Lactational amenorrhoea method (LAM)

The lactational amenorrhoea method (LAM) is a temporary type of contraception that uses breastfeeding to naturally prevent ovulation and reduce the chance of pregnancy in the first 6 months after giving birth.

'Lactational' refers to milk production. 'Amenorrhoea' means not having your menstrual period.

For LAM to work, you must meet all its requirements. If you don't meet these requirements, LAM becomes less effective in preventing pregnancy.

Breastfeeding can temporarily lower your fertility by stopping your body from ovulating.

LAM works because when you breastfeed often, the level of the hormone prolactin increases in your blood. Prolactin helps your body make milk. Prolactin also reduces the hormones that trigger ovulation. If you are not ovulating, you cannot become pregnant. This means that, for a time after giving birth, breastfeeding can act as a natural form of contraception.

LAM relies on exclusive breastfeeding. If you start to breastfeed less, your hormone levels change. You may start to ovulate again, and LAM will be less effective in preventing pregnancy.

Read more about:

• periods while breastfeeding
• periods after pregnancy
• let-down reflex

There are many benefits of LAM, including that it:

• can be up to 98% effective when used correctly
• is a non-hormonal method of contraception, so it doesn't interfere with your body's hormones
• is free and does not need a prescription
• does not reduce your breast milk supply
• has no medicine side effects

LAM supports exclusive breastfeeding, which has many health benefits for you and your baby.

Read more on the benefits of breastfeeding your baby.

LAM works by using the natural effects of breastfeeding on your fertility.

For LAM to be effective, you must meet all 3 of the following conditions:

• you are fully or almost fully breastfeeding
• you gave birth less than 6 months ago
• your period has not yet returned

If you do not meet these conditions, LAM will be less effective, and you are more likely to become pregnant.

Fully or almost fully breastfeeding means that your baby only has breast milk and no other foods or drinks. Introducing other foods (for example, infant formula or first foods) can reduce how often your baby latches onto your breast. This can increase your chance of ovulating, and your chance of becoming pregnant again.

The effect of expressing breast milk on how well LAM works is not fully known. If you express (pump) milk often, LAM may be less effective at preventing pregnancy.

It is important to remember that LAM is about more than just breastfeeding. Not everyone who breastfeeds can rely on LAM as contraception.

You can use LAM as contraception for up to 6 months as long as:

• your period has not returned
• you are exclusively breastfeeding, or almost exclusively breastfeeding

If you do not meet these requirements, you may want to consider another type of contraception.

Your chance of becoming pregnant increases when:

• you breastfeed less often — for example, if you stop night feeds, introduce mixed feeding or use dummies
• your period returns
• more than 6 months have passed since you gave birth

If you want personalised advice on using LAM as contraception, you can speak to your doctor, gynaecologist, midwife, maternal child health nurse or lactation consultant.

They can help you make a fully informed decision about the right type of contraception for you.

If LAM is not the right contraception for you, there are many safe and effective options you can try, including:

• hormonal contraception — the pill, mini-pill, implant or injection
• intrauterine contraception — hormonal or copper IUD (intrauterine device)
• barrier methods — condoms, diaphragm or cup
• fertility awareness method
• oral emergency contraception

Each type of contraception has its own advantages and disadvantages.

Some types of contraception are safe to use while breastfeeding, but others are best to avoid if you want to continue to breastfeed.

Your doctor, midwife or maternal child health nurse can help you find the right contraception choice for you.

Learn more about how breastfeeding affects your fertility at the Australian Breastfeeding Association.

Read more about your contraception choices, including LAM on the Family Planning Australia website.

Visit the Child and Family Health Service website to learn more about breastfeeding.

Information for Aboriginal and/or Torres Strait Islander peoples

Yarning About Contraception has information on contraception for Aboriginal and/or Torres Strait Islander peoples.

The Australian Breastfeeding Association has breastfeeding information and resources for Aboriginal and/or Torres Strait Islander families.

Watch Breastmilk Talk — 'Ngaminjang Djama' where Aboriginal and Torres Strait Islander mums yarn about the benefits of breastfeeding for mum and bub.

Visit Birthing on Country to learn about projects that support Aboriginal and/or Torres Strait Islander babies and their families.

Strong Women Strong Babies has a diary with information on caring for yourself and your baby in the first weeks after birth.

Languages other than English

The Royal Women's Hospital has translated its resources about your contraception choices into many community languages.

Call the Translating and Interpreting Service (TIS National) on 131 450 to ask for an interpreter when speaking with health services.