Lactational amenorrhoea method (LAM) provides contraceptive protection when three conditions are simultaneously met. Which of the following correctly states ALL three required criteria?
- A Exclusive breastfeeding, infant age <12 months, mother is amenorrhoeic
- B Exclusive breastfeeding, infant age <6 months, mother is amenorrhoeic ✓
- C Mixed feeding acceptable, infant age <6 months, no menstruation since delivery
- D Exclusive breastfeeding, infant age <6 months, and at least 4 feeds/day
Explanation
The Bellagio Consensus (1988) established that LAM is 98–99% effective when ALL three criteria are present simultaneously: (1) the mother is fully/exclusively breastfeeding (no supplementary feeds); (2) she has not resumed menstruation (amenorrhoeic); and (3) the infant is less than 6 months old. When any one condition is no longer met (e.g., infant reaches 6 months, menstruation returns, or supplemental feeds are introduced), another contraceptive method must be added. Mixed feeding undermines LAM efficacy by reducing suckling-driven prolactin suppression of ovulation.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.