# Induced Lactation in Non-gestational Mothers in Iran: Outcomes and Predictors of Breastfeeding Success

## TL;DR

This study examines how non-pregnant mothers in Iran can successfully breastfeed using induced lactation and identifies factors that influence breastfeeding duration.

## Contribution

The study is the first in Iran to investigate induced lactation outcomes and predictors of breastfeeding success in non-gestational mothers.

## Key findings

- Exclusive breastfeeding for 120 days significantly increased the likelihood of breastfeeding for at least 180 days.
- Biological reasons were the primary cause of breastfeeding cessation in both short- and long-term groups.
- Pharmacological methods aid lactation initiation, but long-term success depends on consistent breastfeeding practices.

## Abstract

Induced lactation allows non-gestational mothers, such as those adopting or using surrogacy, to breastfeed their children. While widely practiced in various contexts, little research exists on its application in Iran. This study aimed to assess the success and duration of induced lactation in Iranian mothers without prior pregnancy.

This descriptive-analytical study was conducted between 2013 and 2021, recruiting mothers who became parents through surrogacy or adoption. Participants followed a protocol using hormonal (combined oral contraceptives, domperidone) and non-hormonal methods (breast stimulation). Data on breastfeeding duration, exclusivity, and reasons for cessation were collected through regular follow-up. Chi-square tests and multivariable logistic regression were used to assess factors influencing breastfeeding duration.

Of the 117 mothers, 100 breastfed for<180 days and 17 for≥180 days. The median breastfeeding duration was significantly longer in the≥180 days group (240 days vs. 30 days, P<0.001). Exclusive breastfeeding up to 120 days was much more common in the≥180 days group (70.60% vs. 24%, P<0.001) while biological reasons were the primary cause of cessation in both groups but with different frequencies (100% vs. 75%, P=0.022). The results of logistic regression showed that exclusive breastfeeding for 120 days increased the likelihood of successful breastfeeding for≥180 days (OR: 5.72 (1.76‒18.61), P=0.004) adjusting for mother’s age (1.02 (0.92‒1.12), P=0.755), duration of Domperidone use (1.01 (0.98‒1.04), P=0.536), duration of LD use (1.04 (0.95‒1.15), P=0.366), and reason for stopping breastfeeding (7.02 (0.39‒125.30), P=0.185).

This first Iranian study on induced lactation underscores the role of early exclusive breastfeeding in extending breastfeeding duration. Pharmacological support aids in initiating lactation, but long-term success relies on consistent breastfeeding practices. These findings highlight the need for culturally tailored guidelines and support for non-gestational mothers in Iran.