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 To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?'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
What advice and information should I give a woman who is considering using the lactational amenorrhoea method?

  • A woman who is considering using the lactational amenorrhoea method should be given advice and information about:
    • The advantages, disadvantages and risks of the method.
    • The conditions for it to be reliable:
      • Complete amenorrhoea, and
      • Fully or very nearly fully breastfeeding, and
      • No longer than 6 months since birth of the baby.
    • Alternative methods of contraception to consider when the lactational amenorrhoea method becomes unreliable or for now if she wants additional protection, taking into account her personal, cultural, and religious sensitivities.
  • If the woman has a condition which makes pregnancy an unacceptable risk, she should be advised that the lactational amenorrhoea method may not be appropriate for her because alternative contraceptive methods have lower failure rates.
Clarification / Additional information
  • A woman who uses the lactational amenorrhoea method should be encouraged to:
    • Breastfeed often:
      • The baby should get >= 85% of the feedings as breast milk.
      • It is important that feedings be frequent, with little or no other liquid.
    • Breastfeed properly:
      • Counsel her on breastfeeding technique.
    • Start other foods when the baby is 6 months old:
      • Breastfeed before giving other food, if possible. If the baby's hunger is satisfied first by breast milk, this will help ensure good nutrition and will encourage breast milk production.
      • The baby may breastfeed less after starting to eat other foods, and the lactational amenorrhoea method may no longer be reliable. An additional family planning method is recommended.
    • Start another family planning method when:
      • Her menstrual periods return (bleeding in the first 8 weeks after childbirth is not considered menstrual bleeding), or
      • She stops fully or nearly fully breastfeeding, or
      • Her baby is 6 months old, or
      • She wants more protection from pregnancy.
Basis for recommendation
  • These recommendations are based on guidelines published by the Faculty of Sexual and Reproductive Healthcare (FSRH), (formerly the Faculty of Family Planning and Reproductive Healthcare [FFPRHC]), and the World Health Organization [Hatcher et al, 1997b; FFPRHC, 2006a]

© NHS Institute for Innovation and Improvement