Lactational Amenorrhea Method (LAM) is the use of breastfeeding as a temporary family planning method. It is based on natural effect of breastfeeding on fertility. Breastfeeding delays return of ovulation and menstruation in postpartum women. The failure rate of this method as commonly used is about 2 pregnancies per 100 women in the first 6 months after child birth.When correctly used the failure rate is less than 1 pregnancy per 100 women in the first 6 months after child birth.
Following conditions needs to be fulfilled for successful LAM:
1. The baby is fully or nearly fully breastfed and is fed often day and night.
2. The mother’s menstrual periods have not returned.
3. The baby is less than 6 months old.
If any of these three conditions is not fulfilled, the woman should use another method of family planning.
Fully breast feeding includes both exclusive breastfeeding( infant receives no other liquid or food, not even water, in addition to breast milk) and almost exclusive breast feeding ( 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 fourth of all feeds) is breast milk.
Start breastfeeding as soon as possible after the baby is born. An ideal pattern is feeding on demand and at least 10-12 times a day in the first few weeks after child birth and there after 8-10 times a day including at least once at night. Day time feeding should not be more than 4 hours apart and night time feeding should not be more than 6 hours apart.
There are no known side effects of LAM.Rather it has some advantages.
Can be used immediately after childbirth.
Effectively prevents pregnancy for at least six months and may be longer if a woman keeps breastfeeding often, day and night.
No need to do anything at the time of sexual intercourse.
No supplies or procedure required to prevent pregnancy.
No hormonal side effects.
There are few disadvantages also.
Effectiveness after six months is not certain.
Frequent breastfeeding may be inconvenient for some women, especially working mothers.
Contraindications for LAM
There are no medical contraindications for LAM. All breastfeeding women can use LAM, but women in the following circumstances may have to opt for other contraceptive methods.
Mother has HIV infection or AIDS.
HIV transmission through breast milk is more likely among mothers with advanced disease or who are newly infected. HIV infected women should use condoms during intercourse.
Mother is using certain medications.
Mood altering drugs, Reserpine, Ergotamine, Antimetabolites, Cyclosporine, High dose of corticosteroids, Bromocriptine, Radioactive drugs, Lithium and Certain anticoagulants
Newborn has a condition that makes it difficult to breastfed.
Premature baby, Baby needing intensive care, Unable to digest food normally or Deformities of the mouth, jaw or palate.