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Family Planning: A Global Handbook for Providers

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Family Planning

A GLOBAL HANDBOOK FOR PROVIDERS

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.