A 28-year-old woman is counselled on postpartum family planning. She delivered a healthy baby 6 weeks ago and is exclusively breastfeeding. The Lactational Amenorrhea Method (LAM) is offered. Which condition must be STRICTLY met for LAM to provide >98% contraceptive efficacy?
- A Infant is < 12 months old, any breastfeeding including supplementary feeds
- B Infant is < 6 months old with at least one breastfeed per day
- C Infant is < 6 months old, woman is amenorrhoeic, and breastfeeding is exclusive with no supplementary feeds ✓
- D Any breastfeeding after 2 months of age irrespective of amenorrhoea
Correct answer: C. Infant is < 6 months old, woman is amenorrhoeic, and breastfeeding is exclusive with no supplementary feeds
Explanation
LAM provides > 98% contraceptive efficacy when all three criteria are simultaneously met: (1) infant age < 6 months, (2) woman is fully amenorrhoeic (no return of menses), and (3) breastfeeding is exclusive (no supplementary liquids or solids). Any one criterion being absent — resumption of menses, introduction of supplements, or infant age ≥ 6 months — drops efficacy significantly and an alternative contraceptive must be started. This triple requirement is the basis for LAM counselling in the 'Healthy Timing and Spacing of Pregnancies' framework.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.