Bracher M
Health Transition Centre, Canberra, Australia.
Health Transit Rev. 1992 Apr;2(1):19-47.
While the nutritional, immunological and anti-bacterial benefits of breast milk are incontestable, the contraceptive effect of breastfeeding is more apparent in the aggregate than at the level of the individual. Nevertheless, it has recently been recommended that lactating women not consider adopting contraception until the earliest of their first post-partum menstruation, the introduction of supplementary feeding or their child's reaching six months of age. This article employs microsimulation to quantify the implications of this recommendation for the spacing of births and, in particular, for the proportion of birth intervals that are unacceptably short. The findings are not encouraging. The implementation of this protocol would not produce better birth spacing than a simpler strategy of initiating contraception early in the post-partum period and, unless implemented perfectly, the outcomes would be considerably worse. Breastfeeding should be viewed not as a method of birth control but as the best form of infant nourishment. Efficient contraception is the best way to ensure that children in modernizing societies can reap the benefits of breastfeeding, without being endangered by being weaned too early because of a new pregnancy.
虽然母乳在营养、免疫和抗菌方面的益处无可争议，但母乳喂养的避孕效果在总体上比在个体层面更为明显。然而，最近有人建议，哺乳期妇女在产后最早出现月经、开始添加辅食或孩子满六个月之前，不应考虑采用避孕措施。本文采用微观模拟方法来量化这一建议对生育间隔的影响，特别是对过短生育间隔比例的影响。研究结果并不乐观。实施这一方案不会比在产后早期就开始采取避孕措施的简单策略产生更好的生育间隔，而且除非完美实施，否则结果会更糟。母乳喂养不应被视为一种节育方法，而应被视为婴儿营养的最佳形式。有效的避孕措施是确保现代化社会中的儿童能够获得母乳喂养的益处，而不会因新的怀孕而过早断奶面临危险的最佳方式。
