User:Fullerm8/sandbox

Ideas to add to Lactational amenorrhea:


 * Adding a more evolutionary perspective on why lactational amenorrhea came to be and the purpose it plays in protecting an infant and helping it thrive.
 * Potential article: Margulis, Susan W., et al. “Sex-Biased Lactational Duration in a Human Population and Its Reproductive Costs.” Behavioral Ecology and Sociobiology, vol. 32, no. 1, 1993, pp. 41–45. JSTOR, JSTOR, www.jstor.org/stable/4600781.
 * Discusses how some cultures breastfeed females longer or males longer and the effect that has on lactational amenorrhea
 * Male sex-biasing because of male-dominated societies
 * Reproductive costs of sex-biased breastfeeding
 * Discuss the social/relationship consequences of lactational amenorrhea and how it affects the births of subsequent children
 * Purposes of lactational amenorrhea beyond birth control (because that appears that is the main focus of the article currently)
 * Add more sources of different kinds that have different focuses - There are also places that say "citation needed" so we could fill in the gaps there.
 * Adding more cross-cultural information that compares the effects of lactational amenorrhea in different countries and locations
 * Radwan, Hadia, et al. “Breast-Feeding and Lactational Amenorrhea in the United Arab Emirates.” Journal of Pediatric Nursing, vol. 24, no. 1, Feb. 2009, pp. 62–68., doi:10.1016/j.pedn.2007.09.005.

Drafting/Practice
One of the main causes of an earlier return of fecundity and menses in a woman following childbirth is the introduction of supplemental food and liquids into the infant's diet in addition to breast milk. The reduction in breast milk consumption starts to signal to the woman's body that the baby is no longer relying on the mother as much for nutrition.

Return of fertility
(copied from Lactational amenorrhea to edit):

Return of menstruation following childbirth varies widely among individuals. A strong relationship has been observed between the amount of suckling and the contraceptive effect, such that the combination of feeding on demand rather than on a schedule and feeding only breast milk rather than supplementing the diet with other foods will greatly extend the period of effective contraception. The closer a woman's behavior is to the Seven Standards of ecological breastfeeding, the later (on average) her cycles will return. Average return of menses for women following all seven criteria is 14 months after childbirth, with some reports being as soon as 2 months while others are as late as 42 months.[citation needed] Couples who desire spacing of 18 to 30 months between children can often achieve this through breastfeeding alone, though this is not a foolproof method as return of menses is unpredictable and conception can occur in the weeks preceding the first menses.

My edited version:

Return of menstruation following childbirth varies widely among individuals. '''This return does not necessarily mean a woman has begun to ovulate again. The first postpartum ovulatory cycle might occur before the first menses following childbirth or during subsequent cycles. A strong relationship has been observed between the amount of suckling and the contraceptive effect, such that feeding on demand''' rather than on a schedule and feeding only breast milk rather than supplementing the diet with other foods will greatly extend the period of effective contraception. In fact, it was found that among the Hutterites, more frequent bouts of nursing, in addition to maintenance of feeding in the night hours, led to longer lactational amenorrhea. '''An additional study that references this phenomenon cross-culturally was completed in the United Arab Emirates (UAE) and has similar findings. Mothers who breastfed exclusively longer showed a longer span of lactational amenorrhea, ranging from an average of 5.3 months in mothers who breastfed exclusively for only two months to an average of 9.6 months in mothers who did so for six months. Another factor shown to affect the length of amenorrhea was the mother's age. The older a woman was, the longer period of lactational amenorrhea she demonstrated. The same increase in length was found in multiparous women as opposed to primiparous.'''

With regards to the use of breastfeeding as a form of contraception, most women who choose not to breastfeed will resume regular menstrual cycling within 1.5 to 2 months following parturition. Overall, there are many factors including frequency of nursing, mother's age, parity, and introduction of supplemental foods into the infant's diet among others which can influence return of fecundity following pregnancy and childbirth and thus the contraceptive benefits of lactational amenorrhea are not always reliable but are evident and variable among women. Couples who desire spacing of 18 to 30 months between children can often achieve this through breastfeeding alone, though this is not a foolproof method as return of menses is unpredictable and conception can occur in the weeks preceding the first menses.

Although the first post-partum cycle is sometimes anovulatory (reducing the likelihood of becoming pregnant again before having a post-partum period), subsequent cycles are almost always ovulatory and therefore must be considered fertile. For women exclusive breastfeeding ovulation tends to return after their first menses after the 56 days postpartum time period. Supplementing nutritional intake can lead to an earlier return of menses and ovulation then exclusive breastfeeding. Nursing more frequently for a shorter amount of time was shown to be more successful in prolonging amenorrhea then nursing longer but less frequently. The continuing of breastfeeding, while introducing solids after 6 months, to 12 months were shown to have an efficiency rate of 92.6 – 96.3 percent in pregnancy prevention. Because of this some women find that breastfeeding interferes with fertility even after ovulation has resumed.

Note: I am still figuring out how to incorporate all of this back into the article. Some adjustments may need to be made once it is reintegrated. I also still need to look up and add the pages cited from the Wood book.