Lactational amenorrhea in urban poor women and its implications for use of contraception
Kumar, S.; Reddaiah, V.P.
Indian Pediatrics 25(10): 987-992
1988
ISSN/ISBN: 0019-6061 PMID: 3266867 Document Number: 363579
543 mothers of children under 3 years of age, from an urban resettlement neighborhood of New Delhi were interviewed concerning length of lactation, amenorrhea, subsequent pregnancy and contraceptive use. The interview was based on a pretested, structured, semi-open tool. By 18 months after birth, 96.3% of lactating, and 97.9% of non-lactating mothers were menstruating. In the overall group, 52.9% of lactating, and 93.2% of nonlactating mothers were menstruating. 14% had conceived; 5.3% during amenorrhea. The birth interval between the index and penultimate child was 2 years or less in 20% and 2-3 years in 40%. 17.8% were using contraception, and 33% had been sterilized. Since about 5% conceived during lactation, lactation is about as effective as oral contraception when used in developing countries. Lactation alone, however, is not adequate for contraception, and must be supplemented by artificial contraception. WHO recommends that the 25th to 50th percentile of time of resumption of menstruation in a given population be used as the time to suggest contraception. This would be between 6.5 and 10.5 months for these lactating subjects, or 2.5 months if not breastfeeding. Condoms or injectables are recommended for use during breastfeeding.