In the seven years I’ve worked with breastfeeding moms (as a volunteer counselor and lactation consultant), it has never ceased to amaze me the mixed messages mothers get when it comes to the safety of breastfeeding during pregnancy. Some mothers are told point-blank by their doctors that breastfeeding during pregnancy is categorically unsafe and ill-advised in all circumstances. Others are given less heavy-handed advice, but are told in more than one way that weaning is necessary as soon as possible. Still others are told it is perfectly safe, and not to worry one bit.
Ummm…could that be any more confusing, or what?
Now, on the one hand, continuing to breastfeed while pregnant is a very personal decision. If a mom becomes pregnant while still nursing her babe, she may take it as a sign to be done. For some, the hormones of pregnancy make nursing uncomfortable, especially when they feel sick as dogs or exhausted to the bone. Lots of babies and toddlers get fussier at the breast, too, and some (but not all) moms experience a drop in milk supply as a result of the hormones of pregnancy. If, for any reason, a mom wants to end the nursing relationship, she doesn’t owe anyone an explanation for doing so.
But lots of mothers decide to plow through and keep up the nursing relationship with their baby or toddler while pregnant. They are not ready to wean, and the relationship still works for them (and their child). Plus, nursing during pregnancy can actually give moms a needed break — a good excuse to curl up on the couch with their little one and rest. And breast milk doesn’t lose its nutritional value during pregnancy, even if the milk volume might decrease.
Of course, all moms want to be safe, and no one wants to unnecessarily compromise the safety of their pregnancy or unborn child. But what’s a mom to do if she’s getting completely contradictory signals from health professionals, friends and family, and even from other breastfeeding moms?
In my role as a breastfeeding support person, I can never give moms medical advice; instead, I can point them to evidence-based resources that provide up-to-date information on any given breastfeeding issue. And I will tell you this: There is a substantial body of research that says that breastfeeding is rarely a contradiction for healthy pregnant women.
Let’s start with the breastfeeding position paper from the Academy of American Family Physicians (AAFP). This paper states in pretty uncertain terms that for healthy moms, there is no reason to wean during pregnancy. “If the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman’s personal decision,” writes the AAFP. They go on to say that breastfeeding beyond infancy has health benefits for toddlers, and so they encourage mothers to continue breastfeeding during pregnancy: “If the child is younger than two years, the child is at increased risk of illness if weaned.”
The Academy of American Pediatrics (AAP) released a similar statement, explicitly stating the safety of breastfeeding during pregnancy, but emphasizing that mothers who have a history of miscarriage or premature birth should stay in touch with their doctors if they have any unusual uterine contractions.
The reason that health professionals are concerned about miscarriage or premature birth is because it is known that nipple stimulation can cause contractions (you might have heard this as a technique to induce labor when you are overdue!). So the questions then becomes: Is there evidence that breastfeeding during pregnancy increases a mother’s chance of miscarriage or preterm labor?
La Leche League International recently published a summary of the research, and what they found is that there was no clear evidence that breastfeeding causes this to happen.
Take this 2012 study published in the Journal of Nursing Research, and cited in the La Leche League article. The study looked at the possibility that moms who breastfed during pregnancy were more likely to go into preterm labor. They compared two groups of women — a group who breastfed for 30 days or more during pregnancy and a group who did not. The research found no significant differences in terms of premature births or healthy birth weights between the two groups.
The article also cites a 2009 study from the Journal of Obstetrics and Gynecology Research which looked at the risk of miscarriage for women who breastfed during pregnancy. The researchers compared a group of mothers who breastfed during pregnancy to a group who did not. Of the mothers who continued to breastfeed during pregnancy, 7.3% had miscarriages. A similar (but slightly higher) miscarriage rate of 8.4% was found in the non-breastfeeding women. The authors of the study state that there were no statistically significant differences between the two, coming to the conclusion that breastfeeding during pregnancy did not increase the risk of miscarriage.
The La Leche League article cites other studies and interviews experts on the subject. All come to the conclusion that breastfeeding during pregnancy is safe.
So what‘s a mother to do if she continues to be given different information on the subject despite her research? Well, in that case I’d give her the advice I give to all breastfeeding moms (and moms in general): Go with your instincts.
If breastfeeding during pregnancy is something you really want to do, it might be time to find a health professional who supports your decision. It might also be time to find more supportive friends — or just tell the naysayers to politely STFU.
The point is, this is your body, your pregnancy, and your children. You need to get some good info, get some good support, and then figure out what going to work for you. And if breastfeeding during pregnancy is where it’s at for you, go for it, you badass multitasking mama!