1 / 16

Lactational Amenorrhea Method (LAM)

Lactational Amenorrhea Method (LAM). Session III: Counseling on LAM. Return of Fertility and Risk of Pregnancy. In women not breastfeeding, ovulation will occur at 45 days postpartum on average; may occur as early as 21 days.

paulsonj
Download Presentation

Lactational Amenorrhea Method (LAM)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Lactational Amenorrhea Method (LAM) Session III: Counseling on LAM

  2. Return of Fertility and Risk of Pregnancy In women not breastfeeding, ovulation will occur at 45 days postpartum on average; may occur as early as 21 days. Breastfeeding women not practicing LAM are likely to ovulate before return of menses. Between 5% and 10% of women conceive within the first year postpartum.

  3. Counseling about LAM:Key Counseling Topics for LAM Users • Screen for/educate about LAM criteria: • Three criteria and why each is important • Any conditions that exclude use of LAM • Discuss effectiveness of LAM • Select another modern method to which to transition from LAM • Encourage spacing of pregnancies by using another method of family planning for at least 2 years • Discuss optimal breastfeeding practices • Ensure that client knows to return if she has a problem

  4. Transition to Another Method: An Essential Component of LAM • LAM is a “gateway” to other modern methods of contraception • LAM provides the couple time to decide on another modern method to use after LAM

  5. When LAM counseling is initiated, the provider should discuss transition from LAM to another contraceptive method with the client: Another method should be started as soon as any one of three LAM criteria is not met. Transition method should be selected before this occurs. Transition to Another Method

  6. Postpartum Contraceptive Options

  7. Postpartum Contraceptive Options Adapted from: The MAQ Exchange: Contraceptive Technology Update

  8. Antenatal clinic Child health (well-baby) clinic Postpartum ward Postpartum clinic Family planning clinic Labor ward (during early labor or following birth) Community health visits Opportunities to Provide LAM Counseling

  9. Baby Adapts to needs of growing infant Promotes optimal brain development Provides passive immunity and protects from infections Provides some protection against allergies Mother Stimulates uterine contractions in early postpartum period Promotes involution (return of uterus to pre-pregnancy state) Leads to less anemia because of less iron depletion (due to amenorrhea) Strengthens mother–baby bonding Health Benefits Breastfeeding

  10. Offers only temporary contraceptive protection (up to six months) Is not usually appropriate if mother will be separated from baby for periods of time HIV-positive mothers may worry about HIV transmission through breastfeeding Limitations of LAM

  11. There are many misconceptions about LAM that need to be addressed, including: Women with small breasts cannot breastfeed. If a woman breastfeeds a lot, her milk will dry up. Babies need other foods, liquids, to be healthy or for thirst. Correcting Rumors and Misunderstandings

  12. Optimal Breastfeeding Practices Allow newborn to breastfeed as soon as possible after birth, and to remain with the mother after birth Breastfeed as often as the baby wants, for as long as s/he wants, day and night Continue breastfeeding even if mother or infant becomes ill Do not give the baby any foods or other liquids for the first six months Do not use bottles, pacifiers or other artificial nipples

  13. Optimal Breastfeeding Practices, continued Offer the second breast after the infant releases the first Eat and drink more than usual Continue to breastfeed for the first two years, providing complementary foods beginning at six months of age. Remember: breastfeeding mothers often need family or social support.

  14. LAM in the Context of HIV WHO Guidelines for infant feeding in the context of HIV: • Mothers known to be HIV-infected (and whose infants are HIV uninfected or of unknown HIV status) should exclusively breastfeed their infants for the first 6 months of life, introducing appropriate complementary foods thereafter, and continue breastfeeding for the first 12 months of life. • Breastfeeding should then only stop once a nutritionally adequate and safe diet without breast milk can be provided. • When HIV-infected mothers decide to stop breastfeeding (at any time) they should do so gradually within one month. • Every woman should be supported in her infant-feeding decision and in her contraceptive choice.

  15. LAM in the context of HIV, continued A mother with HIV who chooses to breastfeed or use LAM should: • Receive care and treatment for herself to minimize the risk of transmission to the infant and keep herself healthy. • Use condoms consistently • If she experiences cracked nipples or other breast problems, instruct her to feed from unaffected breast (and express and discard milk from affected breast) • Seek immediate care for baby with thrush or other lesions in mouth

  16. LAM – Summary • Over 98% effective as long as all three criteria are met: • No menses • Breastfeeding only • Baby less than 6 months • “Gateway” to other modern methods of family planning • Provides important health benefits to the mother and child • Natural and no side effects

More Related