Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
Lactational Amenorrhea Method, or LAM, uses breastfeeding as contraception, or a form of family planning. It has 98-99.5% effectiveness. It was developed after a conference at Georgetown University Institute for Reproductive Health in 1989.
There are currently three criteria:
A single interval of 10 hours, or intervals of more than 6 hours more than twice a week violates LAM.
Among other things, it is immediately obvious that this is incompatible with getting a baby to sleep through the night.
Slightly less obvious, milk expression by hand or pump may or may not provide enough nipple and breast stimulation to have the same effect on the mother's hormones; if used for regular separations of more than four to six hours, it raises the pregnancy rate to about 5%. Even less obvious, using pacifiers or anything else to satisfy the infant's need to suck may reduce nipple stimulation enough for fertility to return.
Recent research suggests this could be extended to 9 months, as long as the other criteria continue to apply, and possibly 12 months. Its efficacy after six months relies heavily on maintaining frequent, intensive breastfeeding. In that context, its failure rate may be comparable to the failure rates for all other reversible birth control methods (as long as periods have not resumed).
Breastfeeding stimulates the nipple, which produces prolactin.
Much of the research on how prolactin interacts with fertility suggests that this effects drops off after a few months, which is why LAM says six months, max. The research extending that to 9 or 12 months is based on populations of women who engage in intensive, exclusive or near exclusive breastfeeding for longer periods of time than has become the norm. Average return of bleeding with intensive breastfeeding is 15 months. Many women continue amennorheic for much longer than they would like, as they are trying to conceive another child. Some women have had their cycle return for a couple rounds then, when their child becomes ill and nurses intensively again, they went for months (as much as nine, possibly longer) without another period.
In addition to being a cheap, effective form of birth control for six months with no risky side effects and kind of hard to imagine failure in implementing, LAM is great for babies. They get lots of the best food for them, when they want it. Their gut is not disturbed by other foods which they may or may not be able to absorb well yet. When they do have supplemental foods, it is after they have filled up on breastmilk, and have lots of antibodies to help deal with anything unfortunate that came with the food.
Also, hormonal birth control containing estrogen can disrupt milk production (there are theoretical concerns about possible effects on the baby of any hormonal birth control, but no research to that effect). LAM cannot disrupt milk production; on the contrary, it is the best way to maintain an ample milk supply.
If you or your partner dislike barrier methods of birth control, this is one way around having to use them.
Copyright 2006 by Rebecca Allen.
Created February 2, 2006 Updated February 7, 2006