Breastfeeding
Winikoff, B.
Current Opinion in Obstetrics and Gynecology 2(4): 548-555
1990
ISSN/ISBN: 1040-872X PMID: 2130952 Document Number: 377428
Standards for research and study design which allow the study of health effects of breastfeeding and its role in controlling fertility have been developed. Better designed studies and evaluations of breastfeeding promotion programs guide health policy makers to promote and protect breastfeeding. Currently, most breastfeeding surveys do not provide many details. They do not address bottle feeding, night feeding, supplementation patterns, and frequency of feeding. International standards deem exclusive breastfeeding adequate for 4-6 months, but the evidence is not clear whether that means mothers should start supplementing at the end of 3 months or at the end of 6 months. The median time for faltering in exclusively fed infants in Jordan was 6 months. 25% grew adequately for 9 months, yet 20% began to falter at 4 months. Breast milk protects against diarrhea (especially cholera and shigellosis) and respiratory infections. Exclusive breastfeeding provides the most protection against infection; partial breastfeeding also provides more protection than not breastfeeding at all. Heating appears to destroy the protective factors. Breastfeeding also plays a key role in regulating fertility. It significantly delays ovulation in postpartum women. Introduction of supplementary food causes a fall in suckling frequency and duration. Moreover in 98% of lactating women, 1st ovulation followed the introduction of supplementary foods. Thus health workers should advise lactating women to begin contraception, such as IUDs or progestin-only oral contraceptives, after 6 months, since breastfeeding protects them from pregnancy during the 1st 6 months postpartum. In developing countries, there has been a trend away from breastfeeding especially for mothers who stay at home whereas, in developed countries, the opposite is true.