The lactational amenorrhea method (LAM) of contraception is considered highly effective (>98%) under which SPECIFIC conditions?
- A Breastfeeding any frequency, infant less than 12 months, and amenorrhea present
- B Partial breastfeeding with supplementary feeds, infant less than 6 months
- C Exclusive or near-exclusive breastfeeding, infant less than 6 months, and amenorrhea present ✓
- D Exclusive breastfeeding alone regardless of menstrual status
Correct answer: C. Exclusive or near-exclusive breastfeeding, infant less than 6 months, and amenorrhea present
Explanation
The Bellagio Consensus established three criteria that must ALL be present for LAM to provide >98% contraceptive efficacy: (1) the infant is less than 6 months old, (2) the woman is fully or nearly fully breastfeeding (exclusive or near-exclusive, on demand, day and night), and (3) the woman remains amenorrheic. If any criterion is not met, additional contraception must be used. Beyond 6 months or with any menses, LAM reliability declines significantly regardless of breastfeeding intensity.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.