Assessment of a woman who is planning to use the lactational amenorrhoea method should include answers to the following questions:

• Does she have a medical condition that would make pregnancy especially dangerous?
• If she does have such a condition, she may want to choose a more effective contraceptive method. If she does not want to use another method, stress that the lactational amenorrhoea method must be used carefully.
• Can she use the lactational amenorrhoea method?
• Ask:
• Is her baby age 6 months or more?
• Has her menstrual period returned? Bleeding in the first 8 weeks after childbirth does not count.
• Does she regularly give her baby food or liquid other than breast milk?
• If the answer to any of these questions is 'yes', the lactational amenorrhoea method is not suitable for her.
• Does she have a condition in which breastfeeding is not advisable?
• Ask if she has been advised by a healthcare professional not to breastfeed.
• Ask about drugs that contraindicate breastfeeding:
• Mood-altering drugs.
• Reserpine.
• Ergotamine.
• Antimetabolites.
• Ciclosporin.
• Corticosteroids (high doses).
• Bromocriptine.
• Radioactive drugs.
• Lithium.
• Anticoagulants.
• Ask about the baby's health. Breastfeeding can be difficult or contraindicated with certain metabolic disorders or congenital deformity of the mouth, jaw, or palate, and in newborns who are in intensive care.
• Ask if she has active viral hepatitis or HIV, as these can be transmitted through breast milk.
• Is she at increased risk for sexually transmitted infection?
• Assess the risk and, when appropriate, advise testing, promote safer sex, and/or refer for counselling.
• If the woman is at risk for sexually transmitted infection or HIV, recommend correct and consistent use of condoms, either alone or with another contraceptive method.

• The only conditions that limit the use of the lactational amenorrhoea method are those that make breastfeeding difficult or that rule out breastfeeding.
• Physical examination and laboratory tests are usually not necessary when assessing a woman who is planning to use a fertility awareness–based contraceptive method.

• 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].