LAM is the use of breastfeeding as a contraceptive method. It is
based on the physiologic effect of suckling to suppress ovulation. To use breastfeeding
effectively as a contraceptive requires that the mother either feed the baby nothing but
breastmilk (fully breastfeeding) or, at the very least, breastfeed for almost all
feedings (may give infrequent feedings of juice, milk or water).
Mechanism of Action
Benefits
Contraceptive
- Highly effective (1–2 pregnancies per 100 women during first 6 months of use)
- Effective immediately
- Does not interfere with intercourse
- No systemic side effects
- No medical supervision necessary
- No supplies required
- No cost involved
Noncontraceptive
For child
- Passive immunization (transfer of protective antibodies)
- Best source of nutrition
- Decreased exposure to contaminants in water, other milk or formulas, or on utensils
For mother
- Decreased postpartum bleeding
Limitations
- User-dependent (requires following instructions regarding breastfeeding practices)
- May be difficult to practice due to social circumstances
- Highly effective only until menses return or up to 6 months
- Does not protect against STDs (e.g., HBV, HIV/AIDS)
Who Can Use LAM
- Women who are fully (or nearly fully) breastfeeding, whose babies are less than 6 months
old and whose menses have not returned
Use With Care in the Following
Situations
SITUATION |
RECOMMENDATION |
| When regular supplementary feeding begins (replacing a
breastfeeding meal) |
Help client choose another method. Even if another
contraceptive method is required, client should be encouraged to continue to breastfeed. |
| When menstruation begins |
Help client choose another method. Even if another
contraceptive method is required, client should be encouraged to continue to breastfeed. |
| Baby does not suckle frequently (>4 hours between
feedings during the day; >6 hours at night) |
Help client choose another method. Even if another
contraceptive method is required, client should be encouraged to continue to breastfeed. |
| Baby is 6 months old or older |
Help client choose another method. Even if another
contraceptive method is required, client should be encouraged to continue to breastfeed. |
Who Should Not Use LAM
- Women whose menses have returned
- Women who are not fully (or nearly fully) breastfeeding
- Women whose babies are more than 6 months old
Client Instructions
How Often to Breastfeed
Breastfeed your baby from both breasts on demand, about 6 to 10 times per day.
Breastfeed your baby at least once during the night (no more than 6 hours should pass
between any 2 feedings).
Note: Breastfeeding is used primarily for infant nutrition and health. Your baby
may not want to breastfeed 6 to 10 times per day, or your baby may choose to sleep through
the night. This is normal, but if either occurs, breastfeeding will be less effective
as a contraceptive method.
When to Start Solid Foods
As long as the baby is growing well and gaining weight, and as long as you are
eating a balanced diet and resting in order to have a good milk supply, the baby does not
need any other foods until s/he is 6 months old.
Once you substitute other food or drink for breastfeeding meals, the baby will suckle
less, and breastfeeding will no longer be an effective contraceptive method.
Menstrual Periods
When your menstrual period returns it is very likely that you are fertile again and you
should begin using a contraceptive method immediately.
For Contraception and Health
- You will need a contraceptive method if you have a menstrual period, if you no longer
breastfeed fully (or nearly fully) or when your baby is 6 months old.
- Consult your health care provider or clinic before starting another contraceptive
method.
- If you or your partner are at high risk for STDs, including the AIDS virus, you should
use condoms as well as LAM.
What To Do When You Are Not Fully (or Nearly Fully) Breastfeeding or Stop Breastfeeding
- You need to have a temporary supply of lubricated condoms or another method of
contraception at home for use when you stop fully (or nearly fully) breastfeeding your
baby.
- Return to the family planning clinic for help in choosing and using a suitable
contraceptive method.
Summary
Source: Labbok, Cooney and Coly 1994.
 
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