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A biobehavioral model for breastfeeding effects on return to menses postpartum in Javanese women.

This paper examines the effects of nursing behavior on the duration of lactation amenorrhea in 382 rural Indonesian women who experienced resumption of menses while breastfeeding or were breastfeeding and amenorrheic at the end of a 2-year prospective study. 3 primary breastfeeding variables (number of night-time nursing bouts number of day-time nursing bouts and minutes per bout) were used to develop a behavioral model for breastfeeding. 4 breastfeeding patterns were identified for these women. These were designated as: 1) low intensity 2) medium-low intensity 3) medium-high intensity and 4) high intensity breastfeeding behavior. Menses resumed at medians of 11.2 16.0 17.6 and 20.8 months respectively for these groups. The relationships among the breastfeeding variables in the behavioral model and return to menses were developed and tested by life table and proportional hazards models. 10% of the high intensity breastfeeding group (6 women) delayed menses between 33 and 52 weeks while 90% (56 women) postponed return of menses for over 1 year. (authors)