OBJECTIVE: To detect differences between populations in both infant feeding practices and the duration of lactational amenorrhea, if they exist. DESIGN: Prospective, nonexperimental, longitudinal follow-up study. SETTING: Five developing and two developed countries. PATIENT(S): Four thousand one hundred eighteen breast-feeding mothers and their infants. INTERVENTION(S): Breast-feeding women collected ongoing information about infant feeding and family planning practices, plus the return of menses. Fortnightly follow-up occurred in the women's homes. MAIN OUTCOME MEASURE(S): Breast-feeding frequency by day (and by night); 24-hour breast-feeding duration, percent of all infant feedings that were milk/milk-based (and solid/semisolid foods); time until the end of full breast-feeding; time until regular supplementation; and time until the end of lactational amenorrhea. RESULT(S): Differences between the centers in the duration of amenorrhea were substantial, ranging from a median of 4 months in New Delhi (India) to 9 months in Chengdu (China). Women in developed countries (but also women in Chengdu) were more likely to delay supplementation (for up to 5 months), whereas women in Santiago (Chile), Guatemala City (Guatemala), and Sagamu (Nigeria) started supplements much earlier, sometimes as early as 1 week after birth. CONCLUSION(S): Both breast-feeding behavior and the duration of lactational amenorrhea vary markedly across settings, indicating that breast-feeding promotion and family planning advice should be site- and culture-specific.
OBJECTIVE: To detect differences between populations in both infant feeding practices and the duration of lactational amenorrhea, if they exist. DESIGN: Prospective, nonexperimental, longitudinal follow-up study. SETTING: Five developing and two developed countries. PATIENT(S): Four thousand one hundred eighteen breast-feeding mothers and their infants. INTERVENTION(S): Breast-feeding women collected ongoing information about infant feeding and family planning practices, plus the return of menses. Fortnightly follow-up occurred in the women's homes. MAIN OUTCOME MEASURE(S): Breast-feeding frequency by day (and by night); 24-hour breast-feeding duration, percent of all infant feedings that were milk/milk-based (and solid/semisolid foods); time until the end of full breast-feeding; time until regular supplementation; and time until the end of lactational amenorrhea. RESULT(S): Differences between the centers in the duration of amenorrhea were substantial, ranging from a median of 4 months in New Delhi (India) to 9 months in Chengdu (China). Women in developed countries (but also women in Chengdu) were more likely to delay supplementation (for up to 5 months), whereas women in Santiago (Chile), Guatemala City (Guatemala), and Sagamu (Nigeria) started supplements much earlier, sometimes as early as 1 week after birth. CONCLUSION(S): Both breast-feeding behavior and the duration of lactational amenorrhea vary markedly across settings, indicating that breast-feeding promotion and family planning advice should be site- and culture-specific.