Among the benefits of breastfeeding is the delayed return of the menstrual period, hence ovulation resumes at a later time. This effect of breastfeeding on a woman who has just given birth is known as lactational amenorrhea. "Lactational" pertains to breastfeeding, and "amenorrhea" means not having monthly menstrual periods. It is counted among the natural methods of birth spacing, and is recommended to allow women to recover fully from the stresses of childbirth before the next baby comes.
CRITERIA FOR LAM
You need to comply with at least three criteria for the lactational amenorrhea method (LAM) to achieve 98 to 99 percent effectiveness:
1. You should fully or nearly fully breastfeed. This means that you nurse your baby at least every four hours during daytime, and every six hours at night. No substitution or supplementation of breast milk should take place, whether it be water, juice, or cereal drink. A breast pump may be used if certain factors make it difficult to directly breastfeed (you may be away at work or are allowing some time for sore nipples to recover). In this case, use a breast pump then give breast milk to your baby by bottle. You should, however, be cautioned that your risk of pregnancy may be increased to five to six percent if artificial methods to express breast milk are utilized. This is because artificial breast pumps stimulate the release of the hormone prolactin in an amount that may vary from natural breastfeeding. This may not reliably prevent ovulation, increasing the chances of getting pregnant.
2. Your menstrual period has not yet returned. Resumption of menstrual period is defined as having bleeding or spotting for two consecutive days, occurring beyond the first two months after giving birth. This means that you may have resumed ovulating and are already fertile. In this situation, LAM may not be reliable as a birth spacing method.
3. Your baby should not be more than six months old. Infants beyond six months old already need supplemental feeding, hence the decrease in frequency of breastfeeding. With this, the ovarian function may no longer be reliably suppressed by the continuous secretion of the prolactin hormone, and fertile ovulatory periods subsequently return.
OTHER ALTERNATIVES
If you fail to meet even just one of the three criteria above, you should approach your health care provider for a more reliable method for birth spacing. The rhythm or calendar method may not be applicable at this point because ovulation, and hence menstruation, may still be erratic especially if you are still partially breastfeeding.
Barrier methods like condoms, and of course, abstinence will help you space your pregnancies. You may also be given hormonal contraceptives that may be started six weeks after you give birth. If you're breastfeeding, you should be given progesterone-only hormonal contraceptives such as the desogestrel pill, the lynestrenol pill, and the depot medroxyprogesterone injectable. Take the pills continuously, one tablet every day until you decide to have another child, or when you stop breastfeeding. Once you've weaned your baby, any ordinary combined oral contraceptive pill can replace the progesterone-only pill.
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