Fertility After Childbirth: Pregnancy Associated With Breast Feeding

Abstract

During studies on the resumption of fertility postpartum in 12 breast feeding mothers who were using no contraception, eight pregnancies occurred. In seven cases these pregnancies occurred while the mothers continued to breast feed while in one it occurred within 2 weeks of weaning. In two cases pregnancy occurred prior to first postpartum menstruation but followed an abrupt decline in suckling frequency and duration resulting in resumption of follicular development and ovulation. In the remaining six cases, pregnancy was preceded by between 1 and 7 menstrual cycles, the majority of which (13/19) had deficient luteal phases or were anovular (4/19). In all mothers a significant decrease in the suckling frequency and duration observed during lactational amenorrhoea had occurred prior to the resumption of ovulation and conception. No mother conceived with a suckling frequency of greater than three times per day although some mothers ovulated without conceiving when suckling four times per day. The results suggests that if a breast feeding mother wishes to rely upon the infertility associated with lactational amenorrhoea, she must suckle at least five times per day with a total suckling duration of more than 65 min per day (more than 10 min per feed). Any reduction below either of these limits may result in a return of fertility.

Direct in vivo effects of leptin on ovarian steroidogenesis in sheep

“…anorexia nervosa; Katz & Vollenhoven 2000) whereas over-nutrition and obesity are generally associated with impaired folliculogenesis, reduced oocyte quality and embryonic failure (Crosignani et al 1994, Norman & Clark 1998, Bellver et al 2003. Further, the duration and severity of post-partum anovulation is directly associated with the nutritional status of the mother and the amount of nutritional supplementation (milk) provided to the suckling young (McNeilly et al 1983, Butler & Smith 1989. Finally, nutrition profoundly affects the presentation and natural history of polycystic ovary syndrome, which is known to affect 5 -10% of women of reproductive age and is the most common cause of anovulatory infertility (Franks 1995).…”

Os benefícios da amamentação para a saúde da mulher

“…32,33 Among Scottish women, it has been observed that ovulation does not occur while the infant is being breastfed for at least six times for a total of 65 minutes distributed in 24 hours. 34 However, other studies have not confirmed this finding, and they have suggested that there is not a minimal number of feedings that guarantees the ovulation interval. 35 Once any other kind of liquid is introduced in the infant s diet, the infant tends to suck less because his hunger and thirst are partially appeased by these liquids.…”

“…[23][24][25][26][27] Many studies have presented the relationship between breastfeeding and postnatal amenorrhea, and the occurrence of a consequent longer intergestational period. 10,[28][29][30][31][32][33][34][35][36][37][38][39][40][41] Other benefits for lactating women are the faster loss of weight gained during the pregnancy, [38][39][40][42][43][44][45] and the reduced postnatal uterine bleeding, which leads to less anemia 10 due to the faster uterus involution caused by the greater oxytocin release. 46 If compared to the advance of the knowledge about the role played by breastfeeding and the human milk in the infants health, the knowledge about the benefits of breastfeeding for women is scarce, and, therefore, this topic must be further investigated in the next decades.…”

A select issue in the postpartum period: contraception

“…14,16,17 Lactational amenorrhea can be used as an effective method of contraception provided the woman is exclusively breastfeeding (on demand, day and night more than 5 times per day, total suckling duration greater than 65 minutes, and at least 10 minutes per feed), 35 has not resumed menses and is within six months of delivery. 16,23,27 This method, when used properly, is at least 98% effective during the first 6 months postpartum.…”