Is Norethynodrel safe while breastfeeding?

Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Norethynodrel. This is a summary of that source — not our own verdict.

Effects on the breastfed infant

Abnormal breast enlargement was reported in a 3-week-old male breastfed infant whose mother was taking an oral contraceptive containing norethynodrel 25 mg and mestranol 100 mcg.[ 5 ] The contraceptive was the probable cause of breast enlargement, but most likely the estrogen component mestranol rather than norethynodrel caused the effect.

Effects on milk supply

Relevant published information was not found as of the revision date. However, progestins such as norethynodrel are not considered to suppress lactation. A study analyzed data from a prospective cohort study of U.S. women from May 2005 through June 2007. Women were followed from the third trimester of pregnancy throughout the first year postpartum. Data from the subset of women who intended to breastfeed for 3 months or longer postpartum during their third trimester of pregnancy and who were using a contraceptive at 3 months postpartum were analyzed (n = 1349). Women who intended to breastfeed for at least 4 months and were taking a progestin-only oral contraceptive, such as norethynodrel, were 3.15 times more likely to be breastfeeding (exclusive or nonexclusive) at 4 months than women who used a nonhormonal contraceptive. Women who said they would breastfeed for 3 to 4 months had 4-month breastfeeding rates equivalent to those using a nonhormonal contraceptive. These rates were much higher than those of women who were taking an estrogen-containing, combined oral contraceptive.[ 6 ]

Levels in milk

Norethynodrel is a prodrug that is rapidly converted to norethindrone in the body.[ 2 ] Maternal Levels. In one old study using a nonspecific radiolabeling assay technique, 2 women were found to excrete 0.0044% and 0.13% of an administered dose (not weight-adjusted) of norethynodrel into breastmilk.[ 3 ] In another study using radioactive labeled norethynodrel, 4 women who were between days 4 and 6 postpartum excreted an average of 1.1% (range 0.45 to 1.52%) of a dose (not weight-adjusted) into breastmilk.[ 4 ] Infant Levels. Relevant published information was not found as of the revision date.

Alternatives LactMed lists

Source: NIH LactMed (National Library of Medicine).

Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.