New pregnancy when breastfeeding

If you’re expecting a baby and are continuing to breastfeed your older child, many questions may be going through your mind.

There is no reason that you cannot continue breastfeeding if you become pregnant. 

There is no evidence that breastfeeding while pregnant does any harm to you or the baby in your womb or to the one who is nursing. Although breastfeeding may help slow labour to progress, the amount of oxytocin normally released is not usually enough to cause the cervix to open before it is ready to do so.  Oxytocin is also released during sex, which is generally considered to be safe during pregnancy.  If you are expecting multiples or considered to be at risk for miscarriage/early delivery you may be advised to stop breastfeeding. You could discuss this with me.

The decision to stop breastfeeding is a very personal one and one only you or your child will make. If you wish to stop, do so slowly because pregnancy is associated with a decreased milk supply and the baby may stop on his own.

You won’t be depriving your unborn baby of nutrients by continuing to breastfeed so long as you eat reasonably well. Getting plenty of rest and eating nutrient-dense food will help you stay well-nourished and healthy.

Milk supply and colostrum

Around the fourth or fifth month (sometimes before) your milk production is likely to reduce due to pregnancy hormones. The composition of your milk will also change and become more similar to weaning milk. Your child may nurse less or wean completely. The drop in milk production is due to hormonal changes and nursing more frequently or pumping won’t increase production in the same way it does when you are not pregnant.

Continuing to breastfeed during pregnancy has no effect on the milk supply that you will have following the birth of your new baby. Colostrum is produced during pregnancy whether or not it is being removed.

Tandem feeding

If you are breastfeeding during pregnancy, you may be wondering what happens after your new baby is born. Nursing a new baby while an older one is still nursing is generally referred to as tandem nursing. This could be after pregnancy and the arrival of a new baby or having adopted a new nursling while continuing to feed your older child.

The early days – what to expect

When you give birth your body will continue to produce colostrum, with milk becoming plentiful after around 3-5 days. As with your previous baby, you will need to nurse at least 8-12 times per day to establish your milk production. You may worry about your newborn not getting enough colostrum if your older child is feeding too. Some mothers feed their newborn baby first.

Look out for feeding cues and give your baby unrestricted access to your breasts to help ensure he gets plenty of milk. The more milk is removed, the more will be produced. Feeding cues to watch for include rapid eye movement, moving hands, squirming or rooting.

If you are expressing milk for your baby, your toddler’s nursing will help your supply.

You may find that once your baby arrives your toddler starts nursing frequently again, just like your baby. Older siblings may enjoy increased milk supply, or simply be thinking about breastfeeding more as they see the baby breastfeeding often. If your toddler does increase his milk intake, he may lose interest in solid foods for a while as he enjoys your newly increased milk production. He may have looser stools.

Separately or together?

You may prefer nursing your baby and your toddler separately or breastfeeding both nurslings together.

Alternating breasts for each feed helps with the development of newborn vision and keeps the size of your breasts balanced. However, some mums find that giving a toddler his ‘own side’ works for them.

Some mothers find it easier to position the baby first and let the toddler climb on, while others prefer to position the toddler first and then add the baby.

Double cradle hold

Your toddler is positioned curled around or underneath your baby, with each child’s head supported by your arms.

Double underarm (clutch or rugby) hold

Your toddler sits or semi-reclines with legs pointed away from you. Your baby is held underarm with his feet away from you. This position is good for protecting caesarean stitches or if your toddler sometimes kicks or disturbs your baby.

Double side-lying hold

Your toddler is positioned laying down next to you, then the baby is perched on top of your toddler.

There are many other variations and combinations of the above positions which you can try.

Keeping your toddler occupied while breastfeeding your baby may be a challenge you have not faced before.

Here are some ideas to occupy your toddler while you are nursing your baby:

• Have a special “breastfeeding toy box” which is only brought out when you are nursing your baby;
• Ensure your toddler has got a snack and drink prepared beforehand to eat while you are nursing;
• Share a book and a cuddle with your toddler while nursing your baby;
• Play verbal games with your toddler, for example, “I spy”
• Ask your toddler to help you out, for example bringing you a nappy, etc.

If you decide to stop breastfeeding your older child, keep in mind that it may be a gradual process and one which needs gentle encouragement and patience.