I am on thin ice here, as I can't find the reference!
And I can't even remember if I read it in Norwegian or in English, I just
know I read it, and not long ago either.  I believe the Norwegian guidelines
are based on work that took place after 1988, though not after 1995, and
again I don't have the reference in front of me.
If the LAM site says that 56 days is a grace period, I guess they stand by
it.  It seems like a disclaimer of sorts when they say "two consecutive days
of bleeding/spotting or of the woman's perception that her menses have
returned, whichever of the two comes first."
When/if I find my reference I will post it immediately.
And it may be that the mothers I have spoken to who have had a bleeding
episode before two months post partum have not been exclusively BF.  And
they STILL didn't realize they could get pregnant again.

However, with our knowledge of the huge range of physiologic variation among
women, I feel it is safer to have a clear sign than an arbitrary number of
weeks on which women should base an individual decision.  Note the word
'feel', not an evidence based term, just a gut feeling, important
distinction.

The symptothermal method is a good example of how women can use individual
information to apply general principles to themselves with impressive
results.  The rhythm'n'blues method is a good example of the opposite
(statistical odds without consideration for individual differences and much
higher incidental pregnancy rates).
If you are relaxed about pregnancy and number of children it doesn't matter
much.  If it is essential to you to plan and control number and timing of
pregnancies, it matters a lot.
All the alternatives need to be weighed in each situation, by the people
affected.

Rachel Myr

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