Nursing during Pregnancy
By Ruth Lufkin
From LEAVEN, Vol. 31 No. 3, May-June 1995, pp. 35-36
Ed. Note: We provide
articles from our publications from previous years for reference for our Leaders
and members. Readers are cautioned to remember that research and medical information
change over time.
A mother who finds herself
pregnant while breastfeeding presents special challenges to the LLL
Leader she contacts. The mother may be worried and upset. She may have
been advised by her doctor or by friends and relatives to wean. Indeed,
she may have decided to wean, and may be asking how quickly and how
smoothly to accomplish it. On the other hand, she may be wondering whether
it would be harmful to continue nursing her child. Perhaps she has heard
about nursing through pregnancy and tandem nursing and would like to
consider these options. She may even feel pressure to keep nursing,
especially if her baby is less than a year old.
We can reassure the mother
that over the years La Leche League has had contact with many mothers
who have happily nursed through pregnancy with no ill effects. In some
parts of the world nursing through pregnancy is not even questioned.
It is culturally accepted; health care professionals and mothers have
experience with it.
LLL has also helped many
mothers who chose, for a variety of reasons, to wean during pregnancy.
Medical reasons such as uterine pain or bleeding, a history of premature
delivery, or mother's continued loss of weight during pregnancy may
cause a mother to consider weaning during pregnancy. (LLLI's new pamphlet
"Approaches to Weaning," No. 125, can be helpful.) It is important that
the mother remain in close communication with her health care provider
during her pregnancy.
Our challenge as Leaders
is to help a mother identify her feelings and preferences as well as
carefully present advantages and disadvantages so she can make a decision
that suits the needs of her family and her baby. We can support both
those who choose to wean in the face of another pregnancy and those
who continue to nurse.
How old is the nursing child?
When the child at the breast
is only a few months old, the mother may be more inclined to continue
breastfeeding than when the nursling is older, more verbal and less
dependent on nursing. However, children mature at different rates. While
one child may be ready to wean at a certain age, another may not be.
A child whose need seems intense early in the pregnancy may wean happily
a little later.
Is the child's continued nursing a habit or a genuine need?
The Leader can make valuable
suggestions to help the mother answer this question. By discussing the
fact that breastfeeding is just one way to meet the child's needs and
suggesting other ways of providing love and closeness, the Leader can
reassure the mother, leaving her free to come to her own decision.
Mothers may also experience
physical responses to their pregnancy, such as sore breasts or nipples,
which affect their decision to continue nursing. Feelings of restlessness
or a negative reaction to their older child may surprise them. If so,
they will be interested to hear that some scientists theorize there
is a natural biological impulse to wean during pregnancy. A father's
feelings can be extremely influential, also, and should not be overlooked
in discussing the mother's circumstances.
Mothers are likely to ask:
Will the hormones of pregnancy be harmful to the breastfeeding baby
or toddler? and Will breastfeeding during pregnancy deprive the unborn
child of needed nutrients? THE BREASTFEEDING ANSWER BOOK points out
that the hormones that maintain pregnancy are found in very small quantities
in human milk but are not harmful to the breastfeeding child. The baby
in utero is exposed to these hormones at a much higher level than the
nursing child. Usually the pregnancy affects breastfeeding rather than
the reverse, as most women report a reduction of milk supply during
pregnancy while nursing an older baby. While noting that some mothers
find it necessary to consume extra calories while breastfeeding during
pregnancy, THE BREASTFEEDING ANSWER BOOK reminds us that a well-nourished
mother should have no difficulty providing for both the unborn baby
and the nursing child if he is more than a year old. If the nursling
is younger, the mother will need to watch his weight gain and provide
additional solid foods as needed if her milk is not sufficient.
Many mothers wonder whether
uterine contractions stimulated by breastfeeding pose a danger to the
unborn baby or increase the risk of a premature birth. There is no documented
danger to mother or fetus when mothers breastfeed through a healthy
pregnancy. Unfortunately, miscarriage and premature birth do happen
in a percentage of all pregnancies, whether a mother is nursing another
child or not. When there are problems, it is only human to look for
somewhere to place blame. All too often, breastfeeding is a handy scapegoat
when things go wrong.
While there are no formal
research studies specifically examining the relationship between continuing
to nurse through pregnancy and pregnancy problems, the vast number of
women in contact with LLL over many years constitute a large, informal
study population. If the practice of continuing to nurse through pregnancy
were responsible for significantly increased pregnancy problems, it
would surely have become apparent in our LLL population.
Considering the absence
of scientific data on this topic, it seems reasonable to wonder on what
evidence doctors and others base their opposition to pregnant women
breastfeeding? Mothers can be encouraged to ask those who object to
the idea for studies or clinical experience to back up their recommendations.
There have been studies showing that nipple stimulation could initiate
labor in the third trimester, but the types of stimulation used were
significantly more vigorous than one would get from nursing a toddler.
It has also been theorized that an accustomed level of nipple stimulation
from breastfeeding or lovemaking may not have the same effect as the
techniques used in these studies.
Should a woman be more cautious
about breastfeeding while pregnant if she has a history of miscarriage?
Yes, in the opinion of the LLLI Health Advisory Council. However, if
a woman is showing signs of threatening miscarriage (bleeding, contractions)
there is no guarantee that ceasing breastfeeding will save the pregnancy
or that continuing to breastfeed will result in the loss of the fetus.
The parent's feelings and thoughts should be the only determinant in
deciding whether or not to continue breastfeeding a toddler when the
pregnancy is threatened. In some situations the mother may feel that
her nursling's needs are so intense that she will continue to meet them
by breastfeeding and leave the resolution of the pregnancy to nature.
In others she may wish to do everything possible to try and save the
pregnancy, including stopping breastfeeding. The mother may feel that
she is forced to choose between the needs of her older baby and the
life of the fetus. The Leader can provide her with information and sympathetic
support, respecting the mother's right to choose the course of action
that seems most compelling to her.
When a mother is considering
nursing through pregnancy, help her learn all she can. Invite her to
attend LLL meetings, borrow pertinent books from the Group library and
talk with other mothers with similar experiences. Remind her that there
is no absolute answer in this situation but she can decide the right
course of action for her family. Encourage her to give herself time
to decide.
If she feels she must wean
her older child, affirm her loving approach to mothering and offer her
support. If she chooses to continue nursing through her pregnancy, encourage
her to be flexible and take the situation day-by-day. Review the variety
of physical and emotional reactions she may experience: from herself,
from her child, from others. Again, affirm her loving approach to mothering
and offer her support.
References:
Berke, G. Nursing Two: Is It For You? LLLI, 1989. No. 53.
Bumgarner, N. MOTHERING YOUR NURSING TODDLER. LLLI, 1982.
Chayen, B. et al. Induction
of labor with an electric breast pump. Journal of Reproductive Medicine
31(2):116-22, 1986.
Moscone, S.R. and Moore,
M.J. Breastfeeding during pregnancy. Journal of Human Lactation
9(2), 1993, 83-88.
Mohrbacher, N. and Stock, J. THE BREASTFEEDING ANSWER BOOK. LLLI, 1991, 364-67.
Newton, N. and Theotokatos,
M. Breastfeeding during pregnancy in 503 women: does a psychobiological
weaning mechanism exist in humans? Proceedings of the Fifth International
Congress on Psychosomatic Obstetrics and Gynecology. London: Academic
Press, 1979, 845-49.
Tal, Z. et al. Breast electrostimulation
for the induction of labor. OB/GYN 72(4):671-74, 1988.
Related article:
Gomez, S. "Tandem Nursing."
LEAVEN, Sep-Oct 1993, 69-71.
Last updated September 17, 2006 by jlm.
Page last edited Sun Oct 14 09:32:06 UTC 2007.
