title: Health and growth of infants breastfed by Norplant contraceptive implants users: a six-year follow-up study.
abstract: The objective of the study was to evaluate safety to infants whose mothers used Norplant levonorgestrel implants during breastfeeding. A nonrandomized clinical trial design was used. Participants were 220 and 222 healthy breastfed infants of mothers initiating use of Norplant or T-Cu IUD, respectively, at 55 days to 60 days postpartum. Infants were followed from birth through age 6 years. Breastfeeding pattern, infant growth, and disease events were recorded monthly in the first year, three-monthly in the second, and annually thereafter. Most mothers continued use of Norplant (96.4%) and T-Cu (94.1%) during lactation, and 2140 months of infant exposure to levonorgestrel were accumulated. Breastfeeding pattern and infants growth, from admission through age 6 years, were similar in both groups. In the first year, breastfed infants in the Norplant group had higher incidence rates (p < 0.05) of mild episodes of respiratory infections (adjusted RR 1.17, CI 1.08-1.27), skin conditions (adjusted RR 1.46, CI 1.20-1.79), and eye infections (unadjusted RR 1.49, CI 1.03-2.18) than the control group. Later on, a higher proportion of infants in the T-Cu group showed neurological conditions. Although breastfeeding patterns and infant growth is not affected by Norplant use during lactation, the effect on infants' health of steroidal contraception should be further evaluated.
authors.affiliation: Instituto Chileno de Medicina Reproductiva, Consultorio de Planificación Familiar, J.V. Lastarria 29, Depto. 101, Santiago, Chile. icmer@icmer.org
authors.forename: Verónica
authors.initials: V
authors.lastname: Schiappacasse
authors.forename: Soledad
authors.initials: S
authors.lastname: Díaz
authors.forename: Ana
authors.initials: A
authors.lastname: Zepeda
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Alvarado
authors.forename: Carmen
authors.initials: C
authors.lastname: Herreros
mesh_terms: D001942:Breast Feeding; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003271:Contraceptive Agents, Female / Q000009:adverse effects* / Q000097:blood; D004343:Drug Implants; D005128:Eye Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D008297:Male; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000209:etiology; D012871:Skin Diseases / Q000209:etiology
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; D016912:Levonorgestrel