Breastfeeding as a birth control (LAM)
LAM
You may have heard that breastfeeding can, in some defined circumstances, prevent a woman from becoming pregnant.
This is called the Lactational Amenorrhea Method, or LAM.
The World Health Organisation has considered this method, alongside a lot of other modern methods, as 98% effective.
This 98% reliability means that this temporary family planning method is as reliable as the pill.
We know that this method (which involves following strict guidelines and reassessing those over time), can contribute to natural child spacing around the world.
So how does LAM work?
Studies have shown that if you exclusively breastfeed your baby night and day, for the first six months, and you haven’t had a period, it’s very unlikely that you will get pregnant.
We know that breastfeeding interferes with the hormones involved in triggering ovulation, so the more you feed, the less likely ovulation will happen.
If you are breastfeeding, you may be relying on barrier methods of contraception, an intrauterine device, or the mini pill.

Still, it is useful to know that exclusive breastfeeding, combined with those methods, can offer even more protection.
It is, however, essential to know that LAM does NOT offer any protection against sexually transmitted infections.
If you are at risk of these, then barrier methods would be critical.
So how do you use this method?
It’s extremely important that you meet all three of the following conditions.
1) You must be exclusively breastfeeding your baby on demand, night and day, with no more than four hours between feeds in the day, and six hours at night. It’s also important that you are NOT giving any supplementary fluids or food to your baby – just breast milk alone.
2) You must not have had a period since giving birth. That is defined as any bleeding that has occurred over two consecutive days after eight weeks of giving birth.
3) Your baby must be aged six months or younger. It’s far less likely that you will ovulate in the first six months. You are less likely to be fertile at that time (although it is still possible to get pregnant), and that’s why the method is 98% effective and not 100%.
Be aware that your baby suckling at the breast is an essential factor in suppressing ovulation, which means that if you are pumping your milk and giving it by a bottle or other method, this will not be effective.
If you do decide to use LAM it’s really important that you make sure that you fit the criteria, and keep reassessing things over time.
Ask those three questions of yourself, and if you find ONE of those things has changed, then you must consider alternative forms of contraception.
Review dates, references & further resources
Review Dates
Version 1.1 published in March 2019. Next review date: Jan 2022
References
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