Clinical study of the lactational amenorrhoea method for family planning

TLDR

Breastfeeding is known to reduce fertility, and the lactational amenorrhoea method (LAM) was formalized in 1988 to use this effect as a family‑planning method, protecting women who fully breastfeed and remain amenorrhoeic for the first six months postpartum. We evaluated LAM within a breastfeeding support intervention involving 422 middle‑class women in urban Santiago, Chile. The 6‑month pregnancy rate among women using LAM alone was 0.45% (one pregnancy in month 6), demonstrating high acceptance and efficacy and supporting LAM as a safe introductory method for breastfeeding women.

Abstract

The effect of breastfeeding on fertility is well known; however, its use as a method of family planning was, until recently, untested. In 1988, the Bellagio Consensus Conference proposed guidelines that became the basis for a method of family planning called the lactational amenorrhoea method (LAM). The principle of LAM is that a woman who continues to fully or nearly fully breastfeed her infant and who remains amenorrhoeic during the first 6 months postpartum is protected from pregnancy during that time. We have assessed this method in the context of a breastfeeding support intervention study of 422 middle-class women in urban Santiago, Chile. The cumulative 6-month life-table pregnancy rate was 0·45% among women who relied on LAM as their only family planning method (1 woman pregnant in month 6). The findings indicate that LAM, with its high acceptance and efficacy, is a viable method of family planning and can safely serve as an introductory method for breastfeeding women.