Is it safe to breastfeed while pregnant?

Breastfeeding has widely known health advantages. However, when nursing overlaps with pregnancy, a significant cultural tabu typically exists; some cultures even suggest weaning a child during pregnancy. When pregnancy overlaps with nursing, the concern of many mothers and practitioners are sudden abortion, premature birth or rapid reduction of nutrients. Various studies have shown that breastfeeding while pregnant is not an uncommon occurrence in many countries. One study conducted in rural Guatemala by Martorell, Haas, and Merchant 1990, showed that 50% of women breastfeed while pregnant. Another study conducted by Ramachandran,2002, stated that 30% of mothers in India conceived a child while breastfeeding. As of now, there is little to no statistical data on the consequences of breastfeeding while pregnant, and there are sparse rather than recent statistics. Thus, health professionals engaged in pregnancy monitoring and breastfeeding assistance must advise women of pregnancy breastfeeding and give scientific counseling.

So far, the effects of breastfeeding while pregnant have not fully been established. Although there are various studies conducted, they have mainly focused on isolated aspects of breastfeeding during pregnancy, such as the outcomes of nutrition, the result of premature birth or sudden abortion, the outcome of newborn babies such as weight and growth, or the outcome of the older child. In this case, a good picture of the effects of breastfeeding while pregnant is challenging to get. In more recent research by Yalcin, Demirtas and Yalcin, (2021) concluded that the characteristics depend on maternal factors, and cohort research is necessary to evaluate the impact of breastfeeding during pregnancy.

However, health outcomes for the mother and the older breastfed child are not clear. Research conducted by Fernandez, Barrios, Tricas, Benito (2017) reports five key findings:

  1. Breastfeeding during pregnency is associated with increased supplement intake. When pregnancy and breastfeeding overlap, fat reserve often decreases during the first and the second trimesters, but not during the third trimester or postpartum; a study suggests that the high intake of supplements in earlier trimesters can help increase the energy deficit experienced in the third trimester. A study concluded that nutritional supplements during the early stages of pregnancy are recommended to correct nutritional deficiencies.
  2. The study does not report any significant difference in the rate of premature birth concerning pregnant breastfeeding mothers and not pregnant breastfeeding mothers. They also indicate a higher frequency of sudden abortions in breastfeeding mothers, although the difference is insignificant.
  3. The birth weight of newborns in breastfeeding mothers is lower, although the difference is not significantly higher.
  4. Babies born to breastfeeding mothers gained less weight than those born to non-breastfeeding mothers in their first month.
  5. The study suggests that the abrupt weaning of children during gestation is associated with a reduction in growth rate for six to three months.

 

According to the American Pregnancy Association, breastfeeding while pregnant is generally considered safe, but weaning may be advisable if the mother carries twins, has bleeding or uterine pain, or has been advised to avoid sex during pregnancy. The association also emphasises that it is essential to contact a doctor to determine if weaning would be the best option for the mother in such cases.

 

In conclusion, breastfeeding during pregnancy is considered safe as long as you don’t feel some symptoms like;

  • Uterine pain\bleeding
  • Pregnancy-related health issues
  • History of preterm birth
  • Expecting multiples
  • Strong contraction during breastfeeding
  • Significant weight loss
  • Asked to avoid sexual activity
  • Back pain

 

In this case, if the pregnant woman feels one of these symptoms (mentioned above), she should immediately see her doctor to avoid any health risks for her and the child. During pregnancy breast soreness and nipple tenderness are common symptoms. The discomfort might increase during breastfeeding. Fatigue due to pregnancy might also be an issue. Your hormones cause these adverse effects during pregnancy. It is essential to look after yourself and eat well. At our hospital, we have a dietician and various experts who are more than happy to help you out at every step of your pregnancy. Make sure you are well hydrated and getting plenty of rest.

References

Merchant K, Martorell R, Haas J. Consequences for maternal nutrition of reproductive stress across consecutive pregnancies. J Nutr 1990;52(61):616– 20. 25.

Ramachandran P. Maternal nutrition—effect on fetal growth and outcome of pregnancy. Nutr Rev 2002;60(5 Pt. 2) S26–34 Available from: onlinelibrary.wiley.com/Doi/10.1301/00296640260130704/pdf.

López-Fernández, M. Barrios, J. Goberna-Tricas, J. Gómez-Benito, Breastfeeding during pregnancy: A systematic review, Women and Birth, Volume 30, Issue 6, 2017, Pages e292-e300,

ISSN 1871-5192, https://doi.org/10.1016/j.wombi.2017.05.008. (https://www.sciencedirect.com/science/article/pii/S1871519217301105)

Siddika Songül Yalçın, Mehmet Semih Demirtaş, and Suzan Yalçın. Breastfeeding Medicine. Oct 2021.827-834.http://doi.org/10.1089/bfm.2021.0073

https://americanpregnancy.org/healthy-pregnancy/breastfeeding/breastfeeding-while-pregnant/. (Accessed on October 2021)

Molitoris, Joseph. “Breastfeeding During Pregnancy and the Risk of Miscarriage.” Perspectives on sexual and reproductive health 51.3 (2019): 153-163.

The Relation of Infertility and Family History / Genetic Predisposition

Infertility is when a couple fails to conceive after trying for more than a year (≥6 months for ≥35 years old women). It is a personal crisis for a committed couple.

It is not uncommon to observe women in the same environment, friend circle, or social community having trouble getting pregnant. Women from the same family, particularly sisters, may begin to question a genetic link between them.

Infertility has multiple causes, and several problems can contribute to your inability to conceive. Infertility affects males just as much as it does with women. Frequently, the source of the problem is reported as unknown.

But, certain medical conditions can make it difficult to conceive. The following are the most common conditions that run in families and increase the chances of infertility.

  • Family history of thyroid disease endometriosis
  • Obesity
  • Polycystic Ovary Syndrome (PCOS)
  • Recurrent pregnancy loss (RPL)
  • Uterine fibroids
  • Ovarian Reserve
  • Family history of breast or ovarian cancer
  • Early Menopause

Each of these conditions has a treatment option, and If you aren’t ready to start a family yet, you should talk to a fertility doctor about your options here in our Cyprus IVF hospital. You can keep your eggs frozen until you’re ready to use them.

 

References

McLaren, J. F. (2012). Infertility evaluation. Obstetrics and gynecology clinics of North America, 39(4), 453.

Vance, A., & Zouves, C. (2005). The importance of family history risk assessment in the infertility setting. Fertility and Sterility, 84, S125-S125.

Hazar Bayindir. Common connection of infertility. extracted on Oct, 2021.

Breast Cancer: Infertility and Fertility Preservation

Breast cancer is the most frequent malignancy in women, and its incidence rises dramatically during the reproductive years. Based on the most recent anti-cancer molecular targeting medications, successful therapies contribute to disease healing, particularly in young patients, thereby reviving their motherhood programs. However, more than one-third of patients experience early ovarian follicular reserve depletion due to breast cancer treatment, causing permanent infertility.

Infertility caused by cancer is a problem for younger cancer survivors, who make up a significantly smaller fraction of total cancer survivors. However, the emotional toll of not being able to have a child after cancer can be devastating.

Advances in the understanding of how cancer therapies can affect fertility and innovative procedures to preserve fertility give hope to patients who haven’t finished their childbearing at the time of their cancer diagnosis.

Premature ovarian failure and infertility are common side effects of breast cancer treatment. Natural cycle IVF (NCIVF) has been used to preserve fertility and treat infertility in breast cancer patients since elevated estrogen levels are possibly hazardous.

For newly diagnosed young breast cancer patients, ovarian stimulation followed by IVF is a crucial fertility preservation technique; controlled ovarian stimulation procedures have recently advanced, providing practical solutions to some of the issues that breast cancer patients face.

Here in Cyprus IVF Hospital, we offer egg freezing and embryo freezing to help newly diagnosed breast cancer patients.

 

Reference

  • Silvestris, E., Dellino, M., Cafforio, P. et al. Breast cancer: an update on treatment-related infertility. J Cancer Res Clin Oncol 146, 647–657 (2020). https://doi.org/10.1007/s00432-020-03136-7
  • Shapira, M., Raanani, H. & Meirow, D. IVF for fertility preservation in breast cancer patients—efficacy and safety issues. J Assist Reprod Genet 32, 1171–1178 (2015). https://doi.org/10.1007/s10815-015-0519-x
  • K. Oktay, E. Buyuk, O. Davis, I. Yermakova, L. Veeck, Z. Rosenwaks, Fertility preservation in breast cancer patients: IVF and embryo cryopreservation after ovarian stimulation with tamoxifen, Human Reproduction 18(1), 90 -95, (2003). https://doi.org/10.1093/humrep/deg045
  • Leslie R. Schover, Marleen van der Kaaij, Eleonora van Dorst, Carien Creutzberg, Eric Huyghe, Cecilie E. Kiserud. Sexual dysfunction and infertility as late effects of cancer treatment. European Journal of Cancer Supplements, 12(1), 41-53 (2014). https://doi.org/10.1016/j.ejcsup.2014.03.004.

About the Covid-19 Vaccine: Pregnancy and Fertility

As we have reached the point in the Covid 19 pandemic, the vaccination program is essential to containing the pandemic.

The effectiveness and safety of our treatment services will increase—both of us who provide services in the field of health and those who receive services.

There is no evidence to show that the current vaccines cause infertility in both men and women.

It is recommended that all individuals that stay on and/or who are receiving treatment.

Vaccination knows that there is no evidence of adverse effects—vaccine administered in early pregnancy.

Before starting treatment with Assisted Reproductive Technologies (ART), minimize the complications that may develop due to the disease and complete the scheme by obtaining effective immunity during pregnancy.

Short-term fever, which may occur due to vaccination, may not significantly affect sperm parameters. While it is not expected to be affected in any way, the fever may negatively affect sperm parameters temporarily. Therefore, for our female patients and male patients, prevention of the disease and vaccination is essential.

Studies on patients receiving ART treatment show that pregnancy rates of individuals who have undergone, vaccinated and unvaccinated are similar.

As a result, the vaccine should be used in patients who benefit from ART.

There is no negative effect on treatment success.

The disease is more common in pregnant women than women in the same age group.

Hospitalization in intensive care and the need for more mechanical ventilation is known to cause many deaths. The risks include additional risks such as diabetes and obesity, which can increase in the presence of health problems. Therefore, for optimal protection, vaccination for women who conceive before completion is advised because they are at higher risk than individuals, and it is recommended that they complete their scheme. With the vaccine administered during pregnancy, similar immunity can be achieved with individuals without higher antibody levels than shown to be possible. In addition, as a result of vaccination, both cord blood antibodies have been reported in breast milk.

 

Studies on the vaccine’s safety in the United States have shown that mRNA vaccines do not affect pregnant women or babies.

Although not reported, any vaccine-related negativity in pregnancy outcomes in pregnant women, such as preterm labour due to the disease, is said to be safe and has no adverse effects.

In light of this data, we recommend that all our patients, both for their health and society’s health, contribute to their health and get vaccinated.

 

Society of Reproductive Medicine and Surgery

Board of Directors