Effects of assisted reproduction techniques on breastfeeding outcomes

Exclusive breastfeeding at 6 months after assisted and spontaneous conceiving: a prospective study in Northern Italy

Conceiving by assisted infertility treatments may influence breastfeeding duration. In one-year time, to evaluate the goal of 6 months breastfeeding, we recruited 55 consecutive mothers who conceived using assisted treatment compared to 45 mothers conceiving naturally, all giving birth to healthy, full-term, singleton infants, sharing the double-occupancy room. At birth, maternal/neonatal characteristics were obtained by medical records and interviews. Six months after, a telephonic interview was done about the exclusivity of breastfeeding, mood instability, and breastfeeding complications. All the women were supported by the same neonatal-pediatrician team, during the study period. The number of mothers who were exclusively breastfeeding at six months was not statistically different between the two groups, as well as, breastfeeding initiation, BMI, smoking habit, mood instability, co-morbidities. In the assisted group, the women were older, had fewer previous children, upper degree of education, higher rate of cesarean sections, their neonate's birthweight was lower; they reported more breastfeeding complications, but the distribution was not different between groups. The control women had higher number of previously breastfed siblings. Our experience highlights that the mode of conception may not be the defining factor influencing the goal of 6 months lactation. The support of healthcare professional team has a crucial role in maintaining breastfeeding.

The Association of Assisted Reproductive Technology and Breastfeeding Rates: A Systematic Review and Meta-Analysis

Background: There is an inconsistent result regarding the mode of fertilization and breastfeeding. Objective: This systematic review and meta-analysis aimed to determine the association between the mode of conception and breastfeeding continuity. Materials and Methods: The English electronic databases were searched for up to May 20, 2022. The Newcastle-Ottawa Quality Assessment Scale was used to evaluate the quality of the included studies. Publication bias was assessed using a funnel plot. The heterogeneity of studies was evaluated using I² statistics. Results of the random-effects meta-analysis were presented using odds ratios (ORs)/relative ratio (RR) and 95% confidence intervals (CIs). Results: A total of 12 articles with 4,929 subjects were included in this systematic review and meta-analysis. The pool estimates of the meta-analysis show that spontaneous conception is associated with breastfeeding continuity up to 6 months (OR/RR = 0.66, 95% CI: 0.46-0.87) and more than 6 months after childbirth (OR/RR = 0.65, 95% CI: 0.32-0.98) compared to the Assisted reproductive technology (ART) conception. The heterogeneity among the studies was high. The level of breastfeeding, plurality, gestational age, and country were confounding factors that affect the heterogeneity of studies. Conclusion: Our findings confirm an inverse association between ART conception and breastfeeding continuity. Due to the importance of breast milk in improving the health of infants who are born in this way, it is recommended to take appropriate interventions in this field. Possible interaction between ART and breastfeeding continuity in different regions is important to point and future studies on this topic were recommended.

Breastfeeding Experiences in First-Time Mothers After Assisted Conception

Objective: The association between assisted conception and breastfeeding outcomes has been investigated, but the women's experiences have not been fully explored. This study aimed to describe and understand the breastfeeding experience of first-time mothers who conceived using assisted reproductive treatment. Methods: A qualitative study based on Gadamer's hermeneutic phenomenology was conducted with a sample of 27 women who conceived using assisted reproductive treatment during the last 10 years. Focus group and in-depth interviews were conducted using a semistructured interview guide. The interviews' transcriptions were coded and categorized into themes and subthemes. Results: Two main themes emerged from the data analysis: (1) "the transition from infertility to motherhood," with the subthemes "infertility and decision to breastfeed," "the impact of birth experience on breastfeeding," and "hospital factors influencing breastfeeding practice"; and (2) "the reality of becoming a breastfeeding mother after assisted reproductive technology," with the subthemes "I want to breastfeed my infant," "the need for supports from others," and "when breastfeeding lasts longer than expected." Conclusion: Women who conceive by using assisted reproductive treatment experience a strong desire to breastfeed and problems such as low milk supply. Early cessation of breastfeeding provokes feelings of guilt and failure as mothers. Positive family networks and professional assistance are necessary to support breastfeeding.