A breastfeeding mother at her six-week visit asks about contraception using the lactational amenorrhoea method. Which combination must all be satisfied for reliable protection?

• A Exclusive breastfeeding day and night, infant younger than 12 months, and no return of menses
• B Any breastfeeding frequency, infant younger than 12 months, and no return of menses
• C Exclusive breastfeeding day and night, infant younger than 6 months, and no return of menses ✓
• D Breastfeeding plus complementary feeds started, infant younger than 6 months, and no return of menses

Explanation

The three Lactational Amenorrhoea Method criteria are: the mother must be fully or nearly fully breastfeeding with frequent day and night feeds, the infant must be under 6 months old, and menses must not have returned. If any single criterion fails, another contraceptive method is needed because ovulation can precede the first bleed. Option A fails on the age limit, since suckling-induced suppression of GnRH pulsatility becomes unreliable beyond 6 months even with exclusive feeding.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.