4.1
Method
The
use of breast feeding as a temporary family planning method is referred
to as lactational amenorrhoea method or LAM. It provides adequate
protection from an unplanned pregnancy only if the following criteria
are met :
• amenorrhoea since delivery
• complete or nearly complete breast-feeding
the baby, both day and night
• less than six months post-partum.
4.2 Advantages
•
effectively prevents pregnancy for at least 6 months, may be longer
if the woman keeps breast-feeding day and night
• can be used immediately after childbirth
• does not interfere with sex
• no extra cost for family planning or
for feeding the baby
• no supplies or procedures needed to
prevent pregnancy
• no hormonal side-effects
• counseling for LAM encourages starting
a follow-on method at the proper time
• encourages the best breast-feeding patterns
which contribute other health benefits for the baby and mother
including :
– healthiest food for the baby
– protecting the baby from life-threatening
diseases such as measles and pneumonia
– developing mother-baby bonding
4.3 Disadvantages
•
effectiveness after 6 months is not certain.
• frequent breast-feeding may be inconvenient
or difficult for women, especially working mothers.
• no protection against sexually-transmitted
infections (STIs) including HIV/AIDS.
• if the mother has HIV infection, there
is a small chance that breast milk will transmit HIV to the baby.
4.4 Contraindications
•
in women on drugs like antimetabolites, radioactive drugs, lithium,
cyclosporin, high doses of corticosteroid, reserpine, mood altering
drugs and certain anticoagulants breast-feeding is contraindicated,
thus they cannot use LAM.
• diseases such as HIV infection and acute
viral hepatitis can be transmitted to the new born through breast
milk.
• congenital deformities of the mouth,
jaw or palate and prematurity make breast-feeding difficult for
the neonate.
4.5 How to use LAM correctly
•
breast-feed the baby often, at least 8-10 times a day, including
once at night. Day-time feeds should not be more than 4 hours
apart, and night feeds no more than 6 hours apart.
• ensure that the baby gets 85% of his
or her feeds as breast milk.
• other foods may be started when the
baby is 6 month old. Breast-feed the baby prior to other foods,
when possible.
4.6 When to start additional
contraceptive
method in a woman on LAM
• any time the woman starts menstruating
• when baby is 6 months old
• baby is taking less than 85% of his
or her feeds as breast milk
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