title: Levonorgestrel used for emergency contraception during lactation-a prospective observational cohort study on maternal and infant safety.
abstract: OBJECTIVE
  To identify possible effects of levonorgestrel used as an emergency contraceptive during breastfeeding on mothers and their infants.
  
  
  METHODS
  A prospective observational cohort study of all women who contacted the Teratology Information Service between January, 2005 and January, 2010. Breastfeeding women who used levonorgestrel as an emergency contraceptive (study group) were compared to breastfeeding women who used either ethynodiol diacetate or desogestrel (control group). Women were followed for 6-24 months. Main outcome measures were adverse maternal and infant effects and continuation of breastfeeding.
  
  
  RESULTS
  We followed 71 of 128 study group women and 72 of 100 control group women. Maternal adverse effects were mainly vaginal bleeding, which was less frequent in the study vs. control group (16 of 71 vs. 27 of 72, p = 0.068). Decreased lactation was uncommon and similar in both groups. Breastfeeding was reinitiated within less than 8 h in 75% of the levonorgestrel group women. Adverse infant effects were rare (0 of 72 infants vs. 2 of 72 infants, p = 0.5 in the study vs. control group).
  
  
  CONCLUSIONS
  Our findings support the safety of using levonorgestrel as an emergency contraceptive during lactation without the need for withholding breastfeeding.
authors.affiliation: Beilinson Teratology Information Service, Rabin Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Sharon
authors.initials: S
authors.lastname: Polakow-Farkash
authors.forename: Oded
authors.initials: O
authors.lastname: Gilad
authors.forename: Paul
authors.initials: P
authors.lastname: Merlob
authors.forename: Bracha
authors.initials: B
authors.lastname: Stahl
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.forename: Gil
authors.initials: G
authors.lastname: Klinger
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects; D016022:Case-Control Studies; D002657:Child Development / Q000187:drug effects; D044363:Contraception, Postcoital / Q000009:adverse effects* / Q000379:methods; D003271:Contraceptive Agents, Female / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007774:Lactation / Q000187:drug effects* / Q000502:physiology; D016912:Levonorgestrel / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D009034:Mother-Child Relations; D061214:Patient Safety; D011446:Prospective Studies
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel