Longitudinal study of breast-feeding and return of fertility
Chansri, B.
Journal of Thai Association for Voluntary Sterilization 1982: 17-21
1982
PMID: 12265674 Document Number: 407861
This article outlines the objectives, research design, procedures, laboratory investigation, termination of volunteer participation, and personnel of a longitudinal study of breastfeeding and return of fertility among Thai women. For a long time it has been recognized that the return of mentruation and fertility are delayed in women who are breastfeeding, and it has been suggested that breastfeeding acts as a natural fertility control. As there has been no study among Thai women in these matters and no study ever measured both suckling frequency and return of ovulation, a detailed investigation of these subjects was undertaken. The main objectives are as follows: to study the relationship between return of ovulation and fertility after childbirth and the pattern of breastfeeding; to determine whether the early introduction of supplementary food stimulates the early resumption of ovulation; and to examine the effects of other factors, such as resumption of menses and sexual practices ot the women, on the return of ovulation. The information obtained from this study will be applied in the following ways: to provide information and advice to breastfeeding women that will serve to maximize the antifertility effect of breastfeeding; to develop simple policies and guidelines that will help to determine the optimum time for breastfeeding women to start using contraception; and to obtain additional knowledge about the physiology of lactation, by defining the relationship between the endocrine changes during lactation, the infant feeding patterns, and the return of menses and ovulation. Volunteers will be selected from among the women who have decided not to use any contraception, but family planning methods will be provided if they wish to start. The study group will include 25 women who are breastfeeding their babies, and the control group will consist of 10 women who have decided not to breastfeed. All volunteers and their infants will undergo a thorough physical examination. A volunteer will maintain a daily record of the infant feeding, marking the chart with an easy symbol. A trained nurse will visit the volunteers in their homes once a week. Every week, the nurses will obtain a detailed history. A total overnight sample of urine will be taken to the laboratory and tested for levels of pregnanediol and creatine. The principal investigator will coordinate the study and will be responsible for appointing and supervising all the involved personnel.