You may have heard that you can use breastfeeding as birth control instead of another form of contraception.
But is that true? And exactly how effective is it? How long does it last for?
In this post, we’re discussing what LAM is, why breastfeeding prevents ovulation and whether it’s something you should try post-delivery.
Can You Use Breastfeeding as Birth Control?
Yes, you can use breastfeeding as a form of birth control, but only under specific circumstances. Your baby must be younger than 6 months and you must start exclusively breastfeeding before your period returns. If your period returns and you don’t want to get pregnant, using an additional form of birth control is recommended.
Exclusively breastfeeding your baby means that she’s only getting breastmilk and you’re feeding her with frequent intervals. A frequent schedule is considered:
- Day nursing with no longer than 4 hours between feedings
- Night nursing with no longer than 6 hours between feedings
Some healthcare providers also recommend using another form of birth control if you don’t want to get pregnant. This is good advice for women who supplement with formula and who have trouble or can’t keep a regular feeding schedule. Using a breast pump to express milk is not an equal alternative to prevent ovulation.
How to Use Breastfeeding as Birth Control: The LAM Method in 4 Steps
Lactational amenorrhea method (LAM) refers to the method used when a woman wants breastfeeding to act as birth control.
If you are considering using breastfeeding as a form of birth control, you should talk to your healthcare provider. They can help you determine whether it’s the right choice and if you should combine it with another form of contraception.
Since LAM is not very flexible in terms of nursing schedule, your provider can lay out the details so you can understand whether your lifestyle can accommodate it. Since you’ll need contraception after six months (if you don’t want to get pregnant), they’ll help you plan for that too.
Here’s the general steps your doctor will outline when using LAM as birth control:
- After delivery, ensure your period hasn’t returned. This includes spotting.
- Feed your baby on demand. Nursing intervals should be no longer than 4 hours in the day and 6 hours at night. Using a breast pump is not an alternative using LAM.
- Continue exclusively feeding your baby (no other liquids or foods) for the duration of LAM.
- LAM’s effectiveness reduces when your baby is older than 6 months; when your period resumes; when the bottle is introduced; or when breastfeeding is reduced, whichever comes sooner. At this time, another form of birth control is recommended.
As noted above, you still may wish to use birth control while also using LAM to increase effectiveness.
How Effective Is LAM as Birth Control?
How effective LAM is depends on how well it is adhered to. If you stick to a frequent nursing schedule with feedings every 4 hours in the day and every 6 hours at night, it can be about 98% effective. That’s about 2 pregnancies per 100 women.
To put that into perspective, let’s look at the effectiveness of traditional contraception. Taking a sample of 100 women, 18 using a condom will get pregnant, followed by 6-12 using the pill, patch, ring or shot and less than 1 using an IUD or sterilization. When used correctly, this almost puts LAM’s effectiveness on par with the most effective forms of birth control. However, the keyphrase here is “when used correctly.”
Think of LAM’s effectiveness like the pill: If you follow the schedule perfectly, it’s very effective. But with every slip-up, your chances of becoming pregnant keep increasing.
Since that frequent nursing schedule can be difficult to stick to for 6 months, some doctors recommend another form of contraception. Longer intervals between feedings decreases the effectiveness of breastfeeding preventing pregnancy. That means even missing a few nursing sessions in favor of formula or pre-pumped milk can weaken the birth control effect.
LAM does not provide protection against sexually transmitted infections or diseases.
Why Does LAM Breastfeeding Prevent Pregnancy?
Breastfeeding using the LAM method can prevent ovulation (when your ovaries release eggs). So, why does this happen? The pressure of a baby’s mouth on the nipple makes the body produce a hormone, preventing eggs from being produced. When you don’t ovulate, you can’t get pregnant. This also means you won’t get your period for the time you’re using LAM (if you’re using it correctly).
What Happens After Six Months?
At the six-month-old mark, you are much more likely to get pregnant, even if you continue to exclusively breastfeed. For this reason, you should find another method of contraception if you don’t want to get pregnant. It’s important to know that you can get pregnant before your period returns (you ovulate before your period).
If you talked to your doctor before starting LAM, you may already have a birth control plan. If not, now is a good time to go in to discuss your options.
Birth control suitable during breastfeeding includes:
- Progestin-only birth control pills. Your doctor will recommend brands of birth control that include progestin, rather than estrogen. That’s because estrogen-progestin pills can reduce milk supply, making nursing difficult.
- Intrauterine device (IUD)
- Depo-Provera (the shot)
Your doctor will help you determine which form of birth control is right for you based on your lifestyle and needs. If your partner has not been tested or you have multiple partners, any form of contraception should also include a condom for STD and STI prevention.
Pros of Using Breastfeeding as Birth Control
Here are the benefits of using LAM as contraception:
- A good way to “transition” back into using regular birth control
- Can be started right after delivery
- It’s a free form of birth control
- It’s natural and safe
- You don’t need to worry about side effects from hormonal birth control
Cons of Using Breastfeeding as Contraception
There’s some disadvantages to using breastfeeding as birth control:
- Breastfeeding only acts as birth control for 6 months
- For it to be effective, an on-demand schedule must be maintained
- Feeding so frequently means that you can’t be away from your baby for more than 4 hours in the day or 6 hours at night, which may be difficult for some lifestyles
- A breast pump can’t be used, making it difficult or impossible for working mothers
- Nursing so friendly at night can mean a lack of sleep (although you’ll probably be waking up anyway, this means you can’t pre-pump for your partner to wake up and feed instead).
- LAM does not protect against STDs
- In some cases, women or babies with health conditions or on medications may be advised against breastfeeding
Is Using LAM as Birth Control Right for Me?
If you’re trying to decide whether using breastfeeding is a good form of birth control for you, go through our pros and cons lists above.
Probably the biggest hurdle for most women is the frequency of on-demand nursing. In many cases, a working mother can substitute nursing by pumping prior and having a caretaker bottle feed her. However, since pumping isn’t as effective, practicing this means you aren’t following LAM. While using a pump and substituting with formula may be harmless for the baby, it increases your chances of getting pregnant.
Considering this, you should ask yourself a few questions before starting LAM as your single method of birth control:
- Am I away from my baby no longer than 4 hours (6 hours at night)?
- Am I on maternity leave for 6 months or working shifts fewer than 4 hours (6 hours at night)?
- Is it realistic for me to nurse on-demand, every few hours for 6 months?
- If I can’t stick to the LAM method, do I trust myself to immediately find an alternative form of birth control?
If you’re unsure whether LAM is right for you, you may wish to try it out after delivery. You can use it as birth control as long as you can keep the on-demand nursing schedule. If you can’t, you can switch to a more manageable feeding schedule and an alternative form of contraception.
Summary on Using Breastfeeding as Birth Control
If you don’t wish to get pregnant after delivery, you’re probably searching for the best form of birth control. You may come across the term “LAM” as a form of contraception involving breastfeeding. Although it’s true that nursing can be used as a form of birth control, it’s only effective in certain situations. Even then, your on-demand feeding schedule must be adhered to or you risk becoming pregnant. In this post, we’ve provided a list of pros and cons and questions to think about when deciding if LAM is the only form of birth control you should use for your first six months post-delivery.
P.S. Have you used a fetal doppler yet? These handheld devices allow you to listen to your baby’s heartbeat from home—similar to an ultrasound. They can be used as a family bonding experience or as a tool to record and show your doctor for advice.
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