Breastfeeding and fertility.
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Cancer as a natural stochastic phenomenon and disease can be promoted by many non-specific factors, including also such gynecological ones as: 1. faulty prediction and determination of birth date: 2. instrumental instead of possible natural labor; 3. reduction rather prolongation of lactation; 4. acceptation of early sexual life; 5. wrong hormonal therapy; 6. longlasting prescription of pills; 7. infrequent diagnosis and wrong therapy of hypothalamic conditioned abortions and premature deliveries; 8. clinical, colposcopic and cytologic false negative diagnosis of cervical cancer; 9. eradication of neoplastic lesion without normalization of environment, and 10, too radical and aggressive treatment of precancerous states. Medicine as no other field of human activity requires from the gynecologists the specific responsibility for conscientious constant acquisition of general knowledge to ensure the future of human species especially in conquering "cancer of mothers" and preventing "cancer of early sexual life".
The issues related to breast-feeding and problems of the puerperium are often obfuscated by the general but outdated practice of recommending cessation of lactation. This article examines recent literature (June 1991 to May 1992) on breast-feeding and the treatment of puerperal problems, emphasizing that breast-feeding may be maintained during virtually all treatment modalities. Additionally, the use of drugs to support or suppress lactation has been of interest, and the increased attention to the fertility impact of breast-feeding, breast-feeding and maternal health, and human immunodeficiency virus and breast-feeding has resulted in several new articles of note. In general, the recent study of breast-feeding has identified many positive side effects, while other articles confirm that the treatment for retained placenta, postpartum pain, and puerperal infection, as discussed in recent literature, do not contraindicate breast-feeding.
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The presence of lactational amenorrhoea cannot be fully relied upon to protect the individual mother against becoming pregnant. Nevertheless, the use of breast-feeding as a birth-spacing mechanism has important implications for global health policy. This article identifies the information that should be collected and examined as a basis for developing guidelines on how to reduce the dual protection afforded by postpartum lactational amenorrhoea and other family planning methods, and discusses when such methods should be introduced.
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Twenty-nine breast-feeding mothers and 10 non-breast-feeding postpartum comparison mothers from a rural area of Mexico were followed longitudinally until ovulation resumed. A simple set of guidelines is described involving three obvious milestones for the breast-feeding mother to safely use the natural contraceptive benefit of breast-feeding. Those milestones are: the first vaginal bleeding episode, the initiation of supplementation, and the child's monthly birthday. In the absence of bleeding and supplementation, 100% of breast-feeding mothers remained anovular for 3 months postpartum, 96% for 4 months, 96% for 5 months, and 96% for 6 months. This suggests that, if a mother understands these three conditions, she can use breast-feeding alone as effectively as modern family planning methods for the prevention of pregnancy.
Data on fertility and contraception in Micronesian women in the Marshall Islands were collected during a women's health survey in 1985. High total fertility rates were found. The reproductive pattern of many Marshallese women is one that has been associated with adverse health consequences: pregnancies in teenagers and in women over 39 years, high parities of four or more births, and short birth intervals. The practice of breastfeeding is declining in younger women. The prevalence of contraceptive use is low, and the availability of reversible methods is limited. Most contraceptive nonusers would like to practice contraception, but are inhibited by the lack of information about family planning. It is suggested that more attention needs to be given to family planning services in the Marshall Islands, in particular to improving the availability of reversible methods of contraception and of information about family planning. Further research is also needed on how family planning services might best be organized to maximize participation by women and their partners who wish to use such services.
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It has long been recognized that women who breastfeed their children have a longer period of amenorrhea and infertility following delivery than do those women who do not breastfeed. The length of postpartum amenorrhea is quite variable, and depends on several factors, including maternal age and parity, and the duration and frequency of breastfeeding. In general, it would appear that the more frequent and the longer the episodes of breastfeeding, the longer will be the period of anovulation, and the longer the period of infertility.
This paper presents data on contraceptive use and fertility in Honduras obtained from a household survey conducted in 1984, and compares these data with similar information obtained from surveys carried out in 1981 and 1983. About half of the increase that has taken place in contraceptive use in Honduras is accounted for by sterilization. In 1981, 27 percent of women in union aged 15-49 years were practicing contraception; in 1984, the percentage of those 15-44 was 35 percent. The increase in urban areas was smaller (from 47 percent to 51 percent) than in rural areas (from 16 percent to 24 percent). Also, fertility remained almost unchanged in urban areas while declining in rural areas. Information from questions on place of purchase, price, and brand of contraceptive (for orals) was used to determine source of supply. The use of multiple questions to determine source results in a higher percentage of contraceptive use attributed to the Honduran Family Planning Association as compared with answers to a single question. The duration of breastfeeding in Honduras has increased, with the greatest changes occurring among women in urban areas and women with the highest levels of education. Efforts have been made to promote breastfeeding in urban areas and these results suggest that the efforts have been successful.
Data that were collected prospectively from a child health study conducted in Gaza show a strong relationship between breastfeeding and two major components of birth intervals, the postpartum anovulatory period and the waiting time to conception. The Gaza population is similar to other populations in the Middle East in having moderate durations of breastfeeding and short intervals between births. The finding of a strong positive association between breastfeeding and the length of postpartum amenorrhea is as expected from numerous other studies. The relationship between breastfeeding behavior and the waiting time to conception is examined using hazard model analysis. Women who are breastfeeding when menstruation resumes and continue to do so are less likely to conceive than other women, according to the analysis.