Ateneo de Zamboanga University

College of Nursing

Name: Cabrera, Norjetalexis M Clinical Area: Sta Maria Health Center Total number of time: 30minutes General Objective: Acquisition of knowledge, skill and attitude in the utilization of nursing process in the community with emphasis in providing knowledge and health teaching regarding family planning specifically Lactational Amenorrhea Method (LAM). Instructional Objective A. Discuss what is Lactational Amenorrhea Method (LAM) as a family planning method. B. Determine the advantages of Lactational Amenorrhea Method C. Determine the effectiveness of Lactational Amenorrhea Method D. Discuss the proper use of Lactational Amenorrhea Content TA Strategy Evaluation

A. Lactational Amenorrhea Method (LAM) is the natural postnatal infertility that occurs when a woman is amenorrheic (not menstruating) and fully breastfeeding. If not combined with chemicals or devices, Lactational amenorrhea method (LAM) may be considered natural family planning. was created to allow women to safely rely on breastfeeding as a family planning method. Based on scientific research, the method uses three measures of a woman's fertility: 1) the return of her menstrual period, 2) her patterns of breastfeeding, and 3) the time postpartum. B. Advantages of Lactational Amenorrhea Method Lactational amenorrhea encourages exclusive breastfeeding, which has health benefits for both the mother and infant. These include:

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Decreased bleeding after childbirth (mother); The uterus returns to its normal size more quickly after childbirth (mother); Improved nutrition (infant); Reduced risk of infectious disease (infant).

There are also many health benefits associated with the increased birth intervals which arise from use of contraceptives.

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Other benefits of lactational amenorrhoea include:

It does not cost anything; No special supplies are needed; and

It has nWhen used by women who meet all three criteria for the method (i.e. no menstrual bleeding, exclusive breastfeeding and less than six months since childbirth) lactational amenorrhoea is effective in preventing pregnancy in 98% of cases. Menstruation is the key factor which signals the return of fertility, and women who have returned to menses (defined as two consecutive days of bleeding or spotting) cannot use lactational amenorrhoea. In women who do not experience menstrual bleeding and continue to breastfeed exclusively, lactational amenorrhoea provides contraceptive protection which is 94% effective, one year postpartum. However, the effectiveness of the method is dependent of the frequency and intensity of breastfeeding. Fertility will increase as the frequency of breastfeeding and the quantity of breast milk decrease. Women who express milk from their breasts also have a higher risk of pregnancy, even if their infant is feeding exclusively on breast milk. The limited available research suggests that effectiveness is around 95% in women who express milk.

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C. Effectiveness of Lactational Amenorrhea Method When used by women who meet all three criteria for the method (i.e. no menstrual bleeding, exclusive breastfeeding and less than six months since childbirth) lactational amenorrhoea is effective in preventing pregnancy in 98% of cases. Menstruation is the key factor which signals the return of fertility, and women who have returned to menses (defined as two consecutive days of bleeding or spotting) cannot use lactational amenorrhoea. In women who do not experience menstrual bleeding and continue to breastfeed exclusively, lactational amenorrhoea provides contraceptive protection which is 94% effective, one year postpartum.

However, the effectiveness of the method is dependent of the frequency and intensity of breastfeeding. Fertility will increase as the frequency of breastfeeding and the quantity of breast milk decrease. Women who express milk from their breasts also have a higher risk of pregnancy, even if their infant is feeding exclusively on breast milk. The limited available research suggests that effectiveness is around 95% in women who express milk. D. Proper use of Lactational Amenorrhea Method The effectiveness of lactational amenorrhoea is highly dependent on correct use. In particular, it is important that breastfeeding must: 1. Occur at regular intervals (i.e. on demand and at least every four hours during the day and every six hours at night); and 2. Be exclusive, or almost exclusive (i.e. supplemental foods should not exceed 5-10% of the infant's nutritional intake).

It is also important to begin taking another contraceptive method after six months or earlier if the menstrual cycle returns before six months after childbirth. Individuals using lactational amenorrhoea should inquire about and obtain an additional method when they are visiting a health facility, so that they are ready to commence that method at the return of menstrual bleeding. Alternatively breastfeeding women can commence using progesterone-only hormonal contraceptive methods before the return of the menstrual cycle.

Source: http://www.waba.org.my/resources/lam/ http://www.virtualmedicalcentre.com/healthandlifestyle/breastfeeding-as-a-contraceptive-method-lactational-amenorrhoea-method/229 http://www.halton.ca/cms/one.aspx?portalId=8310&pageId=11021