Appropriate Lactational Amenorrhea Method (LAM) Rate

Definition
Proportion of eligible women who give birth in a given period of time who consciously and deliberately accept LAM as a modern contraceptive method and meet the three LAM criteria.

This is self-reported use of a family planning method. This can be calculated using the following equation:

Data Requirements
In order to correctly calculate the appropriate LAM rate, data are needed on the total number of women with infants less than 6 months old, and of those, the number who choose to use LAM as a method of family planning. Also needed are verification checks to determine if the woman meets the three LAM criteria (see below).

Data Source(s)
Population-based surveys employing representative samples (e.g., DHS); family planning service statistics data (if data are systematically obtained on the age of the youngest child, return to menses, and breastfeeding status). A sample survey is attached that includes questions needed to calculate the appropriate LAM rate.

Purpose and Issues
The lactational amenorrhea method (LAM) is a modern, temporary family planning method that promotes pregnancy prevention, improved breastfeeding, health child spacing, child survival, and women's health. LAM is defined by these criteria:

1. The woman's menstrual periods have not resumed, and
2. The infant is fully or nearly fully* breastfed, and
3. The infant is less than 6 months old.

Programmatic considerations may determine that the appropriate breastfeeding message for LAM, according to MOH regulations and for consistency with other program messages, is to breastfeed exclusively. Clinicians, however, must be aware of the criteria that an infant is fully or nearly fully breastfed.

Another family planning method must be introduced in a timely manner to ensure birth spacing when any one of these three criteria is no longer met. This follow-up method would be captured in both the family planning registry and in subsequent population-based surveys.

Rate Calculation
The attached appropriate LAM rate calculator allows you to insert your population-based survey or clinic data from which the appropriate LAM rate will be automatically calculated.

* Full breastfeeding is defined as exclusive (no water, other liquids, or solids are given to infant) or almost exclusive (vitamins, mineral water, juice, or ritualistic feeds are given infrequently in addition to breastfeeds). In nearly full breastfeeding, the vast majority of feeds given to infants are breastfeeds.