Month: March 2013

Is breastfeeding a contraceptive?

I couldn’t help but smile to myself as I wrote that… only today someone was talking about this and said that the chances of sex happening again in the foreseeable future was slim – the process of labour and giving birth was enough to ensure there was little chance of any pregnancy-inducing behaviour happening in their house 🙂

However, the question of the contraceptive effect of breastfeeding does come up quite often so I thought I’d put some information here.  Breastfeeding as a way of avoiding pregnancy is referred to as the Lactational Amenorrhea Method, or LAM.  This method has only a 1% to 2% failure rate providing all 3 of the following are true:

  • the mother’s period have not returned since the birth of her baby (spotting or bleeding during the first 56 days does not count) AND
  • the mother is breastfeeding her baby on demand day and night, with no other regular drink or food substitutes AND
  • the baby is less than six months old

If any one of these is not true then the chance of LAM being effective is reduced, and at the point that any one of the above conditions changes, the couple should use other methods of contraception if they are keen to avoid pregnancy.

Return of Menstruation – during the first 56 days after a woman has given birth, spotting or bleeding does not count as a period.  However, after the first 56 days, spotting or bleeding of 2 days or longer duration should be considered as a period, or any other bleeding that the mothers feels is a return of menstruation.  This would mean that LAM may no longer be effective and other contraception should be used.

Breastfeeding at Night – for the second condition to be considered effective, the mother should be breastfeeding at least once during the night as well as on demand during the day.  Prolactin levels are higher at night thus having a greater impact on fertility.  If the baby goes longer than 4 hours during the day or 6 hours at night without breastfeeding, the effectiveness of LAM may be reduced and other contraception should be considered.

The Baby is less than 6 months old – once a baby reaches 6 months old it is common for other foods to be introduced and for babies to go longer between feeds.  Due to less breastfeeds taking place from 6 months old, LAM may become less effective and other contraception should be used.

Methods of contraception that will not impact breastfeeding are barrier methods such as condoms or diaphragms, spermicides, or non-hormonal IUDs.  Natural family planning methods can be hard to use at this stage due to the impact of breatfeeding on the signs of fertility.

After the first six weeks, progesterone only methods such as the mini-pill, injectable contraceptives, and other IUDs may be suitable.  Progesterone only methods are unlikely to have an impact on breastfeeding, but it is advisable to wait until six weeks or so has passed to allow breastfeeding to become more established.

For more information about LAM and contraception, check out this very useful website:  http://www.waba.org.my/resources/lam/#LAM