While in extreme cases, nutrition can play some role in the return to
fertility, it is fairly minimal and definitely plays far less of a role
than the decline in breastfeeding.

My sources on the nutrition and fertily issue are older - but they were
both excellent pieces of research.  One was a study done by Sandra Huffman
in Bangladesh that looked at BMI and fertility issues.  It really was only
in the extreme cases that there was an impact on fertily. The other was a
doctoral dissertation done by one of my friends when we were at Cornell.
Her research was on supplementation of women in Guatemala and return to
fertility.  The increased intake of nutritonal supplements only made a
difference of one month in the return of menstruation.  I don't have the
dissertation in front of me or any of the articles she published, but I
remember that the return of menstruation was around 15-18 months.

So, my sense of the situation from having worked in Africa is that it has
far more to do with urbanization and HIV than any changes in nutritional
status among women.

Best,

Susan Burger, MHS, PhD, IBCLC

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