Council Commentary

World Breastfeeding Week: Leveraging the Use of Contraception to Optimize the Effects of Breastfeeding

Photo credit: World Bank

As we commemorate World Breastfeeding Week (August 1-7, 2016), let’s take a moment to recognize the importance of breastfeeding for mothers, babies and families around the world.  Breastfeeding contributes greatly to early childhood development with many short- and long term nutritional benefits for infants and children.  It also benefits the mothers, providing stronger protection against certain cancers and other health risks. It also helps to delay additional pregnancies acting as an effective contraceptive in the first six months.

We know that exclusive breastfeeding, defined as breast milk only -- no additional food or liquids, including water - for the first four to six months of an infant’s life provides essential nutrition for babies to thrive.  And for mothers, we know the longer she breastfeeds, the stronger her protection is against ovarian and breast cancers, hip fractures, and cardiovascular disease as she ages.  While a woman is exclusively breastfeeding, she is unlikely to become pregnant. This is known as the Lactational Amenorrhea Method (LAM). LAM can also be an effective contraception strategy if the following three criteria are completely adhered to:

  1. The mother is breastfeeding on demand, day and night, without providing any other supplemental food or drinks for the baby;
  2. The woman’s menstrual cycle has not returned since childbirth;
  3. The baby is less than 6 months old.

However, many women may not want to, or cannot, exclusively breastfeed for 6 months postpartum, yet may want to space their next pregnancy, and therefore would benefit greatly from effective strategies to help delay pregnancy.  A reliable, low-maintenance contraceptive which complements LAM may be an attractive and feasible solution for women looking to delay pregnancy.  It would allow women time to recover from pregnancy and focus their attention on their newborn until they are ready to conceive again.  And preventing a new pregnancy would also help maintain an adequate supply of breast milk for optimal child development.  New technologies, such as the three-month progesterone contraceptive vaginal ring could provide women with a safe, effective, user-initiated contraceptive option.

Recommending a woman to breastfeed as long as she can, delaying her next pregnancy with LAM and any other contraception will pose a great benefit to her immediately as well as throughout her lifetime.  Through adequate nutrition, infant and child mortality rates will drop significantly. With greater confidence in children’s survival, parents can utilize contraception to focus on investing more into making the right choices for their families.