| Abstract: | Although breastfeeding makes a major contribution to fertility control and child spacing in many developing countries, the implications of this are not widely recognized. Terminology may be part of the reason. Contraception may imply something modern, whereas the contraceptive effect of breastfeeding is a natural biological mechanism. Also, many family planning program managers are educated in the West, where breastfeeding is of little contraceptive importance. Regardless of where they were educated, they may consider the pregnancy-postponing effects of breastfeeding as mythology, or may consider breastfeeding as sufficiently effective at the individual level. Breastfeeding as a family planning method cannot be "delivered" to women by family planning methods, and requires an educational approach rather than a clinical or medical approach. A women might use breastfeeding more confidently in avoiding an unplanned pregnancy if she begins using a contraceptive method as soon as she resumes menses, when she begins giving her baby food supplements, or by 6 months post partum--whichever comes first. She can achieve high effectiveness in avoiding pregnancy by keeping the baby nearby and feeding on demand, feeding frequently, sleeping near the baby and maintaining nightfeedings, not giving the baby bottles or pacifiers, and giving the baby only breastmilk for at least 4 months. Breastfeeding can only be used by new mothers and cannot be used to postpone the 1st birth. Nor is it appropriate for women who have attained their desired family size, or who wish to avoid or postpone pregnancy at any cost. |
