[Breast feeding: which contraceptive method?].

Contraception during breast feeding must take two points into account: the first physiological contraception due to anovulation which disappears at around the 9th week of lactation); the second pharmacological: any substance ingested by the mother during breast feeding is excreted in milk, chiefly by passive diffusion. All pharmacokinetic studies have shown that the transfer of progesterone or of estrogen when taking a contraceptive pill is extremely slight, being of the same order as that of natural hormones. When it is decided to use hormonal contraception, this should be started after the 6th week of lactation, when lipid profile has returned to normal and thromboembolic risk is identical to that of the population in general. As with all prescription during lactation, the drug should be taken as far as possible from the next feed. Barrier techniques (combining condoms and spermicides) are an elegant alternative to drug methods.