The Effects of Breastfeeding and Nutrition on Fecundability in Rural Bangladesh: A Hazards-Model Analysis

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Abstract
Data taken from the ‘Determinants of Natural Fertility’ study, Bangladesh, are used with multivariate hazard models to study variations in fecundability between women, especially the relationship between nutritional status, breastfeeding practices, and the monthly probability of conceiving. It is found that fecundability varies both between women of a given age and, for a particular woman, by age. The variation is related to four variables: separation, which affects coital frequency; age, which represents biological changes; lactation practices; and the duration of amenorrhoea. Nutrition above famine or starvation levels is not a significant determinant of fecundability. The most surprising finding is the effect of the pattern of breastfeeding on fecundability: as a menstruating woman begins to wean her child, her probability of conceiving increases as her serum prolactin, which inhibits ovulation, decreases. Thus, those menstruating women who are most likely to conceive are those who have completely weaned their infants in the very recent past.

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