Breastfeeding is an important factor in natural regulation of births globally, the interval between two births is much lower in populations where breastfeeding is the norm. However, what is a conclusion to the population level is not necessarily true for a specific individual. LAM (Lactational Amenorrhea Method) is a very effective at the individual level using the physiology of breastfeeding for child spacing. The suction causes the mother's release specific hormones that inhibit ovulation through mophine-like substances. The beta-endorphins inhibit the secretion of prolactin inhibitory factor and dopamine, which in turn increases the secretion of prolactin. A decrease in time spent in the child may cause resumption of ovulation.
Breastfeeding mothers, the cycles are almost always anovulatory if they occur during the first 6 months, and the level of fertility is very low. LAM is based on three conditions that must be met simultaneously:
- The baby is under 6 months
- The mother is amenorrheic
- Breastfeeding is practiced on demand day and night
The main advantage of LAM is not only that it is a good method of birth control while breastfeeding, but also promotes a smooth breastfeeding. Wherever family planning consultations have included in their strategies for LAM, there was a statistical improvement of breastfeeding. LAM has an efficiency of at least 98%, making it very competitive other methods. It avoids the unnecessary use of another method of contraception, and its acceptability, although not tested on a large scale (like most natural methods in our country) seems excellent for couples motivated. In some cultures, it may even be the only method that seems acceptable (eg religious). It also allows couples to take time to make an informed decision whether they choose contraception after LAM.
The introduction of LAM into programs of family planning requires strong knowledge on the part of teams, special attention to mothers, a positive attitude of the team, the collaboration between the antennas and family planning services monitoring of mothers during pregnancy and postpartum, and close monitoring to detect when another method will take over. It should also invest enough money and energy to enable studies on a large scale, evaluations. how to make this method more effective.
In conclusion, LAM is an effective method of birth spacing that should benefit from the promotion it deserves.
LAM: a reliable option
Breastfeeding is the primary method of birth control throughout the world for centuries. Despite this, the impact of contraceptive breastfeeding is regarded with a skeptical eye in industrialized countries.
The bases of the LAM (Breastfeeding and Amenorrhea) were raised in 1988, based on the findings of the Bellagio Consensus. Three elements are fundamental in LAM: or almost exclusive breastfeeding (space between feeds: no more than 4 hours on the day, not more than six hours at night), the fact that the woman is amenorrheic (no vaginal bleeding after the 56th day postpartum), and age of children less than 6 months. When these conditions are fulfilled, the protection provided by breastfeeding a new pregnancy is greater than 98% during the first 6 months. Theoretically, when a parameter is not respected, the risk of conception increases, and another method of birth control should be considered.
A number of studies on LAM, conducted in 11 countries, showed that the effectiveness of LAM was 98.5 ± 0.7%. Approximately 40% of women who chose the LAM used for the first 6 months postpartum, and 84% of them were perfectly satisfied with this method. Further studies conducted in Canada, England and Australia suggests that the risk of pregnancy would in practice be significantly below 2% in the populations studied. It is believed more than LAM remains effective after six months, or when supplements were introduced. The Australian studies found a risk of 7 to 12% of pregnancy when LAM was used after 6 months postpartum, and that the child was receiving other foods. Studies conducted in 11 countries found themselves an average efficiency to 12 months of LAM from 92.9 ± 1.8%. The use, in conjunction with LAM, natural methods of contraception (the study of mucus, cervix, temperature curve) yielded a risk of pregnancy to 12 months less than 2%.
Studies show that 70-80% of women who breastfeed exclusively for 4 to 6 months have not had their menses for 6 months. The author concludes that the LAM can be considered a reliable method of birth control while breastfeeding.