A couple is using the lactational amenorrhoea method (LAM) of contraception. Which THREE conditions must ALL be met simultaneously for LAM to provide >98% efficacy?

• A Exclusive breastfeeding, infant < 12 months, mother is amenorrhoeic
• B Exclusive breastfeeding, infant < 6 months, mother is amenorrhoeic ✓
• C Partial breastfeeding, infant < 6 months, postnatal period < 3 months
• D Exclusive breastfeeding, infant < 6 months, >3 months postpartum

Explanation

LAM provides >98% contraceptive efficacy only when all three Bellagio criteria are simultaneously met: (1) exclusive breastfeeding (on demand, day and night, without supplementary feeds), (2) infant less than 6 months of age, and (3) the mother has not resumed menstruation. If any one criterion is not met, another contraceptive method should be used. Partial breastfeeding or resumption of menses significantly reduces efficacy.

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.