Seeing images on social media of serene, expectant mothers, nursing thier sun-bathed toddlers with a waterfall backdrop and a crown of flowers is undoubtedly awe-inspiring. But we all know that anyone can make motherhood look like a dream with the right lightning and that second trimester glow...but what is the reality of breastfeeding through pregnancy? Can everyone even get pregnant whilst breastfeeding? If so, is it advised? Are there any risks? What are the benefits? Read on, mama. The answers await...
Conceiving whilst Breastfeeding
You may be aware that there is wide variation between when a mother resumes menstruation postpartum during lactation. Some mums see their periods return within weeks of giving birth despite nursing exclusively and on demand. If this is you, I see you, I feel you, I am you. The sense of injustice is real(!). Others will not see their periods return for as long as they are breastfeeding, which can be problematic for anyone trying to conceive. Many mothers fall somewhere between these two extremes, with the average timeline for the return of menstruation postpartum being 9-18 months for breastfeeding mothers (1). Of course, your period does not necessarily have to have returned in order for you to be able to get pregnant, because ovulation occurs before menstruation. So if you do not want to fall pregnant whilst breastfeeding, use contraception to prevent any surprises.
The question of whether or not a mother will be able to get pregnant whilst lactating is a difficult one to answer. This is because the hormone responsible for breast milk production - prolactin - can also prevent thickenkng of the uterine lining. Consequently, some mothers bodies (but not all) may not be able to support a growing baby whilst breastfeeding. For this reason, some IVF providers do not offer treatment to breastfeeding mothers. Others will require that a mother the amount that she reduces the amount that she breastfeeds or night weans before they will consider her for treatment.
Breastfeeding and Pregnancy
There are very few reasons why a mother should not continue to breastfeed her nursling once she becomes pregnant. However, "If you are expecting multiples or considered to be at risk for miscarriage/early delivery you may be advised to stop breastfeeding," (2). This is because oxytocin, the hormone which triggers your let down, also plays a role in opening your cervix during labour. Nonetheless, oxytocin is also released during sex and this does not typically induce labour prematurely. If you have a history of prematurely going into labour, you should consult a medical professional before planning on breastfeeding through pregnancy.
Assuming you are having a straightforward pregnancy, breastfeeding is safe for you, your nursling and your developing baby. The only exception to this is if you are exclusively breastfeeding and your nursling has not yet started solids and supplementary fluids (3). In other words, it is not recommended for mothers with a baby who is under around 6 months to try to conceive again. This is because their is a higher risk of miscarriage and/or low birth weight (5). In the vast majority of contexts. breastfeeding through pregnancy can offer you and your child myriad benefits, including opportunities for you to rest and nurse them.
Pregnant, nursing mothers will experience a change in their milk from around month 4 of pregnancy. At this time, pregnancy hormones send the signal to your brain and your breasts to produce colostrum for your developing baby. This can affect your older child in several ways:
• They may not be concerned by the change and continue to nurse as usual;
• They could self wean because they do not like the saltier taste of colostrum;
• Your milk could dry up completely until your new baby is born. In this situation, you could continue to dry nurse and then tandem breastfeed after birth. Alternatively, you may take this as an opportunity to stop breastfeeding.
Another important consideration of breastfeeding through pregnancy is that growing and sustaining life separately is extremely demanding on a mother's body. For instance, a pregnant mother needs significantly more vitamin C, iron, calcium, magnesium and so on, than other women. Breastfeeding mothers' nutritional needs are similarly increased (in some cases even more than during pregnancy!). This means that whilst your developing child and your nursling will be supported by your body, you in turn will need adequate nutritional support to rest to take care of yourself. Rising oestrogen levels can also mean that some mothers develop sore nipples, making nursing or pumping very uncomfortable. For this reason, pregnancy could be the ideal time for some mothers to introduce some healthy breastfeeding boundaries, or stop breastfeeding completely.
The obvious question is whether breastfeeding is likely to make life more or less challenging during pregnancy. Again, this will vary from mother to mother, depending upon the support that she receives to take care of herself. For some mothers, symptoms like nausea and fatigue may make continuing breastfeeding feel less appealing. For others, it may be the remedy to rushing around 24/7.
Breastfeeding and Labour
Some mothers may choose to nurse their child(ren) during labour. This may be in order to:
• Provide relaxation for the mother;
• Stimulate contractions through the release of oxytocin;
• Comfort and involve an older child during labour.
This is safe to do unless you have underlying health conditions.
The greatest concern for mothers who may be considering tandem breastfeeding is often that they are worried that they will either not have enough milk for their newborn, or that the quality or composition of their milk will be detrimentally affected by tandem nursing. Studies have found quite the opposite to be true; breast milk continues to meet the nutritional needs of both the older and younger child when tandem breastfeeding (4). This is because after a year of lactation, breast milk contains significantly more fat & protein. Interestingly, after weaning the older child from breastfeeding, the same study found that fat and protein levels in mothers' breast milk reduced to levels which met the needs of the younger child.
As with many aspects of motherhood, tandem breastfeeding mothers may not be aware that they require significantly more calories, macronutrients and micronutrients than non-lactating mothers. This is particularly true of vitamin C - which was observed in increased quantities in tandem breastfeeding mothers' milk (4).
Tandem breastfeeding mothers report many benefits to breastfeeding two or more children at the same time, including the bond that tandem nursing creates between sibling and opportunities for stillness which involves both children. The most commonly reported drawbacks of tandem breastfeeding are tiredness and frequent night waking as well as
negative comments from others (4). My advice for anyone struggling to navigate criticism regarding breastfeeding in any circumstance is to find community. Find your people - parents going through the same experience as you who you can be honest and open with about the challenges that you are facing, without judgement. Facebook is a great place to start to find that community, wherever you are in the world.
I hope that the information in this article empowers you to be able to make an informed decision about whether or not you would like to continue breastfeeding whilst trying to conceive and beyond. If you need support stopping breastfeeding for any reason, get lifetime access to my 60 minute weaning webinar & get my weaning guide free with discount code: BOGOF