Reassessing the Contraceptive Effect of Breastfeeding

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Abstract
Much of the recent demographic interest in the proximate determinants of fertility focuses on the link between breastfeeding and post partum amenorrhoea. Most analyses are based on a causal model, which may be assumed implicitly, and in which the duration of amenorrhoea is determined by the duration of breastfeeding. In the present paper objections to this approach are raised, because an extremely important cause of weaning is a new pregnancy, and hence the direction of causation may be from amenorrhoea to breastfeeding. Analyses performed on prospective Javanese data illustrate how the breastfeeding/amenorrhoea relation can be complicated both by this mechanism, and by factors related to the composition of the population and to sexual abstinence. As the Javanese experience is not unique there are wider implications for demographic research on the spacing of births.

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