Rachel says that in order to use LAM (quoting only one of three criteria
here), "Mother must be amenorrheic, defined as NO VAGINAL BLEEDING POST PARTUM
AFTER THE INITIAL LOCHIA HAS STOPPED (not shouting, just enunciating very
clearly)."

But I would like to know more.

The '88 Bellagio Consensus is quoted in The Art of NFP as stating that
bleeding in the first 56 days postpartum can be disregarded by fully
lactating women.  (K. Kennedy et al., "Consensus statement on the use of
bfing as a family planning method," Contraception 39:5 (May 1989) 485.)

The website http://www.fhi.org/en/gen/lamstat.html gives some information on
the '95 review of the Bellagio Consensus, including this definition of
amenorrhea:

"The end of amenorrhea is the clearest marker indicating increased risk of
pregnancy. The participants agreed that in the use of LAM a reasonable
definition of the end of amenorrhea is the occurrence, after day 56
postpartum, of two consecutive days of bleeding/spotting or of the woman's
perception that her menses have returned, whichever of the two comes first."

And the WABA LAM page (http://www.waba.org.br/lam.htm), which calls itself
the LAM site, allows the same 56-day window.

Is there some newer information available which suggests that this 56-day
period is too long?  Rachel's statement of the amenorrhea criterion for LAM
use seems more stringent than the ones on these websites -- am I
misunderstanding?

Jamie in Oak Park, IL

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