The contraceptive potential of breastfeeding in Bangladesh.

A consensus statement issued by the World Health Organization and the United Nations Children's Fund at the Bellagio conference in 1988 recommended that women begin practicing contraception six months after childbirth or when their menstrual cycle resumes, whichever occurs first. The question to be resolved is whether this approach, known as the Bellagio mixed-t strategy, should be adjusted to local patterns of lactational amenorrhea. Data from interviews with 4,580 Bangladeshi women with a currently open birth interval were analyzed with respect to the women's current status of breastfeeding, amenorrhea, contraception, and pregnancy. Pregnancies among breastfeeding, amenorrheic women occurred only beyond 12 months postpartum, while some menstruating women were observed to be pregnant from three months postpartum onward. The results of this study give evidence that the Bellagio recommendation can be best applied with country-specific adjustments. Bangladesh, for example, could safely adopt a strategy with a 12-months' cutoff point.