Promotion of breastfeeding : can it really decrease fertility?

A discussion of the biological effect on fertility of breastfeeding and of specific breastfeeding practices (suckling, supplementation, and night feeding) is supported by reference to demographic studies of both developed and developing countries and by a comparison of the birth interval of Mexican women who breastfeed and those who do not. The need to promote breastfeeding in the Third World is urged on the basis of data showing a high incidence of contraceptive discontinuation in several developing countries, including some where family planning programs have been successful. Three types of programs designed to increase the incidence and duration of exclusive breastfeeding - hospital-based programs, health professional training, and mass media campaigns - are discussed.