A nurse is caring for a client who is postpartum and requests information about contraception. Which of the following instructions should the nurse include?

A. The transdermal patch should not be placed on the upper arm; it is applied to clean, dry areas such as the upper torso (excluding breasts), abdomen, buttocks, or upper outer arm only if not breastfeeding, since estrogen-containing methods can reduce milk supply. B. The diaphragm must be refitted after childbirth due to changes in the size and shape of the cervix and vaginal canal. Using the same diaphragm used before pregnancy may result in poor fit and decreased contraceptive effectiveness. C. Vaginal spermicides should be avoided during breastfeeding because they can irritate the vaginal mucosa, which is often dry and sensitive due to low estrogen levels, increasing the risk for infection. D. The lactation amenorrhea method (LAM) is only effective for up to 6 months postpartum, provided the client is exclusively breastfeeding and has not resumed menstruation. It is unreliable after that period.