A mother is exclusively breastfeeding her infant day and night, has had no menses since delivery, and the baby is 5 months old. She asks how much contraceptive protection the lactational amenorrhoea method currently gives her.

• A No reliable protection beyond 3 months postpartum
• B Nearly 100 percent, equivalent to sterilization
• C About 85 percent, similar to typical-use pills
• D Approximately 98 percent, provided all three criteria remain satisfied ✓

Explanation

The lactational amenorrhoea method is valid only when all three criteria hold simultaneously: exclusive or near-exclusive breastfeeding day and night, true amenorrhoea since delivery, and infant younger than 6 months. Under these conditions pregnancy protection is about 98 percent, comparable to other modern methods. Once any criterion fails, notably return of menses or introduction of supplementary feeds, or once the infant reaches 6 months, another contraceptive method must be adopted promptly. The method relies on suckling-induced prolactin release suppressing GnRH pulsatility and ovulation.

Reference: Selected Practice Recommendations for Contraceptive Use, 3rd, WHO ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.