Background:

There continues to be controversy regarding the simultaneous encouragement of both breastfeeding and immediate postpartum contraception.

Research Aim:

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.

Methods:

This was a retrospective, longitudinal, three group comparative, secondary analysis of a prospective cohort study (N = 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 (n = 200), depot medroxyprogesterone acetate 150 mg (n = 98), or a non-hormonal method (n = 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.

Results:

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%, p = .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%, p = .30).

Conclusions:

Breastfeeding perspectives and behavioral outcomes over the first 6 months postpartum were not influenced by participants chosen form of immediate postpartum contraception.

中文翻译：

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采取不同激素全身避孕方法的产后妇女对母乳喂养的看法和行为

背景：

关于同时鼓励母乳喂养和产后立即避孕仍然存在争议。

研究目的：

旨在探讨产后女性对母乳喂养的看法及其母乳喂养行为，同时在产后 6 个月的时间内立即使用三种不同的激素全身避孕方法中的一种。

方法：

这是对产后立即避孕的前瞻性队列研究（ N = 471）的回顾性、纵向、三组比较、二次分析。在这项研究中，母乳喂养被定义为向婴儿提供任何母乳。产后立即选择三种不同激素系统避孕方式之一的参与者（长效激素可逆避孕药 ( n = 200)、长效激素醋酸甲羟孕酮 150 毫克 ( n = 98) 或非激素方法 ( n = 173) ）在出院时、产后 6 周、3 个月和 6 个月进行比较。主要结局是 6 个月时的母乳喂养情况。次要结局包括任何纯母乳喂养、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。

结果：

产后 6 个月时，两个激素组和非激素避孕组之间的母乳喂养率没有显着差异（长效激素组 20.1%，非激素组 21.7%，长效醋酸甲羟孕酮 13.9%，p = .77 ，0.28，分别）。在所有时间点，因乳汁供应减少而停止母乳喂养的参与者人数在任何组之间均无显着差异（产后 6 个月停止母乳喂养的总人数中，长效激素类药物占 24.7%，非激素类药物占 25.1%，长效激素类药物占 25.1%，长效激素类药物占 25.1%） 19.3%，p = .30）。

结论：

产后前 6 个月的母乳喂养观点和行为结果不受参与者选择的产后立即避孕形式的影响。