The World Health Organization Multinational Study of Breast-feeding and Lactational Amenorrhea. III. Pregnancy during breast-feeding
Von Hertzen, Helena
Fertility and Sterility 72(3): 431-440
1999
ISSN/ISBN: 0015-0282 DOI: 10.1016/s0015-0282(99)00274-5Document Number: 523529
Objective: To determine the risk of pregnancy during lactational amenorrhea relative to infant feeding status. Design: Prospective longitudinal study. Setting: Five developing and two developed countries. Patient(s): Four thousand one hundred eighteen breast-feeding mother-infant pairs. Intervention(s): Infant feeding practices, menstrual status, and pregnancy were measured. Main Outcome Measure(s): Life-table rates of pregnancy. Result(s): In the first 6 months after childbirth, cumulative pregnancy rates during amenorrhea, depending on how the end of amenorrhea was defined, ranged from 0.9% (95% confidence interval (CI) = 0%-2%) to 1.2% (95% CI = 0%-2.4%) during full breast-feeding, and from 0.7% (95% CI = 0.1%-1.3%) to 0.8% (95% CI = 0.2%-1.4%) up to the end of partial breast-feeding. At 12 months, the rates ranged from 6.6% (95% CI = 1.9%-11.2%) to 7.4% (95% CI = 2.5%-12.3%) during full breast-feeding, and from 3.7% (95% CI = 1.9%-5.5%) to 5.2% (95% CI = 3.1%-7.4%) up to the endof partial breast-feeding. Conclusion(s): These results support the Bellagio Consensus on the use of lactational amenorrhea for family planning, and confirm that the lactational amenorrhea method is a viable approach to postpartum contraception.