Thread by @abbyliberty1

Now Erika Levi talking about an study of immediate postpartum contraceptive implant placement and breastfeeding outcomes. #SFP2022

The study was a single arm non inferiority design. Inclusion criteria:
- Desire for implant
- >14 years old
- Live birth >24w
- English or Spanish speaking

The primary measure was "Has your milk come in?"

Primary lactation failure define as a patient who answered the primary measure NO for 5 days postpartum.

#SFP2022

For people discharged, they followed them by text or phone in the immediate postpartum period. They also followed up at 3 and 6 months postpartum.

#SFP2022

50% who declined participation did so because they had strong opinions about when they got their implant and did NOT want to be randomized and possibly not receive the implant prior to hospital discharge.

#SFP2022

The study controlled for risk factors for low milk supply including
- Diabetes
- Obesity
- Gestational age at delivery / Premature delivery
- PCOS
- History of difficulty with milk supply

#SFP2022

CONCLUSIONS:
- The primary time to lactogenesis was 68 hours.
- There were 6 primary lactation failures
- There was NO difference between lactogenesis between groups
- Participants were very satisfied with the implant across study groups
#SFP2022

This study came out of competing hospital goals: achieving #BabyFriendly hospital status and implementing access to immediate postpartum LARC. There was conflict between #IBCLC groups and #FamilyPlanning about the earlier mixed data on Nexplanon + lactogenesis

#SFP2022

Audience: Is it ethical to randomize someone to a delayed LARC placement?

Dr. Ralph: Excellent point, which is why the study was transparent & why people for whom outpatient Nexplanon was perceived as high risk declined to participate (& got a LARC prior to discharge)

#SFP2022

I am so impressed that there are several lactation consultants in the audience and attending SFP. I learned so much at #ABM2022 this year and hope for more collaboration between @BFMedicine and @SocietyFP in the future!

#SFP2022