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  • Title: A hazards model analysis of breastfeeding variables and maternal age on return to menses postpartum in rural Indonesian women.
    Author: Jones RE.
    Journal: Hum Biol; 1988 Dec; 60(6):853-71. PubMed ID: 3235076.
    Abstract:
    There is mounting research evidence that the duration of lactational amenorrhea is dependent on the infant's suckling input. Multivariate techniques, including the proportional hazards model, offer an effective methodological approach for sorting through the variables that contribute to a process as complex as breastfeeding. This approach was utilized on a sample of 382 mothers who participated in the Ngaglik Study, a longitudinal investigation of maternal health and nutrition, infant development, child spacing, and fertility trends in Central Java, Indonesia. 3 primary breastfeeding variables--average number of nursing episodes during the day, average number of nursing episodes during the night, and average minutes per episode--were obtained from monthly interviews with study subjects, 260 of whom experienced return to menses while breastfeeding. The mean and median durations of amenorrhea were 17.3 and 16.4 months, respectively. The reported total number of suckling bouts per 24 hours averaged 8.85, with an average of 8.23 minutes per nursing episode. Amenorrhea duration ranged from 19.2 months in mothers who nursed 6 or more times during the day-time hours to 12.2 months in mothers who nursed an average of 6 minutes or less per episode. The variable of minutes per nursing bout has the greatest effect on return to menses, while the average number of day-time feeds has the least; the number of night-time feeds is intermediate. When age was introduced into the model, the effects of the nursing variables on return of menses remained constant relative to 1 another but the increment in the risk of menstruating increased with younger age. In summary, this analysis indicates that low intensity breastfeeding with 3 or fewer episodes reported at night, 6 or fewer episodes reported for the day, 6 or less minutes reported per nursing episode, and younger age all increase the risk of early postpartum resumption of menses.
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