From the Guidelines
Breastfeeding while pregnant is generally safe for most women, and they can continue to breastfeed their older child while pregnant with their new baby, as long as they have a healthy, normal pregnancy. According to the guideline on anaesthesia and sedation in breastfeeding women 2020 from the Association of Anaesthetists 1, breastfeeding offers significant short- and long-term health benefits for both infant and mother. The World Health Organization (WHO) recommends exclusive breastfeeding up to 6 months of age, and continued breastfeeding along with complementary foods up to 2 years or beyond 1.
When considering breastfeeding while pregnant, several factors should be taken into account, including the woman's desire to continue breastfeeding, the impact of interrupting lactation, and the ability of the infant to feed from another container 1. It's essential to support the woman's choice to continue breastfeeding, regardless of the age of the infant, and to weigh the risks and benefits of expressing and discarding breast milk against the potential adverse effects of drug transfer into breast milk.
Some women may experience changes during this time, such as a decrease in milk supply due to hormonal changes, a change in the taste of their milk, increased nipple tenderness, or breast soreness. However, with proper nutrition, hydration, and rest, most women can safely continue breastfeeding while pregnant. In certain high-risk pregnancy situations, such as risk of preterm labor or pregnancy complications, a healthcare provider might recommend weaning due to the potential stimulation of uterine contractions by oxytocin released during breastfeeding. Ultimately, it's crucial to discuss individual circumstances with a healthcare provider to ensure the safety of both the mother and her babies.
Key considerations for breastfeeding while pregnant include:
- The woman's desire to continue breastfeeding
- The impact of interrupting lactation on the woman and the infant
- The ability of the infant to feed from another container
- The potential risks and benefits of expressing and discarding breast milk
- The need for proper nutrition, hydration, and rest to support both pregnancy and lactation.
From the Research
Safety of Breastfeeding While Pregnant
- The safety of breastfeeding while pregnant is a concern for many women and healthcare providers 2.
- Research suggests that breastfeeding during pregnancy appears to be unrelated to pregnancy outcome and miscarriage risk, although caution is needed in women at risk of preterm birth and high-risk pregnancies 2.
- It is essential for healthcare providers to consult reliable sources and evaluate the risks and benefits of medication use during pregnancy and lactation to ensure the health and safety of both the mother and the infant 3, 4.
Medication Use During Pregnancy and Lactation
- Most medications can be used safely during breastfeeding at the recommended dose, but there are exceptions that necessitate caution 5.
- Immunomodulating drugs that are not contraindicated in pregnancy are generally compatible with breastfeeding 6.
- The decision to use any medication during pregnancy should be based on the clinical context, risks associated with individual medications, and gestational age 6.
Recommendations for Healthcare Providers
- Healthcare providers should take a comprehensive approach to maximize safe maternal medication use for both the mother and the breastfed infant, including determining if medication is necessary, choosing the safest drug available, and consulting with the infant's pediatrician 3.
- A central source of up-to-date information and counseling services are critical components of a public health approach to ensure safe and beneficial use of medications during pregnancy and lactation 4.