey, 1972, Journal of The Nurses Association of The American College of Obstetrics and Gynecologists, 1:4, November-December 1972

Koetsawang, S. The effects of contraceptive methods on the quality and quantity of breast milk. International Journal of Gynecology and Obstetrics 25 (Suppl.): 115-127. 1987. 

Labbok M Breastfeeding, Fertility, and Family Planning,  Glob. libr. women's med., (ISSN: 1756-2228) 2008; DOI 10.3843/GLOWM.10397

Labbok M, et al. Multicenter study of the lactational amenorrhea method (LAM) I: efficacy, duration, and implications for clinical application. Contraception 1997;55:327-336.

McNeilly AS Lactational Amenorrhea. Endocrinol Metab Clin North Am. 1993;Mar;22:59-73.

McNeilly AS, Tay CC, Glasier A. Physiological mechanisms underlying lactational amenorrhea.Ann N Y Acad Sci. 1994 Feb 18;709:145-55. 

Nath A, Sitruk-Ware R. Progesterone vaginal ring for contraceptive use during lactation. Contraception. 2010 Nov;82(5):428-34.

Shaaban OM, Glasier AF. Contraception. Pregnancy during breastfeeding in rural Egypt. 2008 May;77(5):350-4. doi: 10.1016/j.contraception.2008.01.005.

Shaamash AH, Sayed GH, Hussien MM, Shaaban MM. A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development. Contraception. 2005 Nov;72(5):346-51.

Sivin I, Díaz S, Croxatto HB, Miranda P, Shaaban M, Sayed EH, Xiao B, Wu SC, Du M, Alvarez F, Brache V, Basnayake S, McCarthy T, Lacarra M, Mishell DR Jr, Koetsawang S, Stern J, Jackanicz T. Contraceptives for lactating women: a comparative trial of a progesterone-releasing vaginal ring and the copper T 380A IUD. Contraception. 1997 Apr;55(4):225-32.

Taneepanichskul S, Reinprayoon D, Thaithumyanon P, Praisuwanna P, Tosukhowong P, Dieben T. Effects of the etonogestrel-releasing implant Implanon and a nonmedicated intrauterine device on the growth of breast-fed infants. Contraception. 2006 Apr;73(4):368-71.

The couple to couple league. Breastfeeding Does Breastfeeding Really Space Babies? 2005

Vestermark V, Høgdall CK, Plenov G, Birch M. Postpartum amenorrhoea and breast-feeding in a Danish sample. J Biosoc Sci. 1994 Jan;26(1):1-7. 

Weschler T. Taking Charge of Your Fertility 

Yanet Olivares, IBCLC
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