I think when we are talking about LAM and the risk of pregnancy we need to
remember that the WHO numbers are statistics. They cannot be applied to
individuals in such a way as to indicate that early return of menses equals
insufficient breastfeeding. Really, the question is...when it comes to LAM...did
any of these women find themselves accidentally pregnant...early on.

Lawrence has indicated (in the earlier edition of her book) that it is unlikely
that a woman will conceive before her first period. In the new edition she seems
not quite so sure...but does say that, even when menses returns early... 67% of
those cycles will be anovulatory.

I quote Lawrence here "The degree of inhibition associated with breastfeeding
has decreased remarkably since the time of hunter/ gatherers....(still), LAM can
provide protection against pregnancy for the first 6 months even in
well-nourished women who are giving some supplemental foods."

Susan Keith-Hergert RN, MS, CPN, IBCLC
Mercy Health Partners
Cincinnati

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