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Lactational amenorrhea is the temporary postnatal infertility that occurs when a woman is amenorrheic (not menstruating) and fully breastfeeding.
The lactational amenorrhea method involves the use of a woman's natural postpartum infertility which occurs after delivery and may be extended by breastfeeding. This usually requires the presence of no periods, exclusively breastfeeding the infant, and a child younger than six months.
The World Health Organization states that if breastfeeding is the infant's only source of nutrition, the failure rate is about 2% in the six months following delivery.
Six uncontrolled studies of lactational amenorrhea method users found failure rates at 6 months postpartum between 0% and 7.5%. Failure rates increase to 4 to 7% at one year and 13% at two years.
Feeding formula, pumping instead of nursing, the use of a pacifier, and feeding solids all increase its failure rate. In those who are exclusively breastfeeding, about 10% begin having periods before three months and 20% before six months. In those who are not breastfeeding, fertility may return four weeks after delivery.
Return of menstruation following childbirth varies widely among individuals. A strong relationship has been observed between the amount of suckling and the contraceptive effect, such that the combination of feeding on demand rather than on a schedule and feeding only breast milk rather than supplementing the diet with other foods will greatly extend the period of effective contraception.