CHAPTER 19
Lactational Amenorrhea Method

Key Points for Providers and Clients

A family planning method based on breastfeeding. Provides contraception for the mother and best feeding for the baby.
Can be effective for up to 6 months after childbirth, as long as monthly bleeding has not returned and the woman is fully or nearly fully breastfeeding.
Requires breastfeeding often, day and night. Almost all of the baby's feedings should be breast milk.
Provides an opportunity to offer a woman an ongoing method that she can continue to use after 6 months.

What Is the Lactational Amenorrhea Method?

A temporary family planning method based on the natural effect of breastfeeding on fertility. ("Lactational" means related to breastfeeding. "Amenorrhea" means not having monthly bleeding.)
The lactational amenorrhea method (LAM) requires 3 conditions. All 3 must be met:
1. The mother's monthly bleeding has not returned
2. The baby is fully or nearly fully breastfed and is fed often, day and night
3. The baby is less than 6 months old
"Fully breastfeeding" includes both exclusive breastfeeding (the infant receives no other liquid or food, not even water, in addition to breast milk) and almost-exclusive breastfeeding (the infant receives vitamins, water, juice, or other nutrients once in a while in addition to breast milk).
"Nearly fully breastfeeding" means that the infant receives some liquid or food in addition to breast milk, but the majority of feedings (more than three-fourths of all feeds) are breast milk.
Works primarily by preventing the release of eggs from the ovaries (ovulation). Frequent breastfeeding temporarily prevents the release of the natural hormones that cause ovulation.