Ideal contraceptive for lactating mothers is (AIIMS May 2011)
|D||Progesterone only pill|
Progesterone only pill
a. Barriers have a high failure rate of 4-14 %
b. POP are safe with breast feeding & very effective. They were mainly designed especially for lactating mothers.
c. Lactation Amenorrhea Method (Lam)
d. Excessive secretion of prolactin, which controls lactation, inhibits the pituitary. Prolactin inhibits LH but has no effect on FSH. However, it partially inhibits ovarian response to both of these gonadotropins. As a result, while the prolactin level remains high, the ovary produces little estrogen and no progesterone. Hence, ovulation and menstruation are affected.
e. LAM is effective only till 6 months post-partum. Beyond this it is not a reliable method.
f. Even for the first 6 months it is effective only if there is exclusive breast feeding.
g. If any time in the first 6 months the menses starts then it cannot be used as birth control.
h. As estrogens decrease the quality & quantity of milk COC PILLS are absolutely contraindicated in lactating mothers.
i. Actually the best/ideal for lactating mothers is IUCD as they have very low failure rate (0.5-1.5%) & would provide long term birth control. But as it is not the option the ans is POP