The lactational amenorrhea method is a natural method of family planning for women who breastfeed their infants. The underlying physiology results in a natural suppression of ovulation, and the concomitant amenorrhea, induced by exclusive (or almost exclusive) breastfeeding. This in addition to the infant's age of 6 months or less and specific feeding pattern are the parameters used to identify the possible return of fertility. The lactational amenorrhea method provides at least 98% protection against pregnancy. Data from a recent multicenter study of breastfeeding support the use of the lactational amenorrhea method as a natural family planning method. The lactational amenorrhea method can be incorporated into natural family planning programs and teaching.
PIP: An introduction of the lactational amenorrhea method (LAM) if natural family planning for fully breastfeeding postpartum women is presented based on the Bellagio Consensus Statement and a study at centers in Australia, England and Canada. Natural family planning programs have until recently advised women to accept a 7-12 week period of natural infertility after childbirth, and to improve results of natural family planning by weaning the baby early to obtain regular menstrual cycles so they can use their prior natural method. Now that more women are breastfeeding, and lactational amenorrhea is being studied worldwide, it is recognized that LAM is about 98% effective for the 1st 6 months postpartum in fully breastfeeding women. The collaborative study found that the 1st ovulation occurred on Day 264 in Canada and 237 in Australia on average. An algorithm for questioning a mother to learn if she is a candidate for LAM from the Bellagio Consensus is included. MOre research needs to be done on the significance of spotting, how intense breastfeeding must be, whether any supplementation of use of a pacifier is possible, whether the pregnancy rate can be reduced, and what program changes are needed to put LAM into effect.