From the Guidelines
Most mothers can safely continue breastfeeding during pregnancy and beyond, as long as it remains comfortable and safe for their specific situation, with no set time limit imposed by medical guidelines. Generally, breastfeeding during pregnancy is safe unless a mother has a high-risk pregnancy with conditions like preterm labor history, vaginal bleeding, or is carrying multiples, as stated by the American Academy of Pediatrics 1. The hormones released during breastfeeding (oxytocin) can cause mild uterine contractions, but these are typically not strong enough to trigger labor in a healthy pregnancy. Nutritionally, a pregnant mother's body prioritizes the fetus's needs, so maintaining adequate nutrition and hydration is important. Many mothers notice changes during pregnancy including decreased milk supply, altered milk taste (which may lead to natural weaning), and increased nipple sensitivity. If continuing to breastfeed, mothers should ensure they're consuming an additional 500-650 calories daily above regular pregnancy requirements.
The American Academy of Pediatrics recommends exclusive breastfeeding for approximately 6 months after birth and continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond 1. This guideline supports the practice of tandem nursing, where both the newborn and older child breastfeed after birth. The Association of Anaesthetists also encourages supporting women who wish to continue breastfeeding, regardless of the age of the infant, and considering the impact on ongoing lactation if interrupted by expressing and discarding 1.
Key considerations for breastfeeding during pregnancy include:
- The mother's desire to continue breastfeeding
- The impact on ongoing lactation if interrupted
- The risk of blocked ducts or mastitis
- The ability of the infant to feed from another container
- The risk of necrotising enterocolitis in pre-term infants if breast milk is replaced by formula milk. Ultimately, the decision to continue breastfeeding during pregnancy should be based on individual circumstances and medical guidance, with the goal of supporting optimal health and nutrition for both the mother and child 1.
From the Research
Breastfeeding During Pregnancy
- There is limited research on breastfeeding during pregnancy, and the provided studies do not directly address this topic.
- However, one study 2 discusses the benefits and recommendations for breastfeeding, including the World Health Organization's recommendation to breastfeed for at least two years.
- This study does not specifically mention breastfeeding during pregnancy, but it implies that breastfeeding can continue for an extended period.
- Another study 3 examines the effects of various tocolytics on uterine contractility, which may be relevant to breastfeeding during pregnancy, but it does not directly address breastfeeding.
Tocolytics and Breastfeeding
- The studies on tocolytics 4, 5, 6, 3 focus on their use in preterm labor and do not discuss their impact on breastfeeding during pregnancy.
- These studies evaluate the effectiveness of different tocolytics, such as magnesium sulfate, nifedipine, and indomethacin, in inhibiting uterine contractility.
- While they provide information on the use of tocolytics during pregnancy, they do not address breastfeeding specifically.
Breastfeeding Duration
- The study on breastfeeding 2 recommends breastfeeding for at least one year and suggests that it can continue for up to two years or more.
- However, it does not provide guidance on how pregnancy affects breastfeeding duration or whether breastfeeding can continue during pregnancy.
- There is no clear evidence from the provided studies on the optimal duration of breastfeeding during pregnancy or how it may affect the mother or the fetus.