Lactational Amenorrhoea Method
- What is the Lactational Amenorrhoea Method (LAM)?
- How does LAM work?
- What are the drawbacks of LAM?
- Who can I contact to find out more about LAM?
What is the Lactational Amenorrhoea Method (LAM)?
Over the past few years a consensus has developed among medical professionals and family planning experts that breastfeeding can, under the right conditions, be used as a reliable contraceptive. Briefly, the conditions for the Lactational Amenorrhoea Method (LAM) are as follows:
- The mother has not experienced vaginal bleeding after the 56th day post-partum.
- The baby is less than six months old.
- The baby receives all of its nutrition from the breast, without bottles, supplements, or solid food.
- The baby feeds at the breast at least every four hours during the day and every six hours at night.
A woman who meets the above criteria has a greater than 98% chance of not becoming pregnant, which compares well with other forms of contraception. As soon as any of the conditions are not met, for instance, if the baby weans, begins taking a bottle or sleeping more than six hours at night, or if the mothers period returns, the mother should consider another family planning option. Working mothers who express milk for the baby may still qualify for LAM but need to talk to a natural family planning teacher to clarify the situation.
How does LAM work?
LAM is a contraceptive in that it works on the physiology of breastfeeding. Detailed studies have revealed which types of breastfeeding behaviour have and have not helped women to remain infertile, and the LAM guidelines have been drawn up according to the information shown in these studies.
The body of a breastfeeding woman produces the hormone prolactin, which suppresses ovulation and menstruation. Each feed causes a surge of prolactin. For this reason, the frequency of feeding is important. Most breastfeeding experts suggest that babies be fed on demand anyway, and feeding on demand will help to ensure the efficacy of LAM.
In a bottlefeeding culture like Irelands, it is rare for many women, and indeed many health professionals, to encounter women who have breastfed for more than a few months and/or who have spaced children using LAM. Many people still believe that the link between breastfeeding and delayed return of fertility is nothing more than an old wives tale.
In fact, the link has been irrefutably made in international studies, and worldwide breastfeeding is responsible for more prevention of pregnancy than all other contraceptive methods combined. Some elements of the bottlefeeding culture might, however, have an impact on Irish womens experiences.
What are the drawbacks of LAM?
Women who breastfeed at times but who also introduce bottles of formula or introduce solids prematurely will not fall under the LAM guidelines enumerated at the top of this article. These women may become pregnant sooner than anticipated and further undermine others confidence in breastfeeding as a contraceptive. It is important to remember that it is the kind of breastfeeding which meets the LAM criteria, rather than breastfeeding per se, which can be relied upon as a contraceptive.
The major drawback of LAM in many womens minds will be that it lasts for only six months. This six-month window does, however, allow women a breathing space to explore their family planning options. In women who continue to breastfeed, menstruation may not occur for a year or more after the babys birth.
For breastfeeding women natural family planning (NFP) is an excellent follow-on from LAM because it allows women to perceive for themselves when their fertility is returning, but gives them and their partners freedom during the time that breastfeeding still has a contraceptive effect.
Breastfeeding, as the superior infant food, has many advantages for the baby, but the mother can also benefit significantly through reduced risk of breast cancer, osteoporosis, and other conditions. Breastfeeding is, after all, what a womans body was meant to do following a pregnancy.
Lactational amenorrhoea, the lack of periods which breastfeeding mothers experience, is an important part of the benefits of breastfeeding, in that the mother is able to recover from the birth of a baby without the discomfort of a monthly period, and she is unlikely to conceive a second baby quickly.
Research in this field is ongoing, and it is likely that within a few years lactational amenorrhoea will be even better understood, and even more women will be able to benefit from it. In the meantime, the LAM method is a excellent way for new mothers to work with their fertility.
Who can I contact to find out more about LAM?
You can write to the Natural Family Planning Teachers Association of Ireland at P.O. Box 72, Letterkenny, Co. Donegal, or e-mail firstname.lastname@example.org.
The La Leche League of Ireland provide breastfeeding help and information online at http://homepage.tinet.ie/~lalecheleague.
Written by Jennifer Mooney, NFPTAI
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