Association of Assisted Reproductive Techniques with Infant Feeding Practices: A Community-Based Study in China

With births generated with assisted reproductive techniques (ARTs) increasingly, the effect of ARTs on infant feeding behaviors is an essential topic to explore. However, limited literature focused on this topic. The objective of this study is to examine the effect of ARTs on infant feeding behaviors. Participants, including 41 mothers who conceived with ARTs and 935 conceived spontaneously, were drawn from a prospective birth cohort between January 2015 and December 2015. The participants were followed up at 1, 3, 6, 8, and 12 months postpartum at their residences through a face-to-face interview. Feeding behaviors, including breastfeeding initiation, partial/exclusive breastfeeding duration and formula introduction were assessed using World Health Organization-recommended definitions. Cox and logistic regression models were applied to examine the association of assisted conception with feeding behaviors. Breastfeeding initiation rates were comparable between women who conceived with and without ARTs (70.7% versus 76.0%). Breastfeeding duration and formula introduction were significantly shorter and earlier in assisted conceptions in univariate analyses at 6 months postpartum [crude hazard ratios (HRs), 95% confidence intervals (CIs) 2.02 (1.03-3.84), and 1.63 (1.09-2.44)]. However, after controlling for covariates, assisted conception was only associated with shorter breastfeeding duration at 6 months postpartum [adjusted HR 1.99, 95% CI 1.05-3.80], no significant differences were found in infant feeding outcomes at 12 months postpartum among women with ART conception versus general conception. Mothers who conceived through ARTs with cesarean deliveries were at the highest risks of shorter breastfeeding duration and earlier formula introduction than mothers who conceived spontaneously with vaginal deliveries. Mothers who conceive through ARTs are associated with shorter breastfeeding durations for the first 6 months, compare to mothers who conceive spontaneously. Furthermore, cesarean delivery has a joint effect with the treatment of ARTs on promoting the development of poor feeding behaviors.