Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Contraception - Management
UK Medical Eligibility Criteria for use of the lactational amenorrhoea method

  • The UK Medical Eligibility Criteria are a set of evidence-based recommendations designed to help women select the most appropriate method of contraception for specific clinical conditions without imposing necessary restrictions [FFPRHC, 2006a].
  • The conditions under which breastfeeding can be used safely and effectively for birth-spacing purposes, include the following three criteria, all of which must be met:
    • Amenorrhoea.
    • Fully or nearly fully breastfeeding. Full breastfeeding includes:
      • Exclusive breastfeeding — no other liquids or solids given.
      • Almost exclusive breastfeeding — vitamins, water, or juice given infrequently in addition to breastfeeds.
    • < 6 months postpartum.
  • Partial breastfeeding, even if the vast majority of feeds are breastfeeds, offers little protection against conception.
  • The main indications for breastfeeding remain the need to provide an ideal food for the infant and to protect it against disease.
  • There are no medical conditions in which the use of lactational amenorrhoea is restricted, and there is no documented evidence of its negative impact on maternal health. However, where pregnancy is an unacceptable risk, or where breastfeeding is contraindicated, other methods should be considered in preference.
  • Certain conditions or obstacles which affect breastfeeding may also affect the duration of amenorrhoea, making the lactational amenorrhoea method a less useful choice for family planning purposes. These include:
    • HIV infection. When replacement feeding is acceptable, feasible, affordable, sustainable, and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended.
    • Medication used during breastfeeding. In order to protect the infant's health, breastfeeding is not recommended for women using such drugs as: anti-metabolites, bromocriptine, certain anticoagulants, corticosteroids (high doses), ciclosporin, ergotamine, lithium, mood-altering drugs, radioactive drugs, and reserpine.
    • Conditions affecting the newborn. Congenital deformities of the mouth, jaw, or palate; newborns who are in intensive neonatal care; and certain metabolic disorders of the infant all can make breastfeeding difficult or contraindicated.
  • The lactational amenorrhoea method does not protect against sexually transmitted infections, including HIV:
    • If the woman is at risk for sexually transmitted infection or HIV (including during pregnancy and postpartum), recommend correct and consistent use of condoms, either alone or with another contraceptive method.

© NHS Institute for Innovation and Improvement