The lactational amenorrhea method (LAM) is a type of birth control that relies on hormones your body makes while breastfeeding. If you strictly meet the guidelines, LAM can be 98% effective in preventing pregnancy within the first 6 months after you give birth.
LAM is on the list of the World Health Organization’s list of accepted, proven birth control methods. When followed exactly, it works as well as the pill and other contraceptives.
How Does It Work?
When your baby suckles, or drinks milk from your breast, it sends a signal to your ovaries to stop making eggs. The release of an egg could start another pregnancy. The extra-high level of the hormone prolactin, which prompts your body to make breast milk, works with that mechanism so that you stop having periods. The process is called lactational amenorrhea.
When you stop or taper off breastfeeding, your body will start the fertility cycle again. If you don’t use LAM or another birth control method, you can get pregnant as soon as 1 month after you give birth. The odds of getting pregnant rise to 85% within a year if you’re having sex without using a birth control method.
What Does It Require?
Breastfeeding alone isn’t birth control. If you want to use LAM, you have to follow guidelines exactly to prevent pregnancy. This means all of these things have to happen:
- Your baby is younger than 6 months.
- Your baby’s only nutrition – food and fluids – comes from your breast milk. Sometimes it’s OK to supplement with other fluids or nutrients as long as they don’t replace feedings. You’ll need to stick to your breastfeeding schedule, though.
- Your baby’s nursing schedule must include a feeding every 4 hours during the day, and at least every 6 hours at night. If your baby drops a night feeding, LAM will no longer work.
- You haven’t had a menstrual period. This is any bleeding for 2 days in a row or more that happens starting 2 months after your baby’s birth. It doesn’t include other vaginal bleeding that can happen after you give birth.
If LAM is working, you might be able to use it past 6 months if you keep up your breastfeeding schedule as you introduce solid foods to your baby. When any of the three key factors change, it’s time to have another type of birth control at the ready.
Is It OK to Pump?
It’s not clear if the action of pumping breast milk has the same effect as nursing in stopping you from ovulating. Most experts say that for LAM to work, your baby should be fed 100% from your breast. This means you won’t be protected if you:
- Use a pump to express breast milk
- Use a bottle to feed your baby
- Feed your baby formula
- Give your baby a pacifier often, or at all. LAM requires your baby to suck on your breast.
Other Benefits of LAM
Besides the health and emotional benefits of breastfeeding for both mother and baby, LAM can be a wise choice in other ways. If it suits your lifestyle and the required things are in place, you can expect some other perks, including:
- You don’t need a method of birth control that will add extra hormones or chemicals to your body or your breast milk.
- It’s free and requires no supplies.
- It works right away.
- It’s important in places where other birth control can be hard to get.
Drawbacks of LAM
- LAM has a high “typical use failure rate.” This means lots of women who set out to use the method don’t or can’t meet the guidelines exactly. When this happens, LAM doesn’t work.
- Not everyone finds it realistic.
- Women with certain health issues, including active tuberculosis, H1N1 influenza, or herpes simplex lesions on their breasts, are advised to not breastfeed.
- It’s possible to have a first period within a few months, even if you’re breastfeeding 100%. This is a sign you’re ovulating. It’s also normal to not have a period for a whole year even if you’re not breastfeeding. Either of these means LAM won’t work.
When Do You Need Backup?
If you use LAM, it’s not a bad idea to have another method on the back burner in case following the guidelines doesn’t work out for you. You should be ready to switch to another method of birth control by the time your baby is 6 months old. Also, LAM doesn’t protect against HIV or other STDs. Be sure to use a condom if there’s any chance of transmission.
If you haven’t followed LAM exactly and have had sex without other protection in the last 5 days, consider getting emergency contraception.
