A postpartum woman asks about using breastfeeding alone as contraception. According to the lactational amenorrhoea method (LAM), all of the following conditions must be fulfilled EXCEPT:
- A The mother supplements feeds with expressed milk stored for more than 48 hours ✓
- B The infant is younger than six months
- C Menstruation has not returned
- D The infant is exclusively breastfed, day and night
Correct answer: A. The mother supplements feeds with expressed milk stored for more than 48 hours
Explanation
LAM is approximately 98% effective only when all three criteria are met: exclusive breastfeeding on demand day and night, amenorrhoea, and infant age under six months. Any supplementation with expressed milk, water, or formula breaks the exclusivity criterion, suppresses prolactin pulses less effectively, and disqualifies reliance on LAM alone. Expressed milk storage time is irrelevant; what matters is that the infant suckles directly and frequently.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.