Breast-feeding and post-partum amenorrhoea in Indonesia
Jones, R.E.
Journal of Biosocial Science 21(1): 83-100
1989
ISSN/ISBN: 0021-9320 PMID: 2925702 DOI: 10.1017/s0021932000017740Document Number: 359940
A prospective study on the relationship between breastfeeding patterns and postpartum resumption of menses among Indonesian women collected data on suckling patterns and menstrual status from 444 women once a month for 2 years. The breastfeeding variables of minutes per episode, number of episodes a day, number of episodes per night, and minutes per 24 hours were derived for each woman, giving the average nursing pattern up to menses or the end of the study (whichever occurred 1st). To eliminate bias, separate analyses were conducted for women whose infant died, women who did not lactate, and those who weaned before the return of menses. The median interval from pregnancy to menses was 2.56 months in the nonlactating group. Women who weaned before menses had a median interval from weaning to menses of 3.42 months. Those with infant mortality before menses had a median wait time from infant death to menses of 2.14 months. The relative contribution of suckling patterns to postpartum resumption of menses was investigated directly in only 390 of the women who experienced return to menses while breastfeeding or were amenorrheic and breastfeeding when the study ended. Of these women, 260 had experienced the return of menses while breastfeeding, with a mean duration of amenorrhea of 17.26 months. Women who nursed little during the day, and for shorter durations, and little during the night, significantly increased their risk of early postpartum return of menses. Those women who nursed either frequently during the day, or for longer episodes (but not both), prolonged amenorrhea just slightly beyond the 17.26 month mean. Women who nursed either frequently during the night, or for longer episodes, prolonged amenorrhea on average somewhat less than the population mean. Women in the groups who nursed both for longer episodes and more often during the day, or who nursed both for longer episodes and more often at night, significantly reduced their risk of menstruating early in the postpartum period. On average, the delay in return of menses for these 2 groups was 7-8 months longer than for women nursing intensely.