Breastfeed While Pregnant

If you are breastfeeding and discover that you are pregnant, you may want to continue nursing your child. While doctors generally agree that it’s safe to breastfeed while pregnant, there are certain factors to consider including if your pregnancy is high-risk, discomfort from your changing body, and getting proper nutrition.[1] By consulting a medical professional and taking care of yourself, you may be able to enjoy breastfeeding throughout your pregnancy.

Steps

Consulting a Health Professional

  1. Consult your doctor about continuing to breastfeed. If you discover that you are pregnant while breastfeeding, speak with your doctor about whether or not it’s safe to continue. There are some circumstances in which it may be unsafe for you to keep breastfeeding your child.
    • If you have a high-risk pregnancy or are at risk for preterm labor, your doctor may advise you to wean your child.[2]
    • If you are carrying twins, your doctor may suggest that you discontinue breastfeeding your child.[2]
    • If you have been advised to avoid sex while pregnant, weaning your child may be necessary.[2]
    • If you are having bleeding or uterine pain, your doctor may advise you to wean your child.[2]
    • Make sure to let your doctor know if you are experiencing any difficulties with breastfeeding to ensure that you don’t have any underlying conditions.
  2. Consult a lactation specialist. Many hospitals and doctors offices now staff certified lactation consultants. Consult a certified lactation specialist if you wish to continue breastfeeding while pregnant. They can give you assistance and tips on how best to handle the changes to your body and milk supply, and may have additional dietary and lifestyle suggestions.
    • Ask your lactation specialist any questions you might have about breastfeeding while pregnant including changes to your nipples, milk supply, sex, diet, or the best ways to feed your child.
    • You can find a certified lactation specialist by asking your doctor, a local hospital, or even friends.[2] If you still can’t find a lactation specialist, you can find one through the American Pregnancy Organization’s online search tool at: http://americanpregnancy.org/first-year-of-life/breastfeeding-while-pregnant/
  3. Consult a registered dietician. Women who are nursing have special dietary needs, and if you get pregnant while breastfeeding, you will need to adjust your diet even more to keep you, your child, and your unborn baby healthy. Your OB?GYN should be able to refer you to a registered dietician to discuss your specific dietary needs and how you can best get all of the vitamins and nutrients necessary to keep three people healthy.
    • Nursing women may lack important vitamins and minerals such as calcium or iron, and this can become more acute if you are breastfeeding and suffering from nausea and vomiting due to pregnancy. A registered dietician may help you overcome the nausea while ensuring that you get sufficient nutrients.[3]

Caring for Yourself and Your Children

  1. Eat a healthy, well-balanced diet. As a pregnant and breastfeeding woman, you need to make sure you are eating the proper nutrients to sustain your milk supply and your pregnancy. By eating a healthy, well-balanced diet you can help ensure that you, your child, and your unborn baby get the necessary vitamins and minerals.
    • In addition to your regular calorie intake, you will need to factor in extra calories for nursing and sustaining your pregnancy. You will need up to 650 extra calories per day to produce sufficient milk, and 100 – 300 extra calories (depending on the trimester you are in) to support your unborn child.[4]
    • Eat healthy and nutrient-dense foods such as lean proteins, including chicken or beef; fruits and vegetables, such as raspberries or broccoli; and dairy products like yogurt or cheese for calcium.[2]
    • Be careful when consuming seafood or fish. Limit your cooked fish intake to 8 – 12 oz. per week and your canned intake to 6 oz. per week.[5] Avoid tuna steaks, swordfish, mackerel, shark or any other fish with high mercury levels.[5]
    • Try to avoid unhealthy calories such as those found in sweets and junk food.
    • You might want to avoid any foods that can cause digestive issues for you or your child, or unborn baby, including spicy foods, eggs, wheat, corn, or peanuts.[6]
    • If you are suffering from nausea or vomiting due to either morning sickness or a let-down in your milk supply and find it difficult to eat, consult your doctor or a registered dietician, who can help you find solutions to get proper nutrition.[2]
  2. Drink plenty of liquids. It’s important to make sure that you’re drinking plenty of liquids while pregnant and breastfeeding. Not only do you need enough liquid to avoid dehydration and support your pregnancy, but you also need it to produce milk.
    • You should drink at least 15 cups of water a day to stay hydrated, produce milk, and sustain your pregnancy.[7]
    • Water is the best choice for your needs, but you can also drink non-caffeinated tea, and juices. Clear, non-caffeinated soft drinks such as ginger ale may help with nausea.
    • You may consume coffee or caffeinated teas and soft drinks in limited quantities. The recommended level of caffeine that is safe is equal to less than 750ml of coffee.[8] Consult with your doctor to make sure it’s safe to consume any of these beverages.
  3. Avoid alcoholic beverages and tobacco. It’s advisable to avoid all alcohol and tobacco while you’re pregnant and breastfeeding. Using these substances can be potentially harmful to you, your nursing child, and your unborn baby.
    • While the evidence about breastfeeding and alcohol is not well-defined, doctors know that alcohol passes freely into a mother’s milk.[9]
    • There is plenty of evidence about the risk of alcohol consumption for pregnant women, so avoid alcohol altogether while you’re pregnant and breastfeeding.[9]
    • Tobacco use can put both your nursing and unborn child at risk for conditions such as low-birth weight and respiratory diseases.[10]
    • If you smoke while pregnant and breastfeeding, speak to your doctor about possible treatment options to help you quit and keep your children healthy.[10]
  4. Consider taking prenatal vitamins. Your body will need sufficient additional nutrients to support a pregnancy and milk production. Consider taking a prenatal vitamin to help you get additional nutrients you may need and not be getting through food.
    • During breastfeeding, the body is designed to put your child’s nutritional needs before yours.
    • It’s safe to continue taking prenatal vitamins if you’re breastfeeding and your doctor may recommend them to you to ensure you’re getting the nutrition you need.[11]
    • Try to get as many nutrients as possible from healthy and whole foods.
  5. Make sure you’re getting enough rest. Breastfeeding may not normally cause fatigue, but there is a chance you may feel more tired than usual if you are pregnant and breastfeeding.[4] Making sure that you get plenty of rest will help ensure that you have the energy to nurse your child and sustain your pregnancy.
    • In addition to getting enough rest at night, set aside time during the day to rest if you can.
    • You could use nursing times as a chance to sit or lay down for a little extra rest.[4]
    • Unhealthy eating habits and physical discomforts may contribute to fatigue. Eating healthy foods will help you feel energized, and minimizing physical discomforts such as nausea or sore nipples may also alleviate some exhaustion.[4]
  6. Pay additional attention to the care of your nipples. Two of the most common symptoms of pregnancy are breast tenderness and nipple soreness and nursing a child may heighten these sensations, especially if breastfeeding is already uncomfortable. Paying special attention to the care of your nipples can minimize discomfort.[12]
    • Avoid using soaps, creams or lotions on your nipples. These can irritate your nipples and increase soreness and also make nursing uncomfortable for your child.
    • Try massaging your breasts while bathing to aid circulation. Allow your nipples to air dry to help avoid discomfort.
    • Make sure your baby is latched on properly to prevent nipple cracking or soreness.
    • If you notice that your nipples are cracking, try coating the nipple in breast milk or water and allowing it to air dry.[13] You can also use lanolin cream.
    • Warm compresses can also help sore nipples and breasts.[13]
    • You can also try distracting yourself from the pain by watching TV, listening to the radio, or reading a book while you nurse.[4]
    • If you have breast or nipple pain for more than a few days, see your doctor to rule out conditions such as engorgement, yeast infections (thrush), plugged milk ducts, or vasospasm, a condition that causes nipples to be very sensitive to cold temperatures.[13]
  7. Be aware of common issues of breastfeeding while pregnant. You may experience some special conditions if you’re nursing during a pregnancy, including a reduction and change in taste of your milk supply as well as uterine contractions. These are completely normal conditions and generally are no need for alarm, though you can consult a doctor or lactation specialist if you have any questions.[2]
    • Your milk supply may decrease during the fourth or fifth month of pregnancy, which is also called a let-down of milk. This make it difficult to continue breastfeeding, and may also make you feel nauseous and generally uncomfortable.[2]
    • The decrease in your milk supply will also make the taste of it change.[14] This could make your child dislike your milk and force you to wean them.[1]
    • Breastfeeding releases the hormone oxytocin, which causes mild uterine contractions. These are completely normal and should not cause a miscarriage or preterm labor; however, if any vaginal bleeding occurs with the cramps or contractions you should contact your doctor.[2]
    • The intense nipple stimulation from breastfeeding while pregnant may cause sexual arousal while you’re nursing. These feelings, though complex and upsetting, are normal and have nothing to do with your child.[4]
  8. Consider tandem nursing. Once you’ve given birth to your new baby, you may want to continue nursing your older child along with the newborn. This is referred to as tandem nursing and is a completely safe and normal thing to do.[15]
    • Don’t worry that your body won’t produce enough milk for both children, your breasts can adjust to the demands to produce more milk.[15]
    • You can safely nurse either child or both children as long as you wish.[16] Nursing beyond the first year is sometimes called extended breastfeeding.

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Sources and Citations

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