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Breastfeeding During Pregnancy

Sara Walters
Carmarthen Wales UK
From NEW BEGINNINGS, Vol. 25, No. 1, January-February 2008, pp. 32-33

If you discover that you are pregnant again while you're still breastfeeding, you may have many questions. Will breastfeeding affect the growth of your unborn baby, or interfere with the pregnancy in some way? You may also be concerned about whether you have enough milk for your older child, or you may find it uncomfortable to nurse as your breasts change in response to the pregnancy. As if pregnancy isn't emotional enough, now you have even more to consider.

Can I?

Breastfeeding during pregnancy is perfectly safe. As long as you eat reasonably well, then your unborn baby will not be deprived of nutrients. Even if you suffer from morning sickness and find eating very difficult, your body will naturally go into overdrive to efficiently use all the nutrients it has access to in order to prevent you and the baby from being deficient. Once you are feeling better, then you can make up by eating plenty of nutritious food -- and lots of it!

It is important to eat well. Depending on how old your nursing child is, you may need an additional 650 calories a day if he is under six months, or about 500 if he is now eating other foods. This is on top of the additional 350 (second trimester) and 450 (third trimester) calories you need during pregnancy. (No additional calories are needed during the first trimester, which is a big relief to know when you simply can't face any food at all.) In malnourished populations, pregnant, nursing mothers do have lower weight gain and lower weight babies, as well as lower weight nursing siblings, than those who wean.

You may also be concerned that breastfeeding is stimulating uterine contractions. These pose no risk to the unborn baby and in most cases do not increase the risk of having a miscarriage, or of going into premature labor. This is because the amount of oxytocin normally released during breastfeeding (the hormone that also stimulates labor) is not usually enough to cause the cervix to open before it is ready to do so.

However, if you are having a difficult pregnancy and are at risk for early labor, and in particular have been told to avoid sex during pregnancy, then weaning would probably be advisable. (Oxytocin is also the hormone released during female orgasm.)

Your milk is safe for your breastfeeding child. Although very small amounts of pregnancy hormones pass into your milk, they are not considered to be harmful.

In a nutshell, if you're having a normal pregnancy and are healthy, then there is no physical or medical reason not to breastfeed when pregnant.

Should I?

To continue breastfeeding your child while pregnant again is your decision to make. There may be a physical reason why it is not a good idea to continue nursing, but this is very rare. Otherwise, your choice depends on how you feel about continuing to provide your milk to an older sibling, while growing your new baby.

Only you know how your older child might cope with weaning, and also how you feel about meeting your child's needs at the breast. It may be that you feel your child is ready to be gently encouraged to wean, in which case, now may be a good time as you begin a new chapter in your lives. On the other hand, your child may be particularly attached to the breast, in which case the prospect of weaning may be more than you can handle as you deal with your pregnancy, too. If you are unsure, take each day as it comes and see where it leads you.

Will I?

Although many mothers do not hesitate to say, "Yes, of course I will continue to breastfeed," it often happens that unexpected challenges can arise.

For example, increased fatigue, a normal factor of all pregnancies, may make you more reluctant to breastfeed, fearing it is a drain on you physically. Be assured that there is nothing inherently draining about breastfeeding, and indeed having to sit down (or lie down) to nurse is a good way of ensuring you get to rest.

There may also be physical discomforts that you may or may not be able to tolerate. Nausea caused by the let-down of the milk may happen, especially on an empty stomach. Another, more common complaint is sore nipples. Indeed almost three quarters of mothers will experience this. Some moms find this more difficult to deal with than others. Methods using distraction, such as watching TV, listening to the radio, or reading a book may help you focus elsewhere while you nurse your child. Or using some pain management techniques for coping with labor may be helpful.

Many mothers feel very restless and agitated when nursing. Some describe it as making their skin crawl. Whether you choose to wean or not depends on how you feel about nursing. Remember, the discomfort is only there when the baby is at the breast.

Something that may make you feel uncomfortable is sexual arousal during a nursing session. As pregnancy can be a time of more heightened sexual feeling anyway, the effect of intense nipple stimulation can provoke what is (for many women) unwelcome arousal. Be assured that these complex feelings are not inappropriate: they have nothing to do with your child and are perfectly normal. How you deal with this is a personal decision, whether you distance yourself mentally, decide to cut back or set limits on nursing session, or ultimately, wean.

Will my child?

Of course there isn't just you in the nursing relationship and your plans to continue may be different than those of your nursling. A decrease in milk supply is very common during the fourth and fifth months of pregnancy. The taste of your milk will change, too, and some children will decide that the milk is past its sell-by date! You may feel sad that your pregnancy has brought your nursing days to a premature end, but in this case, your child has outgrown the need.

Will I make the right choice?

Your choice will be the right decision for you. As every situation is unique, there can be no absolutes. Every day brings changes for you, your child, and your unborn baby. In her wonderful book ADVENTUTES IN TANDEM NURSING, author Hilary Flower talks about the value of keeping all your options available and using this as a channel to learn about yourself and what you are capable of. She writes:

A mother facing a weaning dilemma must often make a bold decision, one she considers far from ideal. A mother making this difficult choice needs to draw deep into her reserves for honesty and compassion in evaluating her own needs and those of her child, the courage to face the downside of her decision, and faith that she and her child can go down the road together as a team. In the end it's a leap of faith. Faith not in tandem nursing or pregnant weaning, mind you, but in oneself as a mother.If your gut is telling you one thing, and your head is telling you another, go with your gut.

Talking to a La Leche League Leader and other mothers who have found themselves pregnant while breastfeeding may be very helpful to you.

This article was adapted from the column, "I Need to Know," which appears in LLL GB News.

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