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4.0 Lactational amenorrhoea method

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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