Breastfeeding as a family planning method.

Prompted by declines in average durations and proportions of women breast feeding in several developing countries, international organizations have placed breast feeding promotion high on their health policy agendas. Breast feeding can prolong the length of the birth interval directly through its ability to cause lactational amenorrhea and anovulation. Maintenance of lactational amenorrhea depends, however, on frequent intervals (at least 6 feeds/day) of high intensity (15 minutes on each breast). Breast feeding also enhances child survival through good nutrition and protection from infection. Urban residence, maternal education, and use of modern contraceptives have been associated, in developing countries, with lower levels of breast feeding initiation and duration. Changes in maternity services, including helping mothers to initiate breast feeding within 30 minutes of delivery, 24-hour rooming-in, and encouraging breast feeding on demand, are recommended to promote child survival. Also essential, to encourage breast feeding among working mothers, are policies to provide women with paid maternity leave and workplace-based child care.