Lactational Amenorrhea Method (LAM)

This method works as frequent suckling decreases the secretion of GnRF (gonadotropin-releasing factor) by the hypothalamus. This, in turn, suppresses the anterior pituitary glands secretion of LH. The LH surge required for ovulation does not occur. The Lactational Amenorrhea Method (LAM) is a family planning method for breastfeeding women who must fulfil the following three criteria:

1. The woman must be in the first 6 months postpartum.
2. The woman must be fully or nearly fully breastfeeding. “Fully or nearly fully breastfeeding” means breastfeeding on-demand on both breasts with feedings not more than 4 hours apart during the day, or 6 hours apart during the night.
3. The woman must be amenorrheic (not having menstrual bleeding). Bleeding occurs in the first 56 days postpartum is not considered menstrual bleeding because it is not preceded by ovulation.

If the woman is “fully or nearly fully breastfeeding” and amenorrheic, breastfeeding is 98% effective as a contraceptive method during the first 6 months postpartum or until the first menstrual period. Food or liquid must not be given regularly to the baby as substitutes for breast milk meals. Before any one of these three LAM criteria no longer applies, the woman should be assisted in choosing another available and acceptable family planning method. If a woman chooses to use oral contraceptives, pill packets may be given to the woman in advance (while she is still relying on LAM), so there will be no delay in initiating the new method when the woman needs it.