The Lactational Amenorrhea Method for Women With HIV

  • Women who are infected with HIV or who have AIDS can use LAM. Breastfeeding will not make their condition worse. There is a chance, however, that mothers with HIV will transmit HIV to their infants through breastfeeding. Without any antiretroviral (ARV) therapy, if infants of HIV-infected mothers are mixed-fed (breast milk and other foods) for 2 years, between 10 and 20 of every 100 will become infected with HIV through breast milk, in addition to those already infected during pregnancy and delivery. Exclusive breastfeeding reduces this risk of HIV infection through breastfeeding by about half. Reducing the length of time of breastfeeding also greatly reduces the risk. For example, breastfeeding for 12 months reduces transmission by 50% compared with breastfeeding for 24 months. HIV transmission through breast milk is more likely among mothers with advanced disease or who are newly infected.
  • Women taking ARV therapy can use LAM. In fact, giving ARV therapy to an HIV-infected mother or an HIV-exposed infant very significantly reduces the risk of HIV transmission through breastfeeding.
  • HIV-infected mothers should receive the appropriate ARV interventions and should exclusively breastfeed their infants for the first 6 months of life, introduce appropriate complementary foods at 6 months, and continue breastfeeding for the first 12 months. Breastfeeding should then stop only once a nutritionally adequate and safe diet without breast milk can be provided.
  • At 6 months–or earlier if her monthly bleeding has returned or she stops exclusive breastfeeding–a woman should begin to use another contraceptive method in place of LAM and continue to use condoms. Urge women with HIV to use condoms along with LAM. Used consistently and correctly, condoms help prevent transmission of HIV and other STIs.

(For further guidance on infant feeding for women with HIV, see Maternal and Newborn Health, Preventing Mother-to-Child Transmission of HIV, p. 294.)

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