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.
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
• 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
– healthiest food for the baby
– protecting the baby from life-threatening
diseases such as measles and pneumonia
– developing mother-baby bonding
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.
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
• congenital deformities of the mouth,
jaw or palate and prematurity make breast-feeding difficult for
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,
4.6 When to start additional
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