Tuesday, March 3, 2009

breastfeeding during pregnancy

Recently, I have had a lot of questions about breastfeeding during pregnancy. While I have not had the opportunity to nurse while pregnant (Eva self-weaned when she was three-and-a-half, and Esme was born two years later), I did pull out books and done some research on the subject. Unfortunately, it seems as if the only book actually dedicated solely to tandem nursing and breastfeeding during pregnancy is Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond by Hilary Flower. Flower's book is a great read and has plenty of useful information. I recommend it as required reading for all mamas who are nursing while pregnant, and for those who plan to tandem nurse. I also found even more useful information and resources on breastfeeding during pregnancy on the Nursing During Pregnancy and Tandem Nursing page at Kellymom.com. No surprise there. Kellymom.com provides extensive evidence-based information on many breastfeeding and parenting issues. In our society, many women do not consider nursing during pregnancy, and because of this, not much information is circulated. While many OBs tend to caution against breastfeeding during pregnancy--usually due to mis-information and lack of knowledge on the subject--it is perfectly safe for a pregnant mama to nurse a baby or young child, considering the pregnancy is a healthy one. Women may find that midwives are more knowledgable and supportive of nursing an older child beyond the first trimester of pregnancy. A mother may want to continue the breastfeeding relationship throughout her pregnancy in order for her nursling to continue receiving the many wonderful benifits of breastmilk, benifits which continue even when the child is past two years of age. During the second trimester of pregnancy, many nursing women (and their nurslings) notice a decrease in milk supply. It is at this point that pregnancy hormones take over and a mother's mature milk begins to shift back to colostrum in preparation for the new arrival. In some cases, nurslings may notice a change in the flavor of mama's milk, while in other instances, neither the mother nor the nursing child notice any difference at all. However, it is not uncommon for some nurslings to wean themselves during this supply/flavor shift. If a mother has a young baby who is solely dependent on breastmilk for nourshment, she may have to supplement another form of nutrition during this shift in supply; supplements may include more solid foods, infant formula, or goat, soy or cow milk, depending on the age of the child. If weaning does occour, it is also not uncommon (and perfectly natural, actually) for the child to "un-wean" either later in the pregnancy or after the birth of the new baby. Many women complain of minor "ailments," if you will, in breastfeeding while pregnant, the most common being nipple irritation. It is normal for pregnant women to experience soreness in the nipples and breasts, and this tenderness can be intensified by breastfeeding, often making nursing sessions uncomfortable. While this may be an indication to some women to wean, there are other steps that can be taken to relieve some of the soreness. Varying nursing positions may help, as can shortening nursing sessions. Also, reminding the nursling to open wide and latch properly will help greatly. Nursing around a growing belly may also become a challenge. Again, check out Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond for some good suggestions and helpful photo illustrations. Many mamas find that they must experiment with different nursing positions in order to find the most comfortable. What is comfortable for some may not be so for others. Uterine contractions are another accompanying side-effect of breastfeeding while pregnant. These contractions are a normal part of pregnancy, regardless of a breastfeeding relationship. The act of breastfeeding triggers the release of the hormone oxytocin, which, in turn, triggers uterine contractions. Similar normal contractions may also occur during sexual intercourse and orgasm. However, these contractions may be intensified by nursing, and thus may be unnerving to the pregnant mama. Arguably, some professionals believe that complications may arise in women who are breastfeeding while pregnant, the most serious of which is pre-term labor, which may be a result of nipple stimulation after the twenty-fourth week; this should only be a concern if the woman has a history of pre-term labor, such as in previous pregnancies. If a woman encounters strong contractions, she should, of course, consult her care-giver. The pregnant-nursing mama must consider proper nutrition for herself, her nursling and her fetus. Eating for three is not complicated. A pregnant-nursing mama should gain weight in the same parameters as for pregnant women who are not nursing. Eating and drinking when the need arises are good guidelines, as are following the body's cues. Fatigue may be an indication that the mother is not receiving enough calories and nourshment. Also, if the mother has special dietary considerations (veganism, anemia, etc.) additional nutrients and supplements may be required in order to promote optimum health. Mothers who choose to breastfeeding during pregnancy are able to have happy and healthy pregnancies while simultaniously providing unparalleled nourishment to their nurslings and fetuses at the same time. Continuing the nursing relationship provides the mama and the older child additional oppertunity to bond and connect before the new baby arrives. Many mamas also find that breastfeeding can be a way for an older sibling to accept and welcome the new baby. Overall, breastfeeding while pregnant can be a very rewarding experience for many women and children. Image credit: Gina Casamenti-Brooks, Public Domain fine art

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