A nurse is counseling women about the lactational amenorrhea method of contraception. Which of the following women would the nurse advise to use another method of contraception if pregnancy is not desired? (Select all that apply.)

A.
Baby is 5 months old and started on cereals.
B.
Baby is 8 months old; menses have not resumed.
C.
Baby is 4 months old; breastfed exclusively.
D.
Dad feeds 5-month-old baby the mother's stored breast milk.
E.
Mother uses breast pump while at work.


ANS: A, B
Women who wish to avoid a subsequent pregnancy should be counseled to use another form of birth control in the following situations: menstruation resumes, the frequency or duration of breastfeeding is reduced, bottle feeding or solid foods are introduced, and the baby reaches 6 months of age. Therefore, the mothers of the 5-month-old baby who has started solid food and the baby who is 8 months old should be advised to use another form of birth control. The mother of the 4-month-old who is exclusively breastfed can expect an effectiveness rate of approximately 98%. The nurse needs to assess the other two situations more carefully prior to determining if the mother needs another form of birth control.

Nursing

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