Extending lactational amenorrhoea in Manila: a successful breast-feeding education programme.

An experimental breast-feeding education programme conducted at the Philippine General Hospital in Manila demonstrated that women could be motivated to improve their breast-feeding practices and lengthen their period of lactational amenorrhoea in comparison to a control group. Mothers who participated in the programme breast-fed their babies more frequently, delayed the introduction of regular supplements, used fewer bottles and pacifiers and maintained night feeding longer than mothers who were not exposed to the positive breast-feeding messages. The programme was successful in lengthening the period of amenorrhoea among women with elementary, high school, or technical school education, but not among college-educated women. Different educational approaches may be necessary for women of different education levels.

PIP: Data on mothers living in Manila, Philippines who delivered at the Philippine General Hospital were analyzed to compare suckling frequency, duration of exclusive breast feeding, duration of night feeding, use of bottles and pacifiers, and resumption of menses between women who underwent a breast feeding education program (87 cases) and those who did not undergo such a program (87 controls). Mothers in the program breast fed their infants a mean of 8 times/day for a 24-hour total of 116 minutes compared with 5 times/day and 76 minutes for control mothers (p.01). Case mothers with only a primary school education had a longer duration of lactational amenorrhea (median 32 weeks) than their control counterparts (11 weeks), and also cases with high school/technical education (19 weeks) and with college education (17 weeks). specifically women in the low category of suckling frequency and duration experienced a more rapid return of menses than the medium and high groups. Yet only a limited difference occurred in the return to menses between women in the medium and high categories. The difference in duration of amenorrhea between cases and controls was significant only for mothers with high school/technical education (19 vs. 15 weeks; p=.006), however. Women who supplemented 4-7 months after delivery had much longer durations of amenorrhea than those who supplemented 1-3 months after delivery (p.001). Cases were likely to use a bottle and more likely to use a utensil other than a bottle (e.g., spoon and cup) to give supplementary feeds than controls (p.001-.05). Mothers in the program tended not to give their infants pacifiers during the 1st 8 months (10% vs. 20-30%; p.01-.05). They were also more likely to breast feed more often and for more minutes at night than controls (p.05). These results show that the program was successful, but separate methods are probably needed for women with different education levels.

Clinical assessment of a new triphasic oral contraceptive.

One hundred twenty women completed 901 woman-months of birth control with a new triphasic oral contraceptive. No pregnancies occurred, and good cycle control was achieved. Spotting and breakthrough bleeding were minimal, and amenorrhea did not occur. Changes in body weight and blood pressure were not statistically significant. The triphasic compound was well tolerated. Headache and dizziness were frequent complaints during the initial cycles but tended to subside within a few months.

PIP: The efficacy and safety of a new triphasic oral contraceptive (OC) were evaluated in a trial involving 120 women ages 18-33 years for a total of 901 woman-months of observation. 1 monthly cycle of this triphasic OC provides 6 tablets of 30 mcg ethinyl estradiol (EE) and 50 mcg levonorgestrel (LNg), 5 tablets of 40 mcg EE and 75 mcg LNg, and 10 tablets of 30 mcg EE and 125 mcg NNg. No pregnancies were reported during treatment. Cycle duration was significantly shorter during than before treatment. Before treatment, 88.6% of subjects had cycles of 29-32 days; after treatment, 74.3% had cycles of 20-28 days. The duration of menstruation was 2-5 days in 96.9% of treatment cycles, and the amount of flow was light to moderate in 94.2%. Breakthrough bleeding occurred in 0.4% and spotting in 1.0% of cycles; there was no amenorrhea. Side effects most frequently reported were headache (13.3%) and dizziness (8.2%). Changes in body weight and blood pressure were minimal.