Egyptian Women Would Accept Breastfeeding as Family Planning Method: More Community Education Needed – April 30, 2004

Research Triangle Park, NC – A new study suggests that prolonged breastfeeding would be widely acceptable among Egyptian women as a method of preventing pregnancy and spacing births. However, more community education is needed to inform nursing mothers about the lactational amenorrhea method (LAM) and how to use it most effectively.

International studies, including one from the World Health Organization, show that LAM is more than 98 percent effective as a contraceptive if a woman meets the following criteria: She is fully or nearly fully breastfeeding, she has been amenorrheic (without menses) since childbirth, and she is no more than six months postpartum.

In the April 2004 issue of the journal Contraception, researchers from Ain Shams University in Cairo, the National Population Council in Cairo, and U.S.-based Family Health International (FHI) describe results of a study to evaluate the potential of LAM as a family planning method among breastfeeding Egyptian mothers.

Results showed that breastfeeding is very common among Egyptian mothers and that many of them meet the criteria for using LAM. Yet, a large proportion of these women do not report using breastfeeding as a contraceptive and may not understand exactly how to do so.

"The study revealed that LAM could be a reasonable and suitable method for women who need birth spacing immediately postpartum," says study investigator Dr. Hoda Ibrahim Fahim, professor of community medicine at Ain Shams University. "So health providers, especially at primary health care centers, rural units, and maternal and child health centers, can now educate women about the method and the multiple benefits of using it," she says.

LAM is simple and inexpensive, has no side effects, and decreases postpartum bleeding for women. For infants, it can help ward off infections, is a good source of nutrition, and decreases exposure to bacteria and other potentially harmful organisms in water and other formulations.

"If used properly, LAM can prevent pregnancy, and thus help women space births, for up to six months after delivery," says co-author Dr. Adel Hakim Issa, a biomedical research consultant with the National Population Council at the time of the study. "After that, breastfeeding can continue for up to 18 months or more, but women must switch to another method of contraception," he says. According to Dr. Issa and co-authors, health providers can consider giving women advance supplies of contraceptives so that they can begin using them at six months postpartum, or sooner if their menses resume, without returning to a clinic.

The study was conducted in two parts. First, the researchers analyzed data from more than 5,000 young mothers who had participated in Egypt's 1995 Demographic and Health Survey, which is used to collect information on family planning and other reproductive health issues to help plan, monitor, and evaluate health programs within the country. The second part included eight focus group discussions with 77 breastfeeding women who took part in the survey.

Eighty percent of the women in the survey reported breastfeeding their infants for at least six months. And, more than a third of women who were breastfeeding infants younger than six months and reported using no other method of contraception met all the criteria for LAM. However, only 4 percent of these women reported using breastfeeding as a contraceptive. Focus group discussions also showed that many women knew the contraceptive benefits of breastfeeding but that their knowledge of LAM as a contraceptive method -- and how to use it -- varied widely.

Additional co-authors of the study are Dr. Akila Khella and Dr. Mohsen Gadalla of Ain Shams University and Dr. David Sokal of FHI.

For more information on LAM, see http://www.linkagesproject.org/ and FHI's topic page on LAM. To read more about FHI's work in Egypt, click here.  

Source

Khella AK, Fahim HI, Issa AH, Sokal DC. Lactational amenorrhea as a method of family planning in Egypt. Contraception 2004;69(4):317-322.

Family Health International is dedicated to improving lives, knowledge, and understanding worldwide through a highly diversified program of research, education, and services in family health and HIV/AIDS prevention and care. Since our inception in 1971, FHI has formed partnerships with national governments and local communities in countries throughout the developing world to support lasting improvements in the health of individuals and the effectiveness of entire health systems.