title: Risk of ovulation during lactation.
abstract: 60 breastfeeding mothers in Baltimore and 41 in Manila recorded their infant feeding patterns daily, and gave additional information at weekly interviews. Ovarian activity was monitored by assays for hormone metabolites in daily urine samples. On average, women in Baltimore breastfed less often but for longer at each feed than women in Manila, and the mean times until ovulation were 27 and 38 weeks post partum. 41% of first ovulations had luteal phase defects. Anovular first menses were common (45.1%) during the first 6 months post partum but the rate fell greatly thereafter. The risk of ovulation was reduced by a higher frequency of breastfeeds, longer duration of each feed, and less supplementary feeding. During the first 6 months post partum, amenorrhoeic women had low risks of ovulation (below 10%) with partial breastfeeding, and exclusive breastfeeding reduced the risk to 1-5% with either frequent short feeds or infrequent longer feeds. However, if the woman started menstruating before 6 months post partum, or if she continued breastfeeding beyond 6 months, the risk of ovulation rose, and contraception would be needed.
authors.affiliation: Department of Population Dynamics, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205.
authors.forename: R H
authors.initials: RH
authors.lastname: Gray
authors.forename: O M
authors.initials: OM
authors.lastname: Campbell
authors.forename: R
authors.initials: R
authors.lastname: Apelo
authors.forename: S S
authors.initials: SS
authors.lastname: Eslami
authors.forename: H
authors.initials: H
authors.lastname: Zacur
authors.forename: R M
authors.initials: RM
authors.lastname: Ramos
authors.forename: J C
authors.initials: JC
authors.lastname: Gehret
authors.forename: M H
authors.initials: MH
authors.lastname: Labbok
mesh_terms: D000568:Amenorrhea; D000704:Analysis of Variance; D001942:Breast Feeding; D003267:Contraception; D004958:Estradiol / Q000031:analogs & derivatives / Q000652:urine; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007774:Lactation / Q000652:urine; D008183:Luteal Phase / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood; D008598:Menstruation; D010060:Ovulation / Q000502:physiology*; D010679:Philippines; D049590:Postpartum Period; D011247:Pregnancy; D011276:Pregnanediol / Q000031:analogs & derivatives / Q000652:urine; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors; D014481:United States
chemical_list: C025483:estradiol-17 beta-glucuronide; C022270:pregnanediol-3 alpha-glucuronide; D004958:Estradiol; D007986:Luteinizing Hormone; D011276:Pregnanediol