Why did no one tell me IVF can lead to problems breastfeeding?

When you’re struggling to get pregnant, and find yourself doing fertility treatment in order to get that magic pink line, you don’t really let yourself think further than that point, such is the fear it would never come true.

So it stands to reason that you wouldn’t let yourself think beyond having a bump, wondering about gender and baby names, much less whether you intend to breast or bottle feed the baby. These are things you hope more than anything you’ll get to experience and decide on, but for now, you can’t let your mind go there for fear of it never happening.

However, it’s important to flag one side of fertility treatment that, if successful, may affect your breastfeeding experience. It’s a tricky one, there’s no doubt. IVF and fertility treatment is a very emotional, tough mental challenge and it’s so hard to see that far down the line when, if like me, your coping mechanism is to take it one small step at a time and not think too much about the overall picture and the sometimes overwhelming fear of failure.

None of us had been aware of the link between IVF and breastfeeding

But let’s assume you’ve done treatment and thankfully it has worked, and you’re at the stage where you finally let yourself start thinking about these things. I knew early on I’d want to breastfeed both babies, but it was about five months after my second baby was born that I discovered studies showing a link between IVF patients and difficulty in breastfeeding.

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Furthermore, some studies have found that women who have caesarean sections following successful IVF treatment are at an even higher risk of breastfeeding failing. The Australian Breastfeeding Association states: "If any breastfeeding problems occur after IVF, they may be related to the reasons for using IVF in the first place. For example, polycystic ovarian syndrome (PCOS) may be the reason IVF is needed and can also be associated with a low milk supply in some cases."

The article goes one to suggest that IVF is also associated with an increased risk of caesarean section, premature delivery, multiple births and “reduced confidence in mothering. These situations may create challenges to get breastfeeding going, but do not rule out achieving ‘successful’ breastfeeding”.

A study published in 2013 highlights the complexities.

Lead author Prof Jane Fisher and Jean Hailes, professor of women's health at Monash University in Australia, emphasised the importance of health professionals helping to build confidence in women to breastfeed, particularly in women who have had an assisted conception and caesarean birth.

“We hope this new data will encourage midwives, lactation consultants and doctors to provide women in this situation with additional assistance to help them establish breastfeeding,” Prof Fisher said.

"These are important findings and show that women using assisted reproductive technology (ART) to become pregnant need to be aware that they may find breastfeeding difficult, and so ask for support and help quickly after their babies are born," said John McBain senior fertility specialist at Melbourne IVF and a co-author of the paper.

This is not to say that women who do IVF treatment can’t breastfeed at all. But, considering I check all of the boxes above (PCOS, IVF, C-sections) I sorely wish I had known these flags existed so I could have prepared for them. Maybe it wouldn’t have made a difference, but my failure to breastfeed had a massive impact on my mental health at a time when it was in a very vulnerable state.

Why am I writing about this?

Alex was about five months old when I wrote a blog post about my experience with breastfeeding and how upsetting I had found it; the guilt I placed on myself and the feeling of failure. The post was picked up by an online source and from there made its way to Facebook where people commented on it, and my "lack of effort" in a negative way. It affected me badly and I took every comment to heart. I struggled for a long time with it but two great things came out of the experience. One, was one girl who stuck up for me, who I'm still in regular contact with; and two, a lovely woman from La Leche League, the breastfeeding support group, who got in touch with me privately. She was the first person to tell me about the link between fertility treatment and issues with breastfeeding. As I was reading her kind, helpful, understanding and supportive words, I could almost feel the fog lift and I felt a huge sense of relief – it wasn't that I had given up, or hadn't tried hard enough after all.

Since then I’ve come across a handful of women who ended up in the same boat as me, mothers who had been through fertility treatment and had dealt with issues around breastfeeding. None of us had been aware of the link between IVF and breastfeeding. So I’m writing this in case one woman reads it and either comes out of that same guilty fog, or can prepare herself and make sure she has all the backup she might need for when the time comes.

So, what can you do?

Prepare. Ask questions at the antenatal classes and do the research. Find out where your nearest local support group is and see if you can find a private lactation consultant that could visit you at home. Talk to your partner, family and friends in advance and tell them ways they could help support you, for example, by looking after any older siblings for that extra support and time you might need with the baby.

Ask at hospital appointments about their lactation consultants and the possibility of them visiting you while you’re still in the hospital, rather than when you think there may be an issue.

Inform your doctor and midwife and insist on help if you feel you’re struggling. Often they aren’t aware the two things are linked, at least in my experience.

Finally, and it’s easier said than done, don’t be hard on yourself. Some women have no problems with breastfeeding but many do, it’s something you and the baby have to learn. Often, regardless of how you got pregnant, it can take a little while to establish a good routine but if you’re finding it difficult, remember that can also be normal.

It’s hard to see sometimes through that early newborn fog. But eventually the fog will lift, and when it does, whatever feeding route you find yourself on, that’s the right one for you.

[ Under The Motherhood ]