1. Session II, Slide 1 Lactational Amenorrhea Method (LAM) Session II: Who Can and Cannot Use LAM

2. Session II, Slide 2 LAM Eligibility Criteria 1.The woman’s menstrual bleeding has not returned; AND 2.She fully or nearly fully breastfeeds her baby; AND 3.The baby is less than six months old.

3. Session II, Slide 3 Importance of LAM Criteria (1) 1.The woman’s menstrual bleeding has not returned (“amenorrhea”) Menstrual bleeding signals return of fertility—the woman can become pregnant again. Remember: bleeding before two months postpartum is NOT considered menstruation.

4. Session II, Slide 4 Importance of LAM Criteria (2) 2. She fully or nearly fully breastfeeds her baby If baby receives food or liquids other than breast milk: The baby becomes full and will not want the breast as often. Infrequent suckling will cause the mother to produce less and her fertility to return She can become pregnant again.

5. Session II, Slide 5 Importance of LAM Criteria (3) 3. The baby is less than six months old. Six months is a biologically appropriate cut- off point to start supplemental foods. Remember: continue to breastfeed beyond LAM and until baby is two years old.

6. Session II, Slide 6 Medical Eligibility Criteria What are medical eligibility criteria? Define the categories. Review the job aid.

7. Session II, Slide 7 WHO’s Medical Eligibility Criteria with Clinical Judgment Source: WHO, 2010. CategoryDescriptionWith clinical judgment 1No restriction for use Use the method under any circumstances 2 Benefits generally outweigh risks Generally use the method 3 Risks usually outweigh benefits Use of method not usually recommended, unless other methods are not available/acceptable 4Unacceptable health riskMethod not to be used

8. Session II, Slide 8 WHO’s Medical Eligibility Criteria in Settings Where Clinical Judgment is Limited Source: WHO, 2010. Category When clinical judgment is limited 1 Use the method 2 3 Do not use the method 4

9. Session II, Slide 9 Category 1 Who Can Start LAM WHO CategoryConditions Category 1 All conditions listed in MEC fall into category 1 for LAM LAM is safe for nearly all women. Source: WHO, 2010.