If you're expecting a baby and are continuing to breastfeed your older child, many questions may be going through your mind. Mothers can breastfeed while pregnant; some go on to nurse both their new baby and their older child after the birth. This is known as 'tandem nursing'.
Breastfeeding during pregnancy is a special, unique relationship and one that may constantly evolve to take into account your changing needs and those of your older child. Breastfeeding can help you meet your child's needs more easily, especially if he is tired or unwell, and it continues to give him important nutritional and immunological benefits. However, breastfeeding whilst pregnant can often invoke intense feelings. Extra support at this time can be crucial and you may find talking things over at your local LLL meetings really helpful.
Is it safe? Nutrition Morning sickness Milk supply and colostrum Managing when you are not enjoying it Coping with questions and comments Deciding to wean Tandem feeding Further Reading
Is it safe?
Research tells us there's usually no reason why a mother shouldn't breastfeed while pregnant. Although breastfeeding may help a slow labour to progress, the amount of oxytocin normally released is not usually enough to cause the cervix to open before it is ready to do so. Oxytocin is also released during sex, which is generally considered to be safe during pregnancy. If you are expecting multiples or considered to be at risk for miscarriage/early delivery you may be advised to stop breastfeeding. You could discuss this with a breastfeeding-friendly caregiver.
Nutrition
You won't be depriving your unborn baby of nutrients by continuing to breastfeed so long as you eat reasonably well. Getting plenty of rest and eating nutrient dense food will help you stay well-nourished and healthy.
The UK Department of Health recommends that all pregnant women take a vitamin D and folic acid supplement (often taken in the form of the Healthy Start vitamins).
Calcium needs during pregnancy and the first six months of breastfeeding it is normal to experience a gradual loss of bone density. Even if breastfeeding continues, recovery of bone mineral content (BMC) starts from around 3–6 months and is generally complete by about 12 months after birth. If a mother has breastfed there may even be a small overall increase. When a mother becomes pregnant again before 12 months BMC actually continues to increase and tandem nursing mothers have no increased risk for osteoporosis. During pregnancy your body absorbs more calcium from the food you eat. If you feel your diet is low in calcium, then eating foods rich in calcium (eg leafy greens, nuts and seeds) may be a good idea but otherwise there's no need for any extra.
Morning sickness
Pregnant mothers often have nausea, whether breastfeeding or not, though breastfeeding while pregnant may make it worse. Eating frequent healthy snacks can help manage nausea, as can getting more rest. Some mothers find motion sickness wristbands work for them.
Milk supply and colostrum
Around the fourth or fifth month (sometimes before) your milk production is likely to reduce due to pregnancy hormones. The composition of your milk will also change and become more similar to weaning milk. Your child may nurse less or wean completely. Some children resume nursing at a later stage. The drop in milk production is due to hormonal changes and nursing more frequently or pumping won't increase production in the same way it does when you are not pregnant. Your baby may need age appropriate supplements and a baby under 12 months may need his weight monitored. Continuing to breastfeed during pregnancy has no effect on the milk supply that you will have following the birth of your new baby. Colostrum is produced during pregnancy whether or not it is being removed.
Managing when you are not enjoying it
You may experience nipple soreness, increased nausea and/or feelings of irritability caused by pregnancy hormones. Limiting nursing times, (eg to a few minutes or even a few sucks), ensuring a deep latch, distraction, and offering other snacks/liquids can all help to make nursing through pregnancy more manageable. Support from family and friends can help you get more rest.
Coping with questions and comments
Pregnancy and breastfeeding can be an emotionally challenging time. It can be difficult if you hear negative comments from others. Talking about the importance of breastfeeding to you and your child can sometimes help people appreciate that this is something you have carefully considered and that it is your choice for your family. Sharing information/research and surrounding yourself with supportive people can also help. Your local LLL group will be a good source of support.
Deciding to wean
The decision to stop breastfeeding is a very personal one and one only you or your child will make. It is useful not to have too many expectations when you get pregnant.
Tandem feeding
Continuing to nurse your older child after your new born arrives can help maintain and strengthen your special bond. Mothers often say that tandem feeding helps their older child to be more accepting of their newborn sibling and helps them through the emotional transition of having to now share their mum. Tandem feeding can also foster a special bond between the siblings. Our page Tandem Nursing has more information.
Written by Mhairi Kasapidis, Sue Upstone & mothers of La Leche League GB.
Further Reading
Birth & Breastfeeding Is My Baby Getting Enough Milk? Nipple Pain Safe Sleep & the Breastfed Baby Still Nursing?
Tandem nursing Thinking of Weaning? Toddlers and Food When Mum Can't Be There LLLI page on tandem nursing
References The Womanly Art of Breastfeeding. LLLI, London: Pinter & Martin, 2010. Adventures in Tandem Nursing. Flower, H. Schaumburg, IL: LLLI, 2003. Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010. How Weaning Happens, Bengson, D.Schaumburg, IL: LLLI, 1999. (link contains book review) Mothering Your Nursing Toddler. Bumgarner, NJ. Schaumburg, IL: LLLI, 2000. (link contains book review) Sweet Sleep Nighttime and Naptime Strategies fro the Breastfeeding Family. Wiessinger, D.et al. Pinter & Martin, 2014. Prentice A. Maternal calcium metabolism and bone mineral status. Am J Clin Nutr 2000 May;71(5 Suppl):1312S-1312s
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