Can a woman who is separated from her baby use LAM?
The amount of time that a woman is separated from her baby is a key factor in establishing the LAM criterion of full or nearly full breastfeeding, day and night, with no long intervals between feedings. A woman who is separated from her baby regularly for more than four to six hours cannot expect a high level of contraceptive protection from LAM, even if she expresses milk during the separation. Expressing breastmilk may not be as effective as suckling at the breast in suppressing ovulation, and for this reason a woman who expresses her milk may not be able to rely on LAM. In a study on LAM in working women, the pregnancy rate increased to five percent. Some women can make arrangements to have their babies brought to them to nurse and/or are able to go to their baby at regular intervals. Women who are able to keep their babies with them at the work site, market, or in the fields and are able to breastfeed their children frequently can rely on LAM.
