A breastfeeding mother at 10 weeks postpartum asks about using the lactational amenorrhoea method (LAM) as her sole contraceptive. Which set of conditions must ALL be fulfilled for LAM to be considered effective?

• A Exclusive breastfeeding, infant younger than 6 months, and return of menses
• B Exclusive or near-exclusive breastfeeding, infant younger than 6 months, and continued amenorrhoea ✓
• C Any degree of breastfeeding, infant younger than 12 months, and continued amenorrhoea
• D Exclusive breastfeeding, infant younger than 1 year, and absence of night feeds

Explanation

LAM is valid only when all three conditions coexist: the baby is under 6 months, feeding is exclusive or near-exclusive day and night, and menses have not returned. Option A fails because it requires return of menses rather than their absence, which is the opposite of the criterion. Once any single condition breaks, another method is needed because ovulation can precede the first menses.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.