Mothers know that breastfeeding suppresses fertility, but they don't 
know the "rules" of LAM.  Nurses can be very helpful by explaining that 
LAM requires exclusive breastfeeding (or very nearly exclusive), about 
100 minutes of sucking a day, no more than 6 hours between feedings or 
pumpings at the longest to be most effective.  Also important is that 
once the menstrual period returns, moms must consider themselves fertile.

I've had many clients use LAM to space their children 2-3 years apart.
Catherine Watson Genna, IBCLC  NYC

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