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Breastfeeding while Pregnant

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Breastfeeding while Pregnant
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You can carry on breastfeeding while you’re pregnant with your next child, without causing any harm to your toddler or your unborn baby. Here’s what you need to know if you decide to breastfeed while pregnant.

Breastfeeding while Pregnant

If you just recently had a baby, your mind is probably overflowing with a myriad of questions about your new mom’s life, from how to know whether your baby is getting enough milk to when (or if) you’ll ever score a full night’s sleep again.

One that tends to top the list for most breastfeeding mothers is whether or not you can get pregnant while breastfeeding. You may have heard from a friend that nursing can serve as a form of birth control — and while that’s not entirely untrue, it’s not the whole story either.

Can breastfeeding cause a miscarriage?

Some people believe that continuing to breastfeed when you’re pregnant can increase the risk of miscarriage or preterm labor. This is a myth, says Halifax midwife CJ Blennerhassett, stemming from the fact that breastfeeding releases oxytocin, the same hormone that helps create contractions during labor.

But there’s no legitimate evidence this can be harmful. “Studies have shown the uterus isn’t as responsive or sensitive to oxytocin until the final weeks of a normal pregnancy,” says Anita Arora, an International Board Certified Lactation Consultant based in Oakville, Ont. Just like having sex doesn’t put your unborn baby at risk (except in unusual circumstances), neither does continue to nurse your older child.

Can you get pregnant while you’re breastfeeding?

The simple answer is yes. Although breastfeeding offers some protection from ovulation, the monthly occurrence where you release a mature egg from one of your ovaries, it is possible to ovulate and become pregnant prior to getting your first period.

The key players here are the hormones oxytocin and prolactin, which are responsible for milk production and the let-down reflex. Increased levels of these hormones actually suppress the brain from making the main hormone that stimulates the ovary to grow an egg each month. When a mother is breastfeeding exclusively, or even on a consistent basis, it is less likely that she is going to ovulate at all until she starts to wean.

That doesn’t mean that you won’t ovulate or conceive. The “protective” effect of breastfeeding becomes progressively less effective the longer it’s been since you delivered your baby.

Breastfeeding as Birth Control?

There’s some evidence that breastfeeding reduces the likelihood of pregnancy. Known as the lactational amenorrhea method (LAM), this temporary form of birth control relies on a lack of a period (and thus, the absence of ovulation) as its driving force.

LAM only really works if your period is delayed, and that delay depends on the production of the hormone oxytocin. The love hormone that played such a vital role in pregnancy also plays a starring role in breastfeeding by helping to produce milk. While the brain is under the spell of oxytocin to make milk, it suppresses the hormone responsible for producing eggs in the ovaries. That’s why many exclusively breastfeeding parents don’t get their periods until around six months postpartum.

It’s estimated that LAM is up to 98% effective at preventing pregnancy in the first 6 months postpartum if it’s done correctly, meaning it meets two criteria:

  1. Your period has not returned.
  2. You are fully or nearly fully breastfeeding (going no longer than 4 hours during the day or 6 hours at night between breastfeeds, max).

But LAM isn’t a straightforward method of contraception. If you’re relying on breastfeeding to keep you from getting pregnant again, you have to do it to a T. You must:

  • Practice exclusive nursing, which can mean delaying the introduction of solid foods and formula
  • Nurse on demand and ideally avoid using a breast pump (according to the American College of Obstetricians and Gynecologists, it’s unclear whether pumping decreases the effectiveness of LAM)
  • Ideally, avoid pacifiers

Although exclusively breastfeeding might seem like a convenient form of birth control, it is not guaranteed that the effectiveness will last as time passes. Once your period is back, LAM no longer works. And remember, you will ovulate about two weeks before your first post-baby period shows up, so it’s possible you could get pregnant before Aunt Flo waves the red flag that you’re fertile again.

If you’re not ready to have another child yet, it’s wise to have a backup method to LAM. And, of course, it’s important to know that LAM does not protect against sexually transmitted diseases.

Keep in mind that a few signs of pregnancy look and feel a lot like the same sensations of breastfeeding. If any of these side effects of breastfeeding start to feel more intense, then it might be time to take a pregnancy test.

Breastfeeding while Pregnant

Breastfeeding while Pregnant

Is it best to wean if you get pregnant?

In most cases, there’s no reason to wean solely because of a pregnancy. “As long as parent and baby are coping with the changes a growing uterus brings, and want to keep feeding, they can and should,” says Blennerhassett. Still, it’s important to consider your individual situation, such as how old your nursing child is.

Because McCormick’s son was so young, he was still fully dependent on her breast milk for nutrition. “If your child is under a year and still nursing for their primary food source, consult a healthcare provider to be sure your child’s needs are being met,” says Arora.

With the support of their family doctor, McCormick’s son continued to thrive at the breast. “He didn’t slow down his feeds at all and was a super chubby baby through the whole pregnancy,” she says. She did experience morning sickness, though, which is another important factor to consider when making the decision to continue nursing or not.

It’s important to get enough fluids, calories, and rest when you’re pregnant, so keep your doctor or midwife informed if you are still breastfeeding and are experiencing morning sickness. Be aware that even if you decide to continue nursing, your baby might have a different plan. Some nurslings will self-wean if they aren’t thrilled with the changes in quantity and the consistency of your milk.

Can breastfeeding interfere with your pregnancy if you do get pregnant?

It is generally considered safe to continue to breastfeed once you become pregnant. However, some women may experience cramping due to the release of small amounts of oxytocin (the same hormone that causes contractions) during breastfeeding. The concern is that, in rare cases, this can cause preterm labor or possibly early pregnancy loss.

While this is unlikely if you are pregnant and breastfeeding you should tell your OB/GYN if you start experiencing regular and/or increasingly painful contractions to rule out any interference with your pregnancy. The most important consideration to make when breastfeeding during pregnancy is to get enough calories to support both your growing fetus and developing child at the same time.

While you certainly can use breastfeeding to your advantage if you’re trying to prevent another pregnancy so quickly, it’s not a fool-proof method, so it’s important to be careful.

If you follow the rules laid out in the LAM method — exclusive breastfeeding of an infant younger than 6 months old before your period comes back — you have less than a 5 percent chance of getting pregnant. But you shouldn’t rely on breastfeeding as a form of birth control, and your safest bet is to use a backup method even if you are nursing.

It’s also important to note that doctors advise women to wait a full year and ideally 18 months to get pregnant again because it’s the safest and healthiest option for them and their future pregnancies. Getting pregnant earlier than that, especially within the first six months of your precious baby’s birth, can increase the risk of complications in the new pregnancy

Looking after your first child?

Your breastmilk will still provide your first child with the nutrients they need. However, you are likely to produce less milk as your pregnancy progresses. Also, the content of your milk will change as you start to produce colostrum, and it might taste different. These changes might lead your older child to wean themselves at some point during your pregnancy. This often happens around the 5-month mark.

Colostrum is a natural laxative, so your older child’s poo might be more liquid than normal. This is nothing to worry about.

If your older child is less than 1 year of age when you fall pregnant, keep a close watch to make sure they’re putting on enough weight after your milk changes. You may need to introduce extra feeds if they are still relying on breastmilk for their nutrition. Talk to your maternal child’s health nurse for advice.

Breastfeeding while Pregnant

Breastfeeding while Pregnant

What if I want to wean?

If you’re just not feeling it anymore, let the guilt go and wean. “For some who are breast- or chestfeeding, a new pregnancy can feel like the right time to wean or reduce nursing,” says Blennerhassett. “It’s a relationship between two people and both get to have boundaries,” Arora says shifting from nursing to cuddling can help to maintain the attachment and one-on-one time, although you might find it difficult. “Feeling sad about weaning, even when you choose to, is OK and normal,” she says.

Can you continue breastfeeding while pregnant?

You certainly can. But make sure to get enough calories to feed yourself, your baby, and your developing fetus. Aim for 500 extra calories per day if your baby is eating other foods besides your milk and 650 extra calories if they’re less than 6 months old.

In addition, you’ll want to factor in an extra 350 calories in your second trimester and 450 extra calories in your third. Sound complicated? Make it easier for yourself by listening to your body and making healthy food choices.

You may find that your nipples are more sensitive and that your let-down reflex makes you nauseous. This too will pass.

If you’ve had a miscarriage or generally deliver early, keep an eye out for uterine contractions. You may feel a cramping sensation when your baby suckles. This is because your body releases small amounts of oxytocin, and this hormone causes contractions. (Yes, it’s that multi-functional hormone again!) If you’re concerned about the rare risk of preterm labor, discuss this with your OB or midwife.

Don’t be surprised if, after the first few months of pregnancy, your baby starts to refuse your breast milk. Your milk supply will probably diminish, and the taste of your breast milk may change as well. Either of these changes may cause your baby to refuse breast milk and eventually wean themselves.

On the other hand, some parents successfully breastfeed throughout pregnancy and might go on to tandem nurse their newborn and an older child. (In these cases, the newborn’s breastfeeding needs should always take the highest priority.)

How to look after yourself

Breastfeeding while pregnant can make your breasts sore and your nipples tender. You might find you are even more tired or experience worse morning sickness than you normally would during pregnancy.

These side effects are due to your pregnancy hormones. They may clear up after the first trimester, but for some women, they last the entire pregnancy. It can help if you make sure your older child is attached well, or change your position while breastfeeding.

You can look after yourself by eating well, making sure you are well-hydrated and getting plenty of rest. You don’t need to take lots of vitamin or mineral supplements — your body will adjust to making breastmilk and nourishing your unborn baby at the same time.

After the baby is born

You can keep feeding your older child after the baby is born. This is called tandem feeding. Your newborn will still get all the colostrum they need. You don’t have to limit your older child to one side.

There are different ways of tandem feeding. You could feed both children at the same time (you might need some cushions to prop you up or you might find it easier lying down). Or you could feed the newborn first and then your older child.

You might find your older child wants to feed all the time because you have a lot of milk. If you like, you can limit their feeds. You might also find that your newborn has trouble coping with your letdown reflex because you are producing so much milk. You could try feeding your older child first and then attaching the newborn to the other breast after the milk has started to flow.

How to wean your older child

If you decide to wean your older child, it’s a good idea to do this while you’re still pregnant so they don’t have to cope with so many adjustments after the baby is born.

If you would like to encourage your older child to wean while you are pregnant, you could try weaning them slowly by delaying feeds or encouraging shorter feeds. If your child is old enough, explain to them that your breasts feel sore.

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