ng method. The criteria for breastfeeding have to be clearly defined to ensure the suppression of fertility. The Bellagio conference stated "They (the mothers) should be informed how to maximise the anti-fertility effects of breastfeeding to prevent pregnancy....." What that means is that only 'ecological' breastfeeding provides extended post-partum infertility. This is a form of baby care which is characterised by constant mother-baby togetherness and frequent nursing, both by day and by night. Fully breastfeeding means that the baby is fed by his mother on breast milk alone without the addition of other milk, fruit juices or solids. Water may be given. The baby will be fed on demand and will suckle for nourishment and comfort instead of having a dummy. This frequent suckling is important to maintain fertility during lactation and will be discussed later. It is also important that the feeding technique should be good if fertility is to be suppressed by breastfeeding. Any reduction in breastfeeding will increase the chances of pregnancy and the return of menstruation, or six months post-partum signals the end of protection from LAM. A multi-centre study of LAM was carried out to determine acceptability, satisfaction and utilisation in ten different populations, and to confirm the efficacy of the method. The overall satisfaction with LAM was 83.6% and continuation with another method of family planning was shown to be 67.6% at nine months post-partum. Knowledge and understanding were high, ranging from 78.4 to 88.6% for the three criteria. LAM can be used with a high level of satisfaction and success by women in a variety of cultures, health care settings, socio-economic strata, and industrial and developing country settings. Advantages and Disadvantages of LAMh Advantages1. Breastfeeding does not cost anything and can be convenient. 2. It is the best way to feed a baby, both nutritionally and from the...
