Skip to main content


Kennedy, Kathy I. & Kotelchuck, Milton (1998). Policy Considerations for the Introduction and Promotion of the Lactational Amenorrhea Method: Advantages and Disadvantages of Lam. Journal of Human Lactation, 14(3), 191-203.


This paper explores the advantages and disadvantages of the lactational amenorrhea method (LAM) and their implications for policy and use. Clinical trials of LAM have upheld the Bellagio Consensus that the chance of pregnancy is less than 2% in the first 6 months postpartum in amenorrheic women who are fully or nearly fully breast-feeding. Secondary data analyses in numerous settings have resulted in the same conclusion. LAM, if used correctly or even if used imperfectly, should be a reliable strategy or a method to avoid pregnancy. To the extent that LAM represents an additional contraceptive option, this is also positive because a broad array of contraceptive options maximizes the likelihood of finding a good fit between user and method and increases contraceptive use. Other characteristics of LAM represent potentially positive impacts. If LAM is shown to be an effective conduit to other modern methods, the implications are profoundly positive. If LAM is cost-effective for households and/or programs, this will also make the method extraordinarily attractive. Conversely, some aspects of LAM are negative, such as the fact that it offers no protection against sexually transmitted diseases, it requires counseling from a well-informed provider, and intensive breast-feeding can make heavy demands on the woman's time. Because LAM is effective in preventing pregnancies, and because it extends the range of contraceptive choices, considering LAM at the policy level is always appropriate.


Reference Type

Journal Article

Year Published


Journal Title

Journal of Human Lactation


Kennedy, Kathy I.
Kotelchuck, Milton