The Lactational Amenorrhea Method of Birth Control (LAM)

Different methods of birth control work for different people depending on their personal needs. For postpartum mums, navigating birth control methods can feel complicated at times. Fortunately, you can use a natural method if you breastfeed your baby right after delivery. Breastfeeding exclusively is a natural family planning method called the lactational amenorrhea method of birth control. It is effective in preventing pregnancies and spacing births.

There are a variety of birth control methods you can choose from immediately following the delivery of your baby. However, many women believe that the LAM method is a great choice for several reasons.

What is the Lactation Amenorrhea Method (LAM)? 

The word lactation refers to the release of breast milk from the mammary glands found in the breasts. Amenorrhea refers to the absence of a monthly period. The lactation amenorrhea method is a family planning method that relies on the hormones released during breastfeeding. When this method is used correctly, it is quite effective in preventing pregnancy in breastfeeding mothers.

Women are recommended to talk to their healthcare provider about the method of contraception they plan to use after giving birth. If you choose to use the lactation amenorrhea method, your healthcare provider can explain how to use it correctly.

Does the Lactational Amenorrhea Method Work? 

LAM does work when used correctly. It is 98 % effective for the first six months after childbirth. There is no need for another form of birth control during the time this method is used.

This type of birth control begins when an infant sucks on the breast. This suckling behavior reduces the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. The lowered levels of GnRH cause estrogen levels to drop and the luteinizing hormone (LH) which is released from the pituitary gland to also decrease.

According to the National Library of Medicine, prolactin, (the milk hormone), immediately increases in your bloodstream when breastfeeding is initiated. Lower LH levels and higher prolactin levels stop ovulation from occurring. Not only does ovulation stop, but the lining of the uterus is changed so that the implantation of an embryo is impossible. This period of infertility is temporary.

When Can LAM Be Used as a Birth Control Method? 

Three conditions must be met for breastfeeding to be considered an effective method of birth control. If one of the below conditions is not met, LAM won’t be reliable.

If all of the following conditions are met, then LAM will be 98 % effective at preventing pregnancy. 

• You must be exclusively breastfeeding your baby. Your breast milk should be the sole food that your baby consumes. You shouldn't feed your baby solid foods, formula, or supplements. The baby should feed every 4 hours during the day, and every 6 hours during the night.

• You must be under 6 months postpartum.
• You have not had a menstrual period since delivery.

What Are the Advantages and Disadvantages of LAM? 

There are many advantages and disadvantages of LAM.

Advantages of LAM

• It is effective for 6 months.
• It is a natural contraceptive that works right after giving birth.
• Your milk supply is not affected. According to the National Library of Medicine, hormonal contraception that contains estrogen negatively affects milk supply and reproductive health.
• It doesn’t cost anything.

• Breastfeeding has many benefits. It decreases your chances of getting breast cancer in the future, and it is very nutritious for your child.

Disadvantages of LAM

• It is temporary since it only lasts up to 6 months after birth.

• It can be difficult to exclusively breastfeed. Sometimes, exclusive breastfeeding is not possible for the mother for many different reasons.
• If it is used incorrectly, fertility can quickly return. One may not realize this until their menstrual cycle has returned. 
• Breastfeeding exclusively can cause unwanted side effects like less cervical mucus, which can make sexual intercourse painful.
• If you have a health issue like active tuberculosis, breastfeeding is not recommended. Also, according to the American Academy of Pediatrics, it is not recommended for women who have HIV to breastfeed their children. 

When is Breastfeeding as Contraception No Longer Effective? 

LAM is considered not to be effective in the following circumstances:

• If your first period arrived after delivery. (Any bleeding that lasts for at least 2 days and occurs after 2 months of delivery).
• If your baby is older than 6 months old, has started on solid foods, or drinks formula with breastmilk.

• If you express your milk by pumping.
• If your baby uses a pacifier.
• If your baby dropped a night feeding.
• If you take medications that affect the efficiency of the lactational amenorrhea method. These medications include mood-changing drugs, reserpine, ergotamine, anti-metabolites, cyclosporine, corticosteroids, bromocriptine, radioactive drugs, lithium, and anticoagulants. To find out more about which type of medicine affects the reliability of LAM, consult with your healthcare provider.

Other Methods of Birth Control for Breastfeeding Mothers

When LAM is no longer an option, you should visit a doctor to explore other birth control options that you can switch to. For breastfeeding mothers, non-hormonal birth control methods are safe. Certain hormonal birth control may also be safe to take. These safe methods include:

• Barrier methods including condoms, cervical caps, and diaphragms. Adding spermicide can make these methods much more effective.
• Birth control pills (progestin-only pills or the mini-pill)
• Skin patches and vaginal rings (progestin-only options)
• A copper intrauterine device (IUD)
• Depo-Provera shot

Progestin-only contraceptives may negatively affect your mood. Also, progestin and estrogen-containing hormonal oral contraceptives can negatively affect the quality and quantity of your milk supply.

Moreover, many healthcare systems cover the cost of birth control. Call your insurance to find out if the cost of birth control is covered partially or completely.

In Conclusion 

Since the lactational amenorrhea method is free and good for babies, it is a popular choice among many mothers. It is highly effective when the three conditions are met. However, it may require sacrifice in some areas, such as breast pumping. Consult your doctor about the best birth control method for you – whatever your personal needs and circumstances, there is a birth control method out there that is right for you, and what method you choose is ultimately your decision.