Lactational Amenorrhea Method and Infant Feeding Options Lactational
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Lactational Amenorrhea Method and Infant Feeding Options
Lactational Amenorrhea Method • Temporary contraceptive option • Used by postpartum women who: – are less than six months postpartum – are fully or nearly fully breastfeeding – have no menses • Safe, convenient, effective Source: Hatcher, 2007.
Characteristics of LAM: Advantages • Universally available • At least 98% effective, no side effects • Begins immediately postpartum • Health benefits for mother and child • No direct cost for family planning or feeding the baby • No commodities/supplies required • Bridge to other contraceptives
Characteristics of LAM: Disadvantages • Breastfeeding pattern may be difficult to maintain • No STI or HIV protection • Risk of HIV transmission to baby • Duration of method limited • Only useful for breastfeeding women
Recommended Breastfeeding Behaviors A mother should breastfeed: • Soon after delivery • Without supplementation up to six months • Frequently, upon request, not on schedule • Without long intervals between feeds both day and night • Without pacifiers or bottles
LAM Use by Women with HIV • Advise that children can become infected – risk of acquisition through breast milk ~16% • Exclusive breastfeeding during first 6 months may reduce risk of acquisition by infant (compared to mixed feeding) • Exclusive use of formula or other substitutes eliminates risk of transmission through breast milk (often not possible) Source: WHO, 2004, updated 2008; Nduati, 2000; De Cock, 2000; WHO, 2006.
Infant Infection Risks if Mother with HIV Receives No Treatment If 20 women with HIV have babies: 13 babies will be HIV-free 4 babies will be infected with HIV through pregnancy and delivery 3 more babies will be infected with HIV through breastfeeding Fewer babies are infected if mothers and babies are treated. Source: WHO, 2004.
Factors That Increase Transmission of HIV to Infant during Breastfeeding • High maternal viral load • Duration of breastfeeding • Mixed feeding • Breast abscesses, nipple fissures, mastitis • Poor maternal nutrition status • Infant oral sores Source: WHO, 2004.
Infant Feeding Options for Women with HIV Up to six months: • Exclusive breastfeeding OR • Replacement feeding – expressed, heat-treated breast milk – commercial infant formula – breastfeeding by an HIV-negative wet nurse – breast-milk banks Source: WHO, 2006.
Infant Feeding Options for Women with HIV Beyond six months: • Switch to replacement feeding if acceptable, feasible, affordable, sustainable, safe (AFASS) • If not AFASS, continue breastfeeding along with complementary foods • All breastfeeding should stop if adequate and safe diet without breast milk can be provided If a child is known to have HIV, the mother should be strongly encouraged to continue breastfeeding. Source: WHO, 2006.
Summary of Contraceptive Choices • Use two methods concurrently (condoms plus another contraceptive method) • Use one method and understand its limitations (prevent pregnancy versus prevent transmission) – effective pregnancy prevention but no STI/HIV protection – condoms protect from STIs/HIV but typically less effective preventing pregnancy than some other methods • Use no method and abstain from sexual intercourse
- Lam contraception
- Lactational amenorrhea method
- Lactational amenorrhea
- Lactational amenorrhea
- Infant-driven feeding scale
- Abbott feeding pump error codes
- Anovulation who classification
- Causes of secondary amenorrhea
- Primary amenorrhea
- Causes of secondary amenorrhea
- Most common cause of primary amenorrhea
- Prolectinoma