For privacy reasons, this lovely guest poster has elected to remain anonymous.
My son is almost 2 years old. He was conceived through IVF with donor sperm as my partner and I are both women. It has always been our plan to have another child but when we started talking about the realities of beginning IVF again I realised I may have a difficult decision. Our IVF clinic didn’t want to have a conversation about treatment while breastfeeding a toddler. Their line is that he had to be weaned.
Six months ago, when I had this discussion with a nurse at the clinic, I thought that weaning by age 2 was achievable and something I may be ok with. After having a tough time establishing breastfeeding and working damn hard to overcome our issues it isn’t something I treat lightly. And the closer I got to the looming date the more difficult the decision was.
At 18 months he was nursing around the clock – more than half of his feeds were overnight in bed (90 mins apart). I made the decision to night wean in the hope I would finally get a few hours of unbroken sleep occasionally and to see if we could start to cut down on feeds. We followed Dr Jay Gordon’s plan when my son was 19 months old and found it surprisingly easy and calm for all of us. He still asks for boobie sometimes when he wakes through the night but will resettle with a cuddle.
A side effect of night weaning was that we fell into a breastfeeding routine of morning feeds in bed, afternoon nap feed in bed and evening feeds in bed. He was too busy and distracted to want milk outside of these times so it was easy to cut down the duration and frequency of feeds by getting out of bed in the morning or having his afternoon nap in the car, carrier or pram. By 22 months we were down to 2 feeds a day (morning and night) and seemed on track to meet the deadline to start IVF.
Around this time I started to enjoy the closeness of breastfeeding again, and realised that emotionally I didn’t feel ready to break that bond between us. So with an IVF cycle booked in for the month before his second birthday and drug regime planned out I took to the internet, chatted to ABA counselors and lactation consultants and consulted with pharmacists who specialise in drugs and breastfeeding.
I found some interesting information which challenged the views of my IVF clinic. I’m hoping that this information may help another mum facing the same difficult decision that I have been.
When I asked the clinic nurse why I had to stop breastfeeding I was told that:
a) Increased prolactin may reduce success rates, and
b) Risk of treatment drugs transferring through my milk to my toddler.
These are two very different points so I will discuss each separately.
a) I’m not an expert on prolactin levels. The people I have spoken to who do know about these things (ABA and lactation consultants) have all agreed that the level of prolactin in a nursing mother’s blood is very low (almost insignificant in trying to conceive terms) when your nursling is having no more than 3 feeds a day and not nursing overnight. This information may have been misguidedly supplied by the clinic assuming that all breastfed children are under 6 months and relying exclusively on breast milk for their nutrition. My 22 month old son eats a wide variety of food and drinks a lot of water. He nurses twice a day most days. This is unlikely to impact my likelihood of success with IVF.
b) Transfer of drugs through breast milk. This is well outside my professional knowledge so I talked to a few pharmacists who specialise in drugs and breastfeeding. Monash Pharmacy and the Pharmacy at Royal Women’s Hospital both gave me the same information about the specific drugs prescribed to me. I won’t go through these in detail as I believe you should have these discussions yourself if you’re considering going down this path, but I will summarise some of the findings.
Hormones – these are naturally occurring during pregnancy and may decrease milk production. In a similar way to falling pregnant naturally would. Your toddler may choose to wean if there is no milk supply. (This is a risk I am willing to take).
Steroids/other support drugs – the dosage I’ve been prescribed is well below the level at which there could be an impact on my toddler. One of my drugs has a possible side effect of decreasing blood pressure. I will be taking this for 5 days and during that time I need to watch out for crankiness in my toddler, which could be an indication he has a headache from low blood pressure. It is unlikely given the dose, but it’s something I will be watching out for.
Injections – I don’t need any for my treatment cycle, but these are generally safe. The reason they are given as an injection and not orally is that they are not broken down in the stomach. Therefore even if it transfers into your milk, your toddler’s stomach will not process the drug.
The best source of information I found was a paper written by ABA counselor Jeanette Elliot in 2008 titled Breastfeeding through IVF treatment: a case study. I believe this is available for purchase through ABA. Jeanette did a talk on this topic at the 2007 ABA conference which was recorded and can be listened to here.
For me the most valuable point Jeanette made was to consider all the outcomes and how I’d feel with each, knowing there was no risk to my son.
1. Continue breastfeeding my son and fall pregnant
2. Continue breastfeeding my son and not fall pregnant
3. Cease breastfeeding my son and fall pregnant
4. Cease breastfeeding my son and not fall pregnant
Of these outcomes the one that would devastate me is the last one. I do not wish to risk ending the breastfeeding bond with my son early for nothing. Other people may see this differently and feel the “what if” from outcome 2 would be harder to deal with, in which case weaning would probably be recommended. It’s a very personal decision that another person cannot make for you.
There’s a lot more I could write but most of my thoughts are covered by Jeanette’s podcast which is well worth your time to listen to.
The decision I haven’t made yet is whether to tell my clinic that I am still breastfeeding. It hasn’t been discussed recently and I’m contemplating a “don’t ask, don’t tell” approach.