Capital Ob/Gyn, Sacramento, CA, USA.
Clinical and Translational Science Center, University of California, Davis Health, Sacramento, CA, USA.
J Hum Lact. 2023 Feb;39(1):158-167. doi: 10.1177/08903344221108384. Epub 2022 Jul 4.
There continues to be controversy regarding the simultaneous encouragement of both breastfeeding and immediate postpartum contraception.
To explore postpartum women's perspectives about breastfeeding and their breastfeeding behaviors, while using one of three different hormonally systemic contraceptive methods immediately postpartum over a 6 month period of time.
This was a retrospective, longitudinal, three group comparative, secondary analysis of a prospective cohort study ( = 471) of immediate postpartum contraception. Breastfeeding, for this study, was defined as providing any human milk to the infant. Participants who chose one of three different hormonally systemic forms of contraception immediately postpartum (a long-acting hormonal reversible contraceptive ( = 200), depot medroxyprogesterone acetate 150 mg ( = 98), or a non-hormonal method ( = 173)) were compared at hospital discharge, 6 weeks, 3 months, and 6 months postpartum. The primary outcome was any breastfeeding at 6 months. Secondary outcomes included any and exclusive breastfeeding, concerns about breastfeeding while using contraception, and reasons for breastfeeding discontinuation.
There was no significant difference in the rate of any breastfeeding between the two hormonal and the non-hormonal contraceptive groups at 6 months postpartum (long-acting hormonal 20.1%, non-hormonal 21.7%, depot medroxyprogesterone acetate 13.9%, = .77, 0.28, respectively). The number of participants who reported stopping breastfeeding due to decreased milk supply was not significantly different between any groups at all time points (total number who discontinued at 6 months postpartum was long-acting hormonal 24.7%, non-hormonal 25.1%, depot medroxyprogesterone acetate 19.3%, = .30).
Breastfeeding perspectives and behavioral outcomes over the first 6 months postpartum were not influenced by participants chosen form of immediate postpartum contraception.
关于同时鼓励母乳喂养和产后即时避孕，仍存在争议。
在 6 个月的时间内，探讨产后妇女对母乳喂养的看法及其母乳喂养行为，同时使用三种不同的激素系统避孕方法中的一种。
这是对一项前瞻性队列研究（= 471）的回顾性、纵向、三组比较、二次分析，该研究探讨了产后即时避孕。对于本研究，母乳喂养被定义为向婴儿提供任何人类母乳。选择三种不同激素系统避孕方法之一的产妇（= 200 例长效激素可逆避孕法、= 98 例 depot 甲羟孕酮 150mg 避孕法、= 173 例非激素避孕法）在出院时、6 周、3 个月和 6 个月时进行比较。主要结局为 6 个月时的任何母乳喂养。次要结局包括任何和纯母乳喂养、使用避孕措施时对母乳喂养的担忧以及停止母乳喂养的原因。
在产后 6 个月时，两种激素避孕组和非激素避孕组的任何母乳喂养率均无显著差异（长效激素组 20.1%、非激素组 21.7%、 depot 甲羟孕酮组 13.9%，=.77，0.28）。在所有时间点，因奶量减少而停止母乳喂养的参与者人数在任何组之间均无显著差异（6 个月时总停止母乳喂养人数长效激素组 24.7%、非激素组 25.1%、 depot 甲羟孕酮组 19.3%，=.30）。
产后头 6 个月的母乳喂养观点和行为结果不受参与者选择的即时产后避孕方法的影响。
