Breastfeeding As Birth Control: The Lactational Amenorrhea Method (LAM)

Using Exclusive Breastfeeding To Prevent Pregnancy

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Exclusive breastfeeding can prevent pregnancy for up to 6 months. Kidstock/Getty Images

What is LAM?

The lactational amenorrhea method (LAM) is a natural form of birth control. Lactation is the term used to described breastfeeding and the production of breast milk, while amenorrhea means not having a period. So, since exclusive breastfeeding can put off the return of ovulation, your period, and your fertility for many months, LAM can be used to prevent pregnancy. When followed correctly, LAM is up to 98% effective during the first 6 months postpartum.

But, there are three conditions which need to be met in order for LAM to continue to be a reliable method of birth control. They are:

  1. You must breastfeed exclusively and around the clock: Your baby should be nursing 6 to 8 times throughout the day and night. You should not give any formula, water, other supplementation, or solid foods to the baby for a full 6 months. It is important to note that pumping, even exclusive pumping, is not the same as breastfeeding. If you have to return to work or school, or you need to be separated from your baby and begin to pump for some or all of your child's feedings, LAM will no longer be reliable.
     
  2. You must not have any menstrual or vaginal bleeding: After the postpartum bleeding ends, there should not be any more vaginal bleeding. Once your period returns, so does your fertility, therefore, LAM will no longer be effective.
     
  3. Your baby must be under 6 months of age: LAM is only considered to be an effective form of birth control for the first 6 months after the birth of your baby.

    If at any time, one or more of these conditions are no longer being met, you can become pregnant. If you do not want to have another child right away, you will need to choose another form of birth control. Talk to you doctor to learn about the many types of contraception that are safe and effective for nursing women.

    The Benefits of LAM

    • LAM is up to 98% effective. When used correctly this method of birth control can be as effective as some of the prescription contraceptives.
       
    • It is an all natural form of birth control that can be used for up to 6 months. This gives you time to decide what type of birth control, if any, you would like to use going forward.
       
    • It will not interfere with your milk supply. Some hormonal types of birth control can decrease the supply of breast milk, but since LAM is natural, it will not have any affect on your milk supply.
       
    • It's economical. Birth control can be expensive, but with LAM there's nothing to buy.

    The Drawbacks of LAM

    • LAM is only effective for 6 months. After 6 months you need to use an alternative method of birth control if you do not wish to get pregnant again.
       
    • You must breastfeed exclusively. It can be difficult to exclusively nurse a child for a full 6 months. If you decide to breastfeed only part of the time, you can no longer use LAM. Also, once you begin pumping for your child, or you start giving your baby any type of cereal or solid foods, LAM will no longer work as your method of birth control.
       

    Sources:

    American Academy of Pediatrics. New Mother’s Guide To Breastfeeding. Bantam Books. New York. 2011.

    Labbok, M. H., Hight-Laukaran, V., Peterson, A. E., Fletcher, V., von Hertzen, H., & Van Look, P. F. Multicenter study of the Lactational Amenorrhea Method (LAM): I. Efficacy, duration, and implications for clinical application. Contraception. 1997: 55(6); 327-336.

    Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Seventh Edition.  Mosby. 2011.

    Newman, Jack, MD, Pitman, Theresa. The Ultimate Breastfeeding Book of Answers. Three Rivers Press. New York. 2006.

    Riordan, J., Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2010.

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