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Breastfeeding duration related to practised contraception in the Netherlands

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Author: Wouwe, J.P. van · Lanting, C.I. · Dommelen, P. van · Treffers, P.E. · Buuren, S. van
Type:article
Date:2009
Institution: TNO Kwaliteit van Leven
Source:Acta Paediatrica, International Journal of Paediatrics, 1, 98, 86-90
Identifier: 241342
doi: doi:10.1111/j.1651-2227.2008.01019.x
Keywords: Health · Jeugd en Gezondheid · Breastfeeding duration · Epidemiology · Imputation · Lactation · Practised contraception · Levonorgestrel · Oral contraceptive agent · Adolescent · Adult · Artificial milk · Barrier contraception · Condom · Hormonal contraception · Infant feeding · Lactation inhibition · Maternal behavior · Netherlands · Ovulation inhibition · Puerperium · Adolescent · Adult · Breast Feeding · Confidence Intervals · Contraception Behavior · Contraceptive Agents · Female · Humans · Lactation · Maternal Behavior · Middle Aged · Netherlands · Odds Ratio · Questionnaires · Time Factors · Young Adult

Abstract

Aim: The aim of this study was to gain insight into contraception practised and related to breastfeeding duration. Methods: Mothers with infants up to 6 months received a questionnaire on infant feeding (breast or formula feeding) and contraception (hormonal or non-hormonal methods). Estimates of the time interval between resuming contraception and cessation of lactation was calculated by Chained Equations Multiple Imputation. Results: Of all women (n = 2710), 30% choose condoms, 22% the combined oral contraceptive pill (OCP) and few other methods. Breastfeeding was started by 80%, and 18% continued up to 6 months. Of the breastfeeding mothers, 5% used hormonal contraception; 7% of women who used hormonal contraception practised breastfeeding. After adjustment for background variables, the use of OCP is strongly associated with formula feeding: after delivery to the third month postpartum, the crude OR being 17.5 (95% CI: 11.3-27.0), the adjusted OR 14.5 (9.3-22.5); between the third and sixth month postpartum, respectively, 13.1 (95% CI: 8.6-19.9) and 11.7 (7.6-17.9). Of all breastfeeding women, 20-27% resumed OCP at 25 weeks postpartum and 80% introduced formula feeding. The time lag between these events is 6 weeks. Hormonal contraception was resumed after formula introduction. Conclusion: Mothers avoid hormonal contraception during lactation; they change to formula feeding 6 weeks before they resume the OCP. To effectively promote longer duration of breastfeeding, the BFHI needs to address contraception as practised. © 2008 The Author(s).