Sun | Aug 9, 2020

Dear Doc | I am pregnant, but I am also still breastfeeding

Published:Sunday | August 18, 2019 | 12:00 AM

Q I am pregnant, but I am also still breastfeeding. People look at me weird when I do it as if I’m doing something wrong, so I wanted to know, can I still breastfeed while I’m pregnant? Will it affect my pregnancy or the growth of the unborn baby? Will my breastfeeding child be worse off for having to stop breastfeeding early?

A All of these questions and concerns are expected. The decision of whether or not to breastfeed while pregnant is not always a simple one, and dependent on numerous factors. Understanding the benefits, and risks, and how ready you and your nursing child are to wean, will help you decide what is best for you, your baby and your new pregnancy.

Breastfeeding can cause mild contractions of the uterus. This is because oxytocin, the hormone that is released during labour, is also released during breastfeeding. As a result, it stimulates contractions, which the mother experiences as cramping pain to the abdomen while breastfeeding. It is believed that the oxytocin released during breastfeeding is too small of an amount to cause preterm labour. However, this is in reference to a healthy pregnancy.

It is advised that pregnant women who are at high risk for preterm delivery, or preeclampsia or fetal growth restriction, should stop breastfeeding by about 24 weeks of gestation.

Other cases where weaning is advisable include:

- If you are carrying twins.

- If you have been advised to avoid sex while pregnant.

- If you are having bleeding or uterine pain.

It is important to talk with your doctor to determine whether weaning would be the best option, based on your current pregnancy.

During pregnancy, your breast milk will still provide your first child with the nutrients; however, breast milk supply commonly lessens during the fourth and fifth months of pregnancy. Also, the content of your milk will change as you start to produce colostrum, and as such, it will taste different to your child, who may find it distasteful. Colostrum is also a natural laxative, so your child’s stool might be more liquid than normal.

For this reason, your infant may wean earlier than you anticipated, or your infant may be very attached to breastfeeding and still not wean, despite the changes.

If you decide to continue breastfeeding during your pregnancy, it is crucial to keep a close watch on the health and development of your older child if he or she is less than one year old, and is dependent exclusively on breast milk, to make sure that they are putting on enough weight after your milk changes. Additional feedings may be necessary to ensure the proper nutrition of your older child.

Eating Well

If you decide to breastfeed during your pregnancy, it is important that you also pay attention to your own nutrition. You will need to eat well for the health of your breastfeeding child and your unborn child. Your increased calorie intake will depend on how old your breastfeeding child is and will increase with each trimester. If you are in your first trimester and finding it difficult to eat because of nausea or morning sickness, no need to worry; no additional calories are required during the first trimester.

Have a discussion with your OB-GYN and have them help you decide which is best for you and your pregnancy.