By Neilia Sherman
People you know may be surprised if you decide to breastfeed during a pregnancy or even fear that it is dangerous. However, there is no documented danger to the mother or fetus when mothers breastfeed during a healthy pregnancy.
Joan Fisher, an International Board Certified Lactation Consultant (IBCLC) in Ottawa, Ont., points out that uterine contractions, which are experienced during breastfeeding and sexual activity, are a normal part of pregnancy. She does caution, however, that if a mother has a history of premature delivery or is experiencing uterine pain or continued weight loss, then weaning should be considered.
Kristen Berggren of Burlington, Vt., is nursing her 19-month-old son and expecting her second child in late June. She plans to nurse as long as her son is interested. “I kind of hope that he keeps nursing because I’ve heard that tandem nursing is a great way for the toddler to bond with the new baby and feel less rivalry,” she says.
Angela Imming of St. Louis, Mo., almost gave up nursing her 14-month-old daughter due to the extreme fatigue that she felt in early pregnancy. “But I was soon over that, and my daughter was so interested that I couldn’t bear to wean,” says Imming, who is pregnant with her third child. She also kept nursing because studies show that breastfeeding through the second year provides health benefits to the child.
The Challenges
The choice is a personal one with pros and cons, but it should be noted that there is the potential for added discomfort when nursing during a pregnancy.
For one thing, breasts and nipples tend to become quite sensitive during the first trimester, which can make nursing difficult. Berggren found that she was very sore at first, but the pain lessened in the second trimester. “However, I still have much more nipple sensitivity than usual and I’ve had to work with my son on latching properly to avoid abrading the nipple with his teeth,” she says. “I had to say ‘big open, no teeth’ for about two weeks to help him re-learn a good latch.”
Wendy Thomson, an IBCLC in Hollywood, Fla., suggests dealing with nipple soreness by using breathing techniques, changing nursing positions, starting the letdown before the latch and/or by asking the toddler to nurse more gently.
Dealing with a growing belly is another challenge for moms who breastfeed while pregnant. Creativity is helpful, according to Thompson. “No position is a wrong position,” she says. “Babies are ingenious and if they want to continue to nurse, they will find a way.” Berggren has tried a modified cradle hold or lying on her side to nurse and has found both of these doable.
Kim Hawley George of St. John’s, Newfoundland, didn’t have to contend with fitting her toddler around her stomach, because her daughter self-weaned at 14 months when Hawley George was 5 months pregnant. This is a fairly common occurrence and has to do with the fact that the taste and the consistency of the breast milk changes, usually at some point during the second trimester. Fisher attributes the change in taste to an increase in sodium and protein and a decrease in glucose and lactose.
Milk production may diminish at this time as the milk changes to colostrum in preparation for the newborn. Although the milk automatically reverts to what is best for the newborn, Fisher explains that a nursing toddler is unable to use up the colostrum, and there should be enough milk for both children once the baby is born.
Some toddlers continue to nurse in spite of the changes to breast milk, because of the comfort factor. “I’m actually amazed that he’s still nursing,” Berggren says. “I can’t express more than a few drops by hand … but he’ll stay latched on, sucking for a long time. I think it’s a real comfort to him.” For toddlers, this is fine because they are consuming other types of food by now, but for babies, Thompson suggests monitoring weight gain if breast milk diminishes.
If You Want to Wean
If your toddler doesn’t wean spontaneously and you would like to hasten the process, mother-led weaning is always an option. Some toddlers wean during the pregnancy but ask to taste the milk again when the new baby is nursing. “There is no ideal time to wean during a pregnancy,” Thompson says.
Toddler-led weaning is thought of as ideal, and La Leche League recommends proceeding gradually if you decide to wean during a pregnancy. The “don’t offer, don’t refuse” approach has worked for many moms. Extra attention, avoidance of nursing routines (such as a favorite nursing chair) and the distraction of a drink or snack are also good ways to work toward weaning. Remember that it is safe to wean by dropping one feed at a time. The less milk you take out of the breast, the less you will produce.
Emotional factors have a lot to do with the personal decision to breastfeed during a pregnancy. Imming says that she hates to see mothers sacrifice nursing one child because of the mistaken belief that they are endangering their unborn child. She believes that “you can continue a healthy and loving nursing relationship with your child during pregnancy.”
There is the added bonus of educational value, shocking people who assume that you can’t nurse while pregnant. When people make comments to Berggren about weaning soon, she replies, “No. I don’t have to; I just have to eat a lot.”
Finally, Hawley George reports that the looks of shock and horror on some people’s faces when she told them she was pregnant and still nursing really amused the rebellious part of her. Says Hawley George, “I liked showing people that it is possible to think outside of that formula box.”
