We suggest that breastfeeding, and so child health, could be supported more effectively if those providing postpartum contraception:
1. Routinely offered the Lactational Amenorrhea Method (LAM) as a contraceptive option. LAM can be over 98% effective so long as a woman meets all three lam rules: fully breastfeeding, her child being less than six months old, and her periods not returning. The "fully breastfeeding" rule means it supports good practice in terms of breastfeeding. LAM is not always communicated effectively, but that seems like grounds for research into effective communication, not a reason to dismiss it.
2. Adopted a more cautious approach to prescribing hormonal postpartum contraception. There is substantial anecdotal evidence that this can cause breastfeeding problems for some women. Problems are less likely if women who want to use hormonal contraception start with the progestogen-only pill before moving on to the injection or implant.
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