We aimed to compare 3-month postdelivery breastfeeding and infant growth parameters between women who underwent immediate postpartum implant or copper intrauterine device (Cu-IUD) insertion. Methods: This is a secondary analysis of a prospective cohort study of 171 Malawian women who underwent immediate postpartum insertion of the implant or Cu-IUD between September 2014 and March 2015. The study's primary objective was to compare contraceptive continuation rates between implant and Cu-IUD users 1 year postdelivery. For this secondary analysis, we used Fisher's Exact Test and t tests to compare the breastfeeding and infant growth parameters of women with a singleton pregnancy and live infant at their 3-month postdelivery survey. Results: Some 122 women (71%) completed the 3-month postdelivery survey, and 108 women (61%) were eligible for this secondary analysis: 10 Cu-IUD and 98 implant users. All women (100%) reported that they were breastfeeding, with no significant difference in exclusive breastfeeding (90% for Cu-IUD vs. 93% for implant, p=.55). There were also no significant differences in infant weight (6.3 kg for Cu-IUD vs. 6.2 kg for implant, p=.69), length (60.8 cm for Cu-IUD vs. 59.6 cm for implant, p=.42) or head circumference (40.9 cm for Cu-IUD vs. 41.2 cm for implant, p=.74). Conclusions: Almost all women were still exclusively breastfeeding at 3 months postdelivery, with no differences in infant growth between implant and Cu-IUD users, although sample size limited our power. The high rate of exclusive breastfeeding at 3 months in both groups suggests that both options should be offered to postpartum women who want to prevent short interpregnancy intervals.
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