The LAM Interagency Working Group (LAM IWG), a network of over 20 organisations, has issued this 2-page statement of consensus on simplified criteria for promoting the Lactational Anemorhea Method (LAM) of pregnancy prevention. It describes the benefits of the method (which is based upon breastfeeding the infant) and the rationale for simplifying the messages that family planning counsellors and providers use to promote behaviours necessary for successful pregnancy prevention using LAM. The document also describes the rationale for messages on appropriate and timely transition to another method of pregnancy prevention and for continued breastfeeding of infants, a part of the LAM counsellor and provider training materials.

The document states the 3 criteria and provides a table to explain the message and operational definition for each criterion. The rationale for simplification of language is to establish language clarity for promoting LAM. The terminology chosen is based on field experience that showed significant provider confusion over the former terminology. For example, the new criteria use the term “breastfeed only”, rather than "nearly fully or almost exclusively breastfeed", because it eliminates confusion on giving other foods or liquids to the infant. The intent is to clearly describe this LAM behaviour that should offer health benefits to both mother and child, as shown by research, and the pregnancy prevention offered by LAM.

The question of the viability of this breastfeeding message for women who are HIV-positive is answered in the document as: "In areas of high HIV prevalence, especially where women are not aware of their HIV status, and supplemental feeding does not meet the requirement of being acceptable, feasible, affordable, safe and sustainable (AFASS), providers must counsel women on the importance of exclusive breastfeeding. Mixed feeding (combining breast milk with other foods or liquids) has been shown to increase the risk of HIV transmission to the infant."

The document provides similar clarity of language and rationale for language changes regarding the "menstrual bleeding" and "age of the baby" messages that constitute the second and third LAM criteria. It concludes by describing positive pragmatic implications of using the new terminology, which includes emphasising the need for women to continue breastfeeding while selecting and beginning use of another method of pregnancy prevention.

Institute for Reproductive Health website on June 19 2009.