Breastfeeding During Pregnancy

“Breastfeeding during a subsequent pregnancy is not unusual. If the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman’s personal decision. If the child is younger than two years, the child is at increased risk of illness if weaned.” (References: AAFP, 2001, 2014 COD.)

Breastfeeding through a pregnancy can be emotionally and physically challenging for some mothers while others seem to have no problems. During pregnancy the baby may wean due to changes in flavor and volume of the breastmilk however the main reasons cited for weaning are breast and nipple pain. If it seems challenging the mother should seek help from a Lactation Consultant.

Provider Resources

Patient Resources

Breastfeeding During Pregnancy, LLLI
Breastfeeding Beyond 6 Months (web lesson)
Breastfeeding Beyond 6 Months (PDF) English, Spanish, Vietnamese

Management Recommendations

Have a frank conversation with her and her partner and encourage partner’s involvement about what is to be expected.
Encourage the mother to “eat to hunger” and “drink to thirst.” Let her know that she may feel hungrier and have increased nutritional needs.
Encourage her to get plenty of rest and exercise.
Sore nipples are common.
- The mother can try different positions.
- A mother can ask her child to nurse “more softly”. This works best with older babies and toddlers.
- A warm compress and gentle hand expression before latching can get the milk flowing so their suck is gentler.
- Trauma to the nipple is not normal and would be a reason to consult with a lactation consultant.
Explore any feelings of anxiousness or other emotional concerns expressed by the mother.
If the child nursing is younger than one year, monitor her intake and growth. Milk supply drops dramatically for some women. During this time babies and toddlers typically increase their intake of other foods.
If toddler is only nursing once or twice a day, it is usually easier on the mother with a baby under six months.
Braxton Hicks contractions are common during nursing sessions past 28 weeks of gestation. Some moms never notice them while others must breathe through them. As the pregnancy progresses the uterus may become more sensitive to oxytocin.
If mother chooses to wean or needs to do so for health reasons, when possible, it is best to avoid weaning abruptly as this could cause engorgement, plugged ducts and infection. Hand expression or gentle pumping on the pump’s lowest suction level is advised to relieve pressure and prevent problems.
Encourage her to attend a breastfeeding support group. Interaction with other mothers who have successfully breastfed through a pregnancy can be helpful.
Encourage her to plan for postpartum strategies on how she will handle certain emotional and physical challenges with tandem nursing.
Refer her to a Lactation Consultant for further guidance.

Provider Resources

Patient Resources

Management Recommendations

Contraindications to Breastfeeding During Pregnancy

References

Texas Lactation Support Hotline 855-550-6667

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Provider Resources

Patient Resources

Management Recommendations

Contraindications to Breastfeeding During Pregnancy

References

Texas Lactation Support Hotline 855-550-6667