Breastfeeding Abstracts from LLLI, May 1997, volume 16 no. 4

The duration and character of postpartum bleeding among breast-feeding
women. CM Visness, LI kenniedy and R. Ramos, Obstet Gynecol 1997; 89:159-63

mini version: 26% of 477 women who fit the LAM (by Labbok) breastfeeding
criteria experienced a "sixth week bleed"  and 10 of those resumed normal
cycling with that bleed, the rest became fertile with earlier return of
menses at average of 36 weeks PP vs 41 weeks for those who did not have 6th
week bleeds.


Fertility of fully breast-feeding women in the early postpartum period. CM
Visness, KI Kennedy, BA Gross, et al. Obstet Gynecol 1997; 89:1164-67

73 women (from sydney australia, birmingham england and montreal canada)
followed for relation of bleeding episodes prior to 56 days pp to early
return of fertility.. 33 women (46%) had some bleeding 6-8 weeks pp and had
earlier return of menses -- 28 weeks pp vs 33 weeks for the non bleed group,
5 had follicular development prior to second subsequent bleed.

As an aside, at a recent LLL meeting, of the 15 bfing women present, 5 of us
had "early" return of menses -- I had asked Miriam Labbok about this
personally at the LLLI conference and she said that for reasons unstudied
yet, about 30% of "fully" bfing women will experience early return of menses
and not benefit from the LAMethod... this number 30% has held true now if 4
separate meetings of women who all practice the "ecological" bfing
guidelines in LAM, not scientific, but getting more and more interesting as
I keep track mentally.

I've also heard weight of mother and nutritional status linked to fat stored
estrogen levels being the root of early return (a study of west african
women as I recall), but I know just as many thin american women with early
return.

Anyone know of any more research? I smell a wonderful new avenue of research
here!!! I've got all kinds of ideas about what to look at and what
parameters to use. From talking to many moms "like me" it's more than suck
patterns, more than fat or not; hormones, thyroid or other glandular
concerns, genetics, maybe a combination of these??? but it's not simple for
sure.

The important thing for me as a LLLL, giving mother to mother support is
helping mom's not to think they've "failed" themselves or their babies by
"not breastfeeding right." When early return is written off as "not sucking
correctly, long enough, often enough, etc" even though their next door
neighbor has the same "bad habits" but got 15 months of amenorrhea it's
really hard on moms.

I also think it's important to look at like cultures when making predictions
about average lenth of amenorrhea -- comparing the amenorrhic status of
women with much different social/cultural breastfeeding norms doesn't help
moms have accurate information or understand what they are really making
choices about within the framework of the culture they live in.

in my, as always, my not so very humble opinions,
Anne E. Robb, MAT, LLLL
Off on a Tangent, Oregon, USA
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