Nutrition, lactation, and postpartum amenorrhea ,

Abstract

Findings on the influence of nutritional status and length of lactation on postpartum amenorrhea are reviewed. Evidence suggests that poor nutrition lengthens (and maternal nutritional supplements shorten) the length of postpartum amenorrhea. The duration of lactation is positively associated with the duration of postpartum amenorrhea. For the same duration of lactation mothers from a low socioeconomic group have a longer postpartum amenorrhea than those from a high socioeconomic group; nutrition could be a factor. The mechanisms by which lactation affects ovulation are not understood. Although poor nutrition increases the length of postpartum amenorrhea and thus the infertile period improving maternal nutrition might not result in increased fecundity because 1) better nutrition may bring on longer lactation and 2) better nutrition could reduce infant mortality. The increase in lactation could compensate for the shortening effect of nutritional improvement on postpartum amenorrhea and the increase in the number of surviving children could provide motivation to use family planning.