Lactational Amenorrhea Method (LAM) for Fertility Control

A mother breastfeeding her baby

Breastfeeding is a natural way of providing nutrition to your baby. Breastfeeding your baby is recommended at least for the first six months of your baby’s life to build up his immunity and aid growth. While it has its list of benefits for your baby, you are not left out of the equation either.

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Breastfeeding can also be an effective method of contraception for women. Although effective only for a limited period, you can explore the possibilities and suitability of this method for you.

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What Is Lactational Amenorrhea Method?

Lactational amenorrhea method is a natural birth control method based on the biological fact that breastfeeding delays menstruation in women. This provides a window period for women to use breastfeeding as a form of birth control without any additional requirement for contraception.

The Effectiveness of LAM Contraception

When used properly, with all the conditions effectively fulfilled, LAM can be about 98% effective as a form of birth control. There is only a 2% chance that you can get pregnant with this method. If you do not want to take the risk, you can always use contraceptives that are compatible with breastfeeding like IUDs, diaphragms, etc.

Birth Control Options

How Does LAM Contraceptive Method Work?

Breastfeeding causes the body to release certain hormones. These hormones are also known to interfere with the process of ovulation, which essentially means that your ovaries will not release any eggs as long as you are breastfeeding your baby on a regular basis. And since no ovulation, it means no pregnancy.

Who Can Use This Method?

Lactational amenorrhea can be used by breastfeeding mothers who meet the following conditions.

  • Your menstrual bleeding has not commenced after delivery. The initial period of bleeding due to delivery is not considered as bleeding for this purpose.
  • You are breastfeeding your baby every day as and when the baby requires it.
  • Your baby is under six months of age.

When all three conditions are met successfully, you can use LAM as an effective method of birth control with less than 2% chance of pregnancy. However, when even one of the above conditions is not met, you will need to start an alternative method of contraception to prevent pregnancy.         

Who Should Avoid LAM Method of Birth Control?

Women should avoid using LAM as a method of birth control under the following circumstances.

1. When Your Period Returns

After the postpartum bleeding of 56 days, if a woman has consecutive bleeding for two days or if she notices that her periods have returned, LAM is no longer advisable. This is because you will begin to ovulate and your fertility would have returned.

2. When the Baby is Fed Supplements or Baby Sleep Through the Night

The hormones that prevent ovulation are released due to the suckling of the breast by the baby. If you are not regularly breastfeeding your baby, then the chances of your baby suckling your breasts are reduced. This reduces the level of fertility suppressing hormones. If your baby is known to sleep through the night, then there will be long intervals between breastfeeding. Intervals of over four hours in the day and over six hours in the night can also render LAM ineffective.

3. When the Baby is Older Than 6 Months

If your baby is older than six months, he will be on the other nutritional foods too and hence will breastfeed less often. This can reduce the efficiency of LAM.

Certain medical conditions also rule out the possibility of LAM, which are as follows:

  • If your baby has specific infant metabolic disorders.
  • If you use drugs for mood alteration.
  • If you use reserpine, bromocriptine, cyclosporine, antimetabolites, anticoagulants, radioactive drugs, lithium, or ergotamine.
  • AIDS or HIV+ mothers may not be able to breastfeed as the virus can be transferred through milk. Hence LAM is not effective.
  • Active tuberculosis in the mother may pass on to the child when the infant is placed in direct contact with the mother.

How Can You Use LAM?

To effectively use LAM as your birth control method, you will need to begin breastfeeding your baby regularly. It is best to feed the baby on demand and at least about ten to twelve times every day in the first few weeks. In the subsequent months, you can breastfeed about eight to ten times every day.

THere should not be a gap of over 4 hours in the day and over 6 hours in the night between feedings. If your baby does not want to be fed eight to ten times a day, you will need to encourage him a little.

If you do not meet even one of the eligibility conditions for LAM, you will need to stop using it as your sole method of birth control and opt for alternative contraceptive methods.

Can This Method Be Used while Pumping and Bottle-Feeding?

No, LAM is not effective if you are pumping or bottle feeding. For LAM to work your baby needs to suckle your breast triggering the suppression of ovulation. This is not possible if you are pumping or bottle feeding. Certain doctors may even suggest you to stop allowing your baby to suckle on a pacifier in case it affects his desire to suckle your breasts.

Advantages

The advantages of using the LAM method of birth control are as follows:

  • It does not cost you anything.
  • It is simple to use and is rather a by-product of a task that you are already performing.
  • It rules out the need for any visits to a doctor or the use of an external drug.
  • It does not interfere with sexual intercourse as it uses no external method of contraception.
  • LAM may also help the woman return to her pre-pregnancy weight as breastfeeding is known to burn about 300 to 400 calories a day.

Disadvantages

There are certain disadvantages associated with LAM. Some of them include:

  • It is a temporary method of contraception and works best for only six months.
  • If you feed formula to your baby, it is not a feasible option for you.
  • If you are a working woman, you will not be able to breastfeed your baby frequently, rendering LAM ineffective.
  • Predicting when your ovaries will release an egg may be difficult. Hence, it is best to get a different method of contraception when you start menstruating again.
  • It does not protect you against any sexually transmitted diseases.

While prolonged lactation method can be used even after your baby turns six months, it may not be a practical option for all the mothers. Especially since babies need to get all the nutrition they can get from other food sources to develop properly. This will make it difficult to breastfeed them over 8 to 10 times every day.

However, LAM method is an effective form of birth control if you fulfil all the requirements. It is important to switch to a more reliable method of birth control to prevent pregnancy when even one of the conditions of LAM are not met.