Monthly Archives: February 2017

Breastfeeding and Trying Again

OK, here’s the thing… we are three weeks away from my son’s first birthday.  There are many amazing things to reflect on at the end of this first year.  I am acutely feeling the parenting cliches: on the one hand, it feels like only yesterday that I was holding my wide-eyed newborn son in my arms, and on the other hand, it feels like he’s been with us forever, and I can hardly remember my life without him.  There are many more things I hope to write about as his first birthday approaches and passes, but another thing I’ve started thinking about as his first birthday approaches is our strategy for conceiving the  living sibling we hope that he will one day have.

Surprisingly for me, my thoughts on trying to conceive our third child are all tangled up with my feelings about breastfeeding my son.

Conception and pregnancy have never been easy for us.  It took 2.5 years from the time we started trying to conceive to the birth of our son.  There were two pregnancies along the way, including the loss of our daughter in the middle of the second trimester.  Both pregnancies involved consultation and testing with a reproductive endocrinologist, and the second time around the RE had recommended moving onto IVF due to tubal factor infertility, which we were in the process of preparing to do when I became spontaneously pregnant with my son.  I am not expecting conception or pregnancy to be easy the next time around either.  Tubal factor infertility (in my case, due to the infection and scarring that occurred after the loss of our daughter) does not tend to get better with time, and it might have gotten worse since the birth of our son.  It is likely, though not definite (we might get lucky again!), that IVF is in our future.

What does all of this have to do with breastfeeding?  For one thing, breastfeeding influences menstrual cycles.  My period returned when my son was 10 months old, but it’s been irregular.  While I’m breastfeeding, it may remain irregular, but I won’t know whether the irregularities are due to breastfeeding or some other hormonal imbalance.  Muddying the waters, I had wildly irregular periods for 11 months before conceiving our daughter, and then clockwork regular periods for 8 months before conceiving our son.  We’d like to try for a while on our own before going back to the RE, but it’s trickier while my periods are irregular.  There are also some data indicating that breastfeeding might impede implantation and reduce the likelihood of pregnancy.  Finally, most REs make a blanket recommendation that you should cease breastfeeding before starting fertility treatments, although it’s not clear how evidence-based that recommendation is.

Many women think of it as a tension between their living child and their hoped-for child: do I prioritize the breastfeeding relationship with the child I have and love, or do I wean in order to maximize the probability of conceiving the child I hope to have?  I suspect there’s a middle-of-the-road option I might be comfortable with, but I’m not yet sure what that looks like.  My breastfeeding relationship with my son is still going strong as his first birthday approaches, but he doesn’t seem to be as attached to breastfeeding as some of my friends’ children.  He doesn’t really ask to breastfeed very often, and he’ll often refuse when I offer because he’s much more interested in seeing what’s going on in the world around him and doesn’t want to take any time out to nurse.  So a bit of mama-led weaning might be well received.  At the same time, I love our breastfeeding relationship and am not sure I’m ready to encourage its end, plus I know that my son derives comfort from it, especially when he is sick or tired.

So, what does our plan going forward look like?  When he was first born I thought “We’ll start trying when he’s a year old, and go back to the RE at six months.”  Now, with no end to breastfeeding in sight (and, honestly, with sex still kinda uncomfortable thanks to the breastfeeding hormones), I’ve started to think “Maybe we’ll start trying when he’s 18 months and go back to the RE when he’s 2.”  I don’t want to wait too long, because I’m not expecting the road to be easy, and I’m not getting any younger.  I’m turning 34 next week, and staring Advanced Maternal Age squarely in the face.  I know that timing can make a huge amount of difference in IVF cycles, and that waiting to even go back to the RE until I’m already 35 (when my son turns 2) might be risky, especially since we’d love to keep the option of a third living child open if we are lucky enough.   I feel sad contemplating the end of our breastfeeding relationship.  But the experience of having our son in our lives has only made our desire for another living child stronger, and my husband and I don’t want to wait too long.