Lactational Amenorrhea Method
(LAM)
LACTATIONAL AMENORRHEA METHOD
The Lactational Amenorrhea Method is a
contraceptive method that relies on the
condition of infertility that results from
specific breastfeeding patterns. LAM is the use
of breastfeeding as a temporary family
planning method. “Lactational”- means
related to breastfeeding. “Amenorrhea”-
means not having menstrual bleeding.
Three criteria that must be met to be able
to qualify for the use of LAM
• 1. The woman exclusively breastfeeds infant.
a. Exclusive means no supplements of any sort are given.
Infant receives no other liquid or food, not even water in
addition to breast milk.
b. Very small amount (one or two swallows) of water,
vitamins or antibiotics as medically prescribed.
c. Simply put, the woman should use both breasts to
breastfeed her baby on demand with no more than a four-
hour interval between any two daytime feeds and no
more than a six-hour interval between any two nighttime
feeds.
2. Amenorrhea. Mother’s monthly bleeding has
not returned. In the first weeks postpartum (e.g.
in the first 56 days postpartum), there is often
continued spotting. This is not considered to be
a menstrual period if the woman is fully
lactating.
3. Infant is less than six months old. If she is fully
breastfeeding and her menses have not
returned, the effectiveness of LAM diminishes
over time. Ovulation resumes in 20% to 50% of
women near the end of the six-month
postpartum.
• MECHANISM OF ACTION 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.
• EFFECTIVENESS The effectiveness of LAM as
consistently followed at 99.5%; if typically
used, it is 98%.
ADVANTAGES OF LAM
1. It can be started immediately after delivery.
2. It is economical and easily available.
3. It does not require a prescription.
4. No action is required at the time of intercourse.
5. There are no side effects or precautions to its use.
6. No commodities or supplies are required for clients or for the
family planning program.
7. Fosters mother-child bonding.
8. It serves as a bridge to using other methods since LAM is used
for a limited time only.
9. It is consistent with religious and cultural practices.
DISADVANTAGES OF LAM
1. Full or nearly full breastfeeding pattern may be difficult for
some women to maintain.
2. The duration of the method's effectiveness is limited to a
brief six-month postpartum period. If a mother and child
are separated for extended periods of time (because the
mother works outside the home), the breastfeeding
practice required for LAM cannot be followed.
3. There is no protection against sexually transmitted
infections, including HIV.
4. In addition, it may be difficult to convince some providers
who are unfamiliar with the method
Categories of Choice of FP methods for
postpartum breastfeeding women.
Intrauterine device, condom, tubal
1st choice: ligation, natural family planning, or
Non-hormonal methods vasectomy (for the woman’s partner)
other than LAM
2nd choice: DMPA and progestin-only pills (both of
Progestin-only methods which can be initiated after six weeks
postpartum)
3rd choice: Combined oral contraceptives (COCs are
Methods containing recommended only after six months when
estrogen (only after six complementary foods are introduced and
months) the baby is less dependent on breast milk
as its sole source of nutrition.) Estrogen
can reduce breast milk volume.
THANK YOU!
