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Netw Res Triangle Park N C. 1996 Fall;17(1):12-14, 24.

Research confirms LAM's effectiveness. Contraceptive update.



In December 1995, in Bellagio, Italy, 24 specialists in the lactational amenorrhea method (LAM) from nine countries served on a panel that analyzed the results of studies in more than 12 countries. These studies were coordinated by Family Health International, the World Health Organization, and Georgetown University's Institute for Reproductive Health (IRH). LAM is more than 98% effective during the first 6 months postpartum. The three criteria a woman must meet to use LAM correctly are: 1) she must be amenorrheic since delivery; 2) she must be fully or nearly fully breast feeding; and 3) she must be in the first 6 months postpartum. Should any of these criteria change, LAM users should switch to another family planning method if they wish to prevent pregnancy. The recent research suggests that increasing the 6-month criterion to 9-12 months after delivery might be possible under certain conditions (e.g., if breast feeding takes place immediately before each supplemental feeding). Further research is needed before amending this criterion, however. The most critical of the LAM criteria is being amenorrheic, since the end of amenorrhea indicates a return of ovarian activity. Based on the research findings, the specialists put together a consensus statement: The efficacy of LAM has now been well established in prospective studies, and programs should regard LAM as an additional method that increases family planning choices for postpartum women. The consensus also stated that the lactational amenorrhea method should receive the programmatic and policy support necessary to become available worldwide. IRH has developed and tested LAM use guidelines in five languages. The LAM specialists in Bellagio emphasized that they were not promoting LAM above other methods but rather validating its scientific effectiveness. They did not limit their promotion of breast feeding to LAM but also promoted breast feeding for its other benefits (e.g., it lowers an infant's risk of infection).

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