The World Health Organization Multinational study of breast-feeding and lactational amenorrhea: I. Description of infant feeding patterns and of the return of menses
Van-Look, P., F.A.; Von-Hertzen, H.
Fertility and Sterility 70(3): 448-460
1998
ISSN/ISBN: 0015-0282 DOI: 10.1016/s0015-0282(98)00190-3Document Number: 279662
Objective: To detect differences between populations in both infant feeding practices and the duration of lactational amenorrhea, if they exist. Design: Prospective, nonexperimental, longitudinal follow-up study. Setting: Five developing and two developed.countries, Patient(s): Four thousand one hundred eighteen breast-feeding mothers and their infants. Intervention(s): Breast-feeding women collected ongoing information about infant feeding and family planning practices, plus the return of menses. Fortnightly follow-up occurred in the women's homes. Main Outcome Measure(s): Breast-feeding frequency by day (and by night); 24-hour breast-feeding duration, percent of all infant feedings that were milk/milk-based (and solid/semisolid foods); time until the end of full breast-feeding; time until regular supplementation; and time until the end of lactational amenorrhea. Result(s): Differences between the centers in the duration of amenorrhea were substantial, ranging from a median of 4 months in New Delhi (India) to 9 months in Chengdu (China). Women in developed countries (but also women in Chengdu) were more likely to delay supplementation (for up to 5 months), whereas women in Santiago (Chile), Guatemala City (Guatemala), and Sagamu (Nigeria) started supplements much earlier, sometimes as early as 1 week after birth. Conclusion(s): Both breast-feeding behavior and the duration of lactational amenorrhea vary markedly across settings, indicating that breast-feeding promotion and family planning advice should be site- and culture-specific.