Maternal and child nutritional status: Its association with the risk of pregnancy

Breastfeeding reduces the interval between births by its effect on prolonging the period of postpartum anovulation and in some cases, reducing the likelihood of conception once ovulation has occurred. Extended durations of postpartum amenorrhea (18 months and longer) are observed among many women in developing countries, while shorter durations (6 months or less) are common among women in developed countries. This differential effect has been suggested to be related to maternal nutritional status, but numerous other factors also differ. This paper reviews the literature in this area, and suggests that most studies indicate a small and demographically insignificant effect of maternal nutritional status on the period of postpartum amenorrhea. Factors associated with suckling patterns appear to be more important in determining the length of postpartum infertility. Suckling frequency and intensity which affects the hormonal stimulus preventing ovulation appear to be affected by the type of and how supplemental feeding is given to the child (use of bottles), whether suckling is on demand or scheduled, the frequency of night-time feedings (influenced by whether or not the mother sleeps with the child), whether or not pacifiers are used, and the child's nutritional and health status.