Abstract
Background: Lactational amenorrhea (LA) is a contraceptive method that suppresses ovulation postpartum through frequent and exclusive breastfeeding, with up to 98% effectiveness in the first six months if practiced optimally (Curtis et al., 2024). LA relies on consistent breastfeeding intervals and nipple stimulation, which inhibit gonadotropin-releasing hormone (GnRH) secretion (McNeilly, 2001). Factors such as supplemental feeding, breast pump use, and early return to work may reduce LA's efficacy (Stuebe & Chen, 2022). This review assesses the impact of various lactation practices on LA to provide current insights and support informed counseling on breastfeeding as a contraceptive method.
Methods: Following PRISMA guidelines (Page et al., 2021), a systematic review was conducted using nine databases to identify studies from 1988 to 2024 on lactation practices and their effects on LA. After screening, 29 studies were included, examining relationships between breastfeeding frequency, spacing, method (direct feeding, pumping), and the duration of LA. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool (Joanna Briggs Institute, 2020). Most included studies were conducted before the year 2000, with variations in methodologies and lactational behavior measures.
Results: Frequent direct breastfeeding, particularly when feedings are spread consistently throughout the day, significantly extends the duration of LA compared to partial or intermittent breastfeeding. Factors such as maternal age, infant feeding method, and return to work may influence the duration of amenorrhea. Recent studies suggest that while direct breastfeeding supports longer LA, the impact of breast pumps on LA requires further investigation (Kunwar et al., 2010; Stuebe & Chen, 2022).
Conclusions: This review highlights breastfeeding as an effective short-term contraceptive for postpartum individuals, with LA duration positively correlated with frequent, exclusive breastfeeding. The literature underscores a gap in knowledge regarding the effectiveness of breast pumping and its role in maintaining LA. Nurses should provide tailored guidance on LA, emphasizing frequent, exclusive breastfeeding to maintain its contraceptive efficacy. Expanded research on the effects of breast pumps on LA will further enhance postpartum contraceptive counseling.
Notes
References:
Curtis, K. M., Nguyen, A. T., Tepper, N. K., et al. (2024). U.S. selected practice recommendations for contraceptive use, 2024. MMWR Recommendations and Reports, 73(RR-3), 1–77. https://doi.org/10.15585/mmwr.rr7303a1
Joanna Briggs Institute. (2020). Checklist for systematic reviews and research syntheses. https://joannabriggs.org/ebp/critical_appraisal_tools
Kunwar, S., Faridi, M. M. A., Singh, S., Zahra, F., & Alizaidi, Z. (2010). Pattern and determinants of breast feeding and contraceptive practices among mothers within six months postpartum. Bioscience Trends, 4(4), 186-189.
McNeilly, A. S. (2001). Lactational control of reproduction. Reproduction, Fertility and Development, 13(7-8), 583-590. https://doi.org/10.1071/RD01056
Page, M. J., McKenzie, J. E., Bossuyt, P. M et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Stuebe, A. M., & Chen, M. J. (2022). Reproductive Function During Lactation. In Breastfeeding (pp. 651-661). Elsevier
Sigma Membership
Alpha Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Systematic Review
Research Approach
Other
Keywords:
Public and Community Health, Primary Care, Health Equity or Social Determinants of Health, Lactational Amenorrhea, Contraceptive Methods
Recommended Citation
Baker, Helen; Newton-Levinson, Anna; and Leslie, Sharon, "The Effects of Lactation Practices on Lactational Amenorrhea: A Systematic Review" (2025). International Nursing Research Congress (INRC). 264.
https://www.sigmarepository.org/inrc/2025/presentations_2025/264
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
The Effects of Lactation Practices on Lactational Amenorrhea: A Systematic Review
Seattle, Washington, USA
Background: Lactational amenorrhea (LA) is a contraceptive method that suppresses ovulation postpartum through frequent and exclusive breastfeeding, with up to 98% effectiveness in the first six months if practiced optimally (Curtis et al., 2024). LA relies on consistent breastfeeding intervals and nipple stimulation, which inhibit gonadotropin-releasing hormone (GnRH) secretion (McNeilly, 2001). Factors such as supplemental feeding, breast pump use, and early return to work may reduce LA's efficacy (Stuebe & Chen, 2022). This review assesses the impact of various lactation practices on LA to provide current insights and support informed counseling on breastfeeding as a contraceptive method.
Methods: Following PRISMA guidelines (Page et al., 2021), a systematic review was conducted using nine databases to identify studies from 1988 to 2024 on lactation practices and their effects on LA. After screening, 29 studies were included, examining relationships between breastfeeding frequency, spacing, method (direct feeding, pumping), and the duration of LA. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool (Joanna Briggs Institute, 2020). Most included studies were conducted before the year 2000, with variations in methodologies and lactational behavior measures.
Results: Frequent direct breastfeeding, particularly when feedings are spread consistently throughout the day, significantly extends the duration of LA compared to partial or intermittent breastfeeding. Factors such as maternal age, infant feeding method, and return to work may influence the duration of amenorrhea. Recent studies suggest that while direct breastfeeding supports longer LA, the impact of breast pumps on LA requires further investigation (Kunwar et al., 2010; Stuebe & Chen, 2022).
Conclusions: This review highlights breastfeeding as an effective short-term contraceptive for postpartum individuals, with LA duration positively correlated with frequent, exclusive breastfeeding. The literature underscores a gap in knowledge regarding the effectiveness of breast pumping and its role in maintaining LA. Nurses should provide tailored guidance on LA, emphasizing frequent, exclusive breastfeeding to maintain its contraceptive efficacy. Expanded research on the effects of breast pumps on LA will further enhance postpartum contraceptive counseling.
Description
This session explores lactational amenorrhea (LA) as a contraceptive method, focusing on how breastfeeding practices impact its effectiveness. Participants will gain evidence-based insights into LA, including the effects of breastfeeding frequency, spacing, and breast pump use, to enhance counseling for postpartum contraceptive options.