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  • Title: Breastfeeding as a means of contraception.
    Author: Diaz CA.
    Journal: Initiatives Popul; 1983; 7(3):16-22. PubMed ID: 12339840.
    Abstract:
    The University of the Philippines Institute of Public Health (UPIPH) and the Family Health International (FHI) brought together health professionals, nutritionists, and family planning experts from different parts of the world to share and gain insights into the issue of breastfeeding and contraception. The participants met in Manila in 1983 and analyzed research findings on breastfeeding and discussed their implications relevant to nutrition and family planning policies and programs. Studies conducted in several countries show a general decline of breastfeeding practice in both urban and rural areas. The issue appears to be not whether women in developing countries breastfeed their infants but for how long. Popkin cites a study in Thailand, which showed very little change in the proportion of babies ever breastfed but large declines in the duration of breastfeeding from 1969-79. In the Philippines, national surveys since 1973 indicate that mothers throughout the country practice breastfeeding but do so for a relatively short period. Scientific data supporting the folk belief that breastfeeding delays the return of fertility after childbirth is growing. The phenomenon is believed to be governed by a sophisticated control mechanism in the female reproductive system. Some researchers suggest that prolactin may be responsible for the delay of fertility in breastfeeding mothers. In a series of studies done in the Philippines and Australia, researchers Barbara Gross and C.J. Eastman found that high prolactin levels were almost always associated with proloned amenorrhea during lactation. A decline in prolactin concentrations accompanied the resumption of menstruation. Gross and Eastman found evidence of ovulation before the 1st menses in only 1 out of 54 fully breastfeeding mothers, or less than 2%. This implies that at least the first few menses of most fully breastfeeding mothers are not accompanied by ovulation, suggesting that breastfeeding continues to affect fertility even after the resumption of breastfeeding. Zablan's study in the Philippine analyzed the various factors contributing to fertility reduction. Breastfeeding appeared to have the greatest impact on the Filipino woman's level of fertility. Zablan points out that, while breastfeeding is a major factor influencing fertility in the Philippines, it "can be relied upon only to postpone childbearing (and then only at the aggregate level), but not to prevent childbearing altogether." Much work needs to be done to help people realize the value of breastfeeding, to encourage mothers to practice it, and to do so for as long as possible.
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