# Understanding the Lactational Amenorrhea Method of Contraception for Mothers of Preterm and Term Infants

> **NIH NIH K23** · UNIVERSITY OF CALIFORNIA AT DAVIS · 2021 · $167,821

## Abstract

7. Project Summary/Abstract
Melissa Chen, MD, MPH is an Assistant Professor in the Department of Obstetrics and Gynecology at UC
Davis who completed fellowship training in family planning in June 2016. She is seeking this Career
Development Award to establish herself as an independent investigator in postpartum contraception with a
specific focus on lactation as a contraceptive method. This K23 award enables Dr. Chen to achieve her career
goal through the following objectives: (1) to broaden her understanding of clinical research through
coursework, (2) to diversify her research skills with experience in conducting different types of patient-oriented
contraception studies, and (3) to facilitate her professional development into an academic researcher. Dr. Chen
has assembled a team of mentors and advisors to guide her through her research and career development.
Her primary mentor is Dr. Mitchell Creinin, an expert in contraceptive clinical trials, and her co-mentor is Dr.
Eleanor Bimla Schwarz, who has expertise in lactation on maternal health and qualitative research methods.
Research: Postpartum contraception plays a role in determining interpregnancy intervals, but lactation experts
express concerns that early initiation of hormonal contraception may adversely affect breastfeeding. The
lactational amenorrhea method (LAM) is an effective initial method of contraception; however, the extent to
which women who are pumping can rely on LAM is unknown. This issue is particularly relevant to mothers of
preterm infants who are at risk of recurrent preterm birth and who often delay hormonal contraception while
pumping breast milk. The proposed research will improve counseling about LAM as a contraceptive method
by: (1) understanding differences in ovarian suppression between mothers who are breastfeeding (i.e. feed at
the breast) and those who are pumping breastmilk and (2) exploring whether these differences exist between
mothers who deliver preterm compared to those who deliver at term. This goal will be accomplished with 3
aims. The first aim is to compare amenorrhea rates, duration of lactation, and resumption of sexual activity
among postpartum women who are breastfeeding versus expressing milk after term and preterm delivery
through a prospective observational study following women through 6 months postpartum. The second aim is
to conduct a pilot study assessing the feasibility and acceptability of using home urinary luteinizing hormone
test kits to detect ovulation in exclusively breastfeeding women. Serum progesterone levels will be drawn to
confirm ovulation, and the average time to ovulation as determined with this technology will be assessed. The
third aim is to understand decision-making regarding contraception and infant feeding practices in mothers of
preterm infants using a qualitative approach with semi-structured interviews. Findings from these proposed
studies will form the basis for a potential R01 grant application for a multicenter...

## Key facts

- **NIH application ID:** 10169481
- **Project number:** 5K23HD090323-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA AT DAVIS
- **Principal Investigator:** Melissa Joy Chen
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $167,821
- **Award type:** 5
- **Project period:** 2017-09-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10169481

## Citation

> US National Institutes of Health, RePORTER application 10169481, Understanding the Lactational Amenorrhea Method of Contraception for Mothers of Preterm and Term Infants (5K23HD090323-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10169481. Licensed CC0.

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