Breastfeeding During Pregnancy: Safety and Recommendations
Breastfeeding during pregnancy appears to be unrelated to adverse pregnancy outcomes or miscarriage risk for most women, and can generally be continued safely throughout pregnancy if desired by the mother. 1
Safety of Breastfeeding During Pregnancy
Systematic review evidence shows no significant association between breastfeeding during pregnancy and negative pregnancy outcomes or increased miscarriage risk in healthy women with uncomplicated pregnancies 1
Breastfeeding provides numerous health benefits to mothers, including reduced risk of breast cancer, ovarian cancer, diabetes mellitus, and hypertensive heart disease, which remain relevant during pregnancy 2
The American Academy of Pediatrics (AAP) supports continued breastfeeding for 2 years or beyond as long as mutually desired by mother and child, which would include during subsequent pregnancies 3
Special Considerations and Caution
Women with high-risk pregnancies or at risk for preterm birth should exercise caution and consult with their healthcare provider about continuing breastfeeding during pregnancy 1
Nutritional requirements are increased for pregnant women who are also lactating, making proper nutrition especially important 1
Some women may experience physical challenges with continued breastfeeding during pregnancy, including nipple pain or discomfort, which may contribute to early weaning 2
Impact on Milk Production and Nursing Child
Hormonal changes during pregnancy may affect milk production and composition, potentially reducing supply or changing the taste of breast milk 1
The older nursing child may naturally wean during pregnancy due to these changes in milk composition or reduced supply 1
If breastfeeding continues through pregnancy, the mother may eventually tandem nurse both the newborn and the older child 1
Recommendations for Healthcare Providers
Healthcare providers should discuss the benefits and potential challenges of breastfeeding during pregnancy with mothers who wish to continue nursing 2
Nutritional counseling should be provided to ensure adequate intake for the mother's needs, the developing fetus, and the nursing child 1
Regular monitoring of maternal health, fetal growth, and the nursing child's development is recommended to ensure all nutritional needs are being met 1
For women with uncomplicated pregnancies who wish to continue breastfeeding, support should be provided rather than discouraging this practice 1, 3
When to Consider Weaning During Pregnancy
Women with a history of preterm labor or miscarriage may be advised to wean during pregnancy as a precautionary measure, although evidence for this recommendation is limited 1
If the mother experiences significant uterine contractions during breastfeeding that cause concern, discussing with a healthcare provider is recommended 1
If the mother experiences excessive fatigue, significant weight loss, or nutritional deficiencies that cannot be corrected with dietary changes, weaning may be considered 1
The decision to continue or stop breastfeeding during pregnancy should ultimately be based on the individual mother's health status, the health of the fetus, and personal preference 1, 3