Lactational Amenorrhea Method (LAM): Understanding Natural Pregnancy Prevention

The Lactational Amenorrhea Method, or LAM, is also known as continuous breastfeeding. This is a natural option to prevent pregnancy after you have given birth. Many women find LAM to be appealing because it is safe, free, and effective.

Can You Get Pregnant While Breastfeeding?

Although the Lactational Amenorrhea Method is an effective birth control option, there are some things to be aware of—if not, you can get pregnant while breastfeeding.

• You should only rely upon continuous breastfeeding as a contraceptive method if it has been less than six months since you have given birth and your period has not yet returned.
• If you are a breastfeeding mommy, you might be more comfortable relying on an additional contraceptive method.

How Continuous Breastfeeding Works

Breastfeeding can be used as a contraceptive method if you are practicing continuous breastfeeding after giving birth. In order for LAM to be effective, you must solely be breastfeeding your baby—this means that your baby is not drinking anything besides your breast milk. Continuous breastfeeding works because the hormone required to stimulate milk production prevents the release of the hormone that triggers ovulation. And, pregnancy cannot take place if your body is not releasing an egg each month.

Advantages of LAM

Breastfeeding is a safe and effective birth control method. The Lactational Amenorrhea Method:

• Has no side effects.
• Is convenient and free.
• Does not affect your natural hormone balance.
• Requires no prescription or medical supervision.
• Is immediately effective.
• Reduces bleeding after delivery.
• Allows for greater sexual spontaneity—nothing needs to be put in place before having sex (like a condom, female condom, spermicide, sponge, or diaphragm).

Continuous breastfeeding also offers many health advantages for your baby. These include:

• Increased body contact—which leads to enhanced comfort for your baby and bonding between mommy and baby.
• Protection against the development of allergies and may protect against the development of asthma.
• Allows for the passage of some of the mother's antibodies which can protect your baby from certain infections.
• Providing your baby with the best nutrition available.

Disadvantages of Continuous Breastfeeding

• No protection against sexually transmitted infections.
• Can only be relied on for six months after delivery.
• May lessen vaginal lubrication.
• Exclusive breastfeeding may be difficult to accomplish.
• Some women say that breastfeeding may make the breast seem less sexual.

Effectiveness of the Lactational Amenorrhea Method

Continuous breastfeeding is up to 98% effective as a natural contraceptive for up to six months after childbirth and if your period has not returned.

• Typical use: 95% effective
• Perfect use: 98% effective

This means that of every 100 women who use LAM, 5 will become pregnant within the first 6 months (with typical use) and less than 2 will become pregnant with perfect use.

• Effectiveness rates only apply to women who are exclusively breastfeeding for the first 6 months after giving birth.

If You Don't Want to Get Pregnant While Breastfeeding

If you are relying on continuous breastfeeding as your birth control method, it is super important that you understand the following (if not, you could get pregnant while breastfeeding):

• You can only rely on continuous breastfeeding—as contraception—for six months after you have delivered your baby.
• During this time, do not substitute other foods for a breast milk meal.
• You should be breastfeeding your baby at least every four hours during the day and every six hours at night.
• You have not had a monthly period since you delivered your baby.

So, for maximum effectiveness, you should not rely on LAM for more than 6 months or if you have had a period since giving birth. This means that even if you are exclusively breastfeeding your baby, you must choose another birth control method by the time the baby is six months old (or if you get your period before this time).

Also, the Lactational Amenorrhea Method is only effective (as birth control) if you feed your baby at least 6 times a day, with both breasts, You also cannot be substituting other foods for breast milk. Breastfeeding women who depend on LAM to prevent pregnancy should:

• Limit the number of supplemental feedings given to their babies to no more than 5% to 10% for the best contraceptive results.
• Feed their babies every 4 hours during the day and every 6 hours at night—spacing feedings out this way will maximize the effectiveness of continuous breastfeeding.

What About Pumping Breast Milk?

You may be wondering if pumping breast milk to put into bottles will make continuous breastfeeding less effective. It seems that the answer to this is yes. The American College of Obstetricians and Gynecologists advises that direct breastfeeding (not pumping) is the most effective method for women relying on the Lactational Amenorrhea Method. When you bottle-feed your baby (even if the bottle contains your pumped breast milk), it lowers the frequency and vigor of your baby's suckling. It can also lower your maternal neuroendocrine response—this means that you have a higher chance that your fertility will return, and you could get pregnant even though you are breastfeeding.