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8/2/2019 LAKTASI AMENORE

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LAKTASI AMENORE

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TOPIC

Pengaruh ASI terhadap fertilitas

Faktor yang mempengaruhi lama laktasi

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Effect of nuptiality, contraception and breast-feeding on fertility inBangladesh

M. Kabira1 and M. Mosleh Uddina2

a1 Department of Statistics, Jahangirnagar University, Savar, Dhaka

a2 Department of Statistics, University of Dhaka, Dhaka, Bangladesh

Summary

The effects of marriage, contraception and post-partum lactationalinfecundability on fertility in Bangladesh are assessed by applyingBongaarts' formula to survey data for the period 197585.

Marriage is universal and age at marriage is low. Breast-feeding isprolonged and has a pronounced effect on fertility. The fertility-reducing effect of contraception increased over the period throughincreased use of modern methods. The TFR declined by 24% from1975 to 1985.

(Received July 24 1986)

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Original Articles

Contraception, Marital Fertility, and Breast-Feeding in the Yemen Arab Republic

Article author query

H. I. Goldberga1, J. E. Andersona1, D. Millera2 and O. Dawama3

a1 Family PlanningEvaluation Division

a2 Nutrition Division, Centers for Disease Control, Atlanta, Georgia

a3Yemen General Grain Corporation, Yemen Arab Republic

Abstract

Major findings from an analysis of demographic information collected in a

1979 survey in the Yemen Arab Republic (North Yemen) are that: levels ofcontraceptive use are extremely low in the rural areas that constitute mostof the nation and considerably higher in the capital, Sana'a; fertility is veryhigh and, until recently, was higher in Sana'a than in rural areas; mortality ofchildren is very high with small urbanrural differentials; breast-feedingdurations tend to be short, considering Yemen's extremely low level ofdevelopment; and, female infants appear to be breast-fed longer than male

infants in Sana'a, a phenomenon never previously documented. It is arguedthat the observed convergence between fertility levels in Sana'a and ruralYemen results from increased contraception in Sana'a, which offsets fertilitydifferences introduced by longer breast-feeding in rural areas.

(Received January 18 1982)

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Research Article

The role of breast-feeding beyond postpartum amenorrhoea on the return offertility in India: a life table and hazards model analysis

Article author query Dilip C. Natha1, Kenneth C. Landa1 and Kaushalendra K. Singha2

a1 Department of Sociology, Duke University, Durham, North Carolina, USA.

a2 Centre ofPopulation Studies, Banaras Hindu University, Varanasi, India.

Summary

This paper investigates the effects of continued breast-feedingafter resumption of menses on fertility, using data from tworetrospective surveys in India and single decrement life tableand multivariate time-dependent hazards analyses. Breast-

feeding even after the return of menses is found to beassociated with longer birth intervals. The interaction of breast-feeding duration after resumption of menses and postpartumamenorrhoea has a significant effect on the risk of conceptionafter return of menses.

(Received September 16 1992) 5


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Research Article

Energy requirements during pregnancy and

lactation

Article author query

Nancy F Buttea1 c1 and Janet C Kinga2

a1 USDA/ARS Children's Nutrition Research Center,

Children's Nutrition Research Center, Department

ofPediatrics, Baylor College of Medicine, 1100

Bates Street, Houston, TX 77030, USA

a2 Children's Hospital Oakland Research Institute,

5700 Martin Luther King Jr Way, Oakland, CA

94609, USA6


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Abstract

Objective To estimate the energy requirements of pregnantand lactating women consistent with optimal pregnancyoutcome and adequate milk production.

Design Total energy cost of pregnancy was estimated usingthe factorial approach from pregnancy-induced incrementsin basal metabolic rate measured by respiratory calorimetryor from increments in total energy expenditure measured by

the doubly labelled water method, plus energy depositionattributed to protein and fat accretion during pregnancy.

Setting Database on changes in basal metabolic rate andtotal energy expenditure during pregnancy, and incrementsin protein based on measurements of total body potassium,

and fat derived from multi-compartment body compositionmodels was compiled. Energy requirements during lactationwere derived from rates of milk production, energy density ofhuman milk, and energy mobilisation from tissues.

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Subjects Healthy pregnant and lactating women.

Results The estimated total cost of pregnancy for womenwith a mean gestational weight gain of 12.0 kg, was 321 or325 MJ, distributed as 375, 1200, 1950 kJ day -1, for thefirst, second and third trimesters, respectively. For exclusivebreastfeeding, the energy cost of lactation was 2.62 MJ day-1

based on a mean milk production of 749 g day-1, energydensity of milk of 2.8 kJ g-1, and energetic efficiency of 0.80.

In well-nourished women, this may be subsidised by energymobilisation from tissues on the order of 0.72 MJ day-1,resulting in a net increment of 1.9 MJ day-1 over non-pregnant, non-lactating energy requirements.

Conclusions Recommendations for energy intake of pregnant

and lactating women should be updated based on recentlyavailable data.

KeywordsLactation; Exclusive breastfeeding; Energy intake;Basal metabolic rate;Total energy expenditure

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