A mother who is exclusively breastfeeding her 8-week-old infant chooses progestogen-only pills. What instruction regarding their use is correct?
- A Take the pill at approximately the same time each day, with a maximum permissible delay of 3 hours before needing backup precautions ✓
- B Take the pill anytime within 12 hours of the usual time without loss of efficacy
- C Stop the pills once menstruation returns and switch to combined pills while feeding
- D Take two tablets together if one dose is forgotten
Correct answer: A. Take the pill at approximately the same time each day, with a maximum permissible delay of 3 hours before needing backup precautions
Explanation
Progestogen-only pills depend heavily on their effect on cervical mucus, which dissipates quickly, so they must be taken at nearly the same time daily; a delay beyond 3 hours counts as a missed pill requiring backup contraception. They are safe in lactation from 6 weeks postpartum because they do not affect milk volume, unlike combined pills, whose estrogen component suppresses lactation and carries thrombotic risk.
Reference: WHO Family Planning: A Global Handbook for Providers, 2018 update ed.
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Written and medically reviewed by the StethoPrep medical team.