From the Research
Breastfeeding during pregnancy is generally safe for most women with healthy pregnancies, and they can continue to breastfeed their older child while pregnant with their new baby. However, if a woman has a history of preterm labor, miscarriage, vaginal bleeding, or if her pregnancy is considered high-risk, she should consult with her healthcare provider as breastfeeding stimulates the release of oxytocin, which can potentially cause uterine contractions 1.
During pregnancy, a woman's milk supply may decrease and the taste may change due to hormonal shifts, which might cause her nursing child to wean naturally. She may also experience increased nipple tenderness and fatigue. To manage these challenges, it is essential to ensure she is eating enough calories (about 500 extra calories daily beyond regular pregnancy needs), staying well-hydrated, and getting adequate rest 2.
Some studies have investigated the potential risks of breastfeeding during pregnancy, including the risk of miscarriage. A study published in 2021 found that breastfeeding during pregnancy did not lead to adverse outcomes in the mother and her fetus in normal low-risk pregnancy, although it may lead to a nutritional burden on the mother 3. However, another study published in 2019 found that exclusive breastfeeding during pregnancy was associated with an elevated risk of miscarriage, but no increased risk was found with complementary breastfeeding (i.e., the child also consumed other food) 4.
If a woman chooses to continue breastfeeding after her new baby arrives (called tandem nursing), it is recommended to feed the newborn first to ensure they receive the nutrient-rich colostrum and sufficient milk for their growth needs. The most recent and highest quality study on this topic, published in 2023, found that breastfeeding during pregnancy appeared to be unrelated to pregnancy outcome and miscarriage risk, notwithstanding the need for caution in women at risk of preterm birth and high-risk pregnancies 1.
Key considerations for breastfeeding during pregnancy include:
- Ensuring adequate nutrition and hydration
- Managing potential challenges such as decreased milk supply and nipple tenderness
- Consulting with a healthcare provider if there are any concerns or high-risk pregnancy conditions
- Prioritizing the newborn's needs if tandem nursing is chosen.