breast feeding while pregnant

Your child is still nursing and not likely to give it up any time soon. Which is just fine by you. But what happens when there’s a new baby on the way? Here’s what you need to know about breast-feeding while pregnant.

Can I Get Pregnant If I’m Breast-Feeding?

There’s a common misconception that you can’t become pregnant if you’re breast-feeding. You can. However, this myth is rooted in fact.

The Lactational Amenorrhea Method (LAM) is a temporary method of birth control in which the production of milk suppresses menstruation, preventing ovulation. It’s noninvasive, highly effective, and safe, and has been used worldwide to space pregnancies so that mothers don’t have children too close together.

However, like any form of birth control, you have to follow the rules for it to work. For LAM to be effective, your baby needs to be less than 6 months old, you can’t have experienced any menstrual bleeding, and your baby needs to be exclusively breast-fed.

Even if you can check off each of those, there’s still a 2 percent chance you’ll conceive, according to Pamela Berens, professor of obstetrics and gynecology at McGovern Medical School at the University of Texas Science Center at Houston.

“It’s the exclusive breast-feeding which is the biggest stumbling block for most mothers,” says lactation consultant and president of Baby Gooroo Amy Spangler. “That means no supplemental formula or foods and the baby can’t be sleeping for extended periods of time.”

Berens advises women using this method to breast-feed at least eight times a day with no more than six hours in between feedings.

How Can I Tell If I’m Pregnant?

The symptoms that can alert you to pregnancy are more or less the same as those you probably experienced at the beginning of your first pregnancy.

Telltale signs of pregnancy are nausea, fatigue, and breast tenderness (not related to breast-feeding). The trick is determining whether these are symptoms of pregnancy or something else, like illness or PMS.

Spangler and Berens both point to the absence of a menstrual period after six months once you’ve transitioned to fewer breast-feedings as a clue that you might be pregnant.

If you want to know for sure, nothing beats a good old-fashioned pregnancy test.

Can I Still Breast-Feed My Child While I’m Pregnant?

If you’re comfortable with it and have gotten the OK from your doctor, there’s no reason to quit breast-feeding once you become pregnant. Though you may be advised to wean your child if:

  • you have a history of preterm labor
  • breast-feeding becomes uncomfortable
  • there are any problems or complications with your pregnancy
  • you’re carrying multiple babies

“As far as breast-feeding positions, you’ll adjust those as the uterus grows,” says Spangler. Berens advocates gently reminding your child to be careful around your growing belly, as “strong hits to the tummy” could cause problems with the pregnancy.

Once the baby comes, be sure to nurse your newborn first. Diapers that are frequently wet or soiled and a steady, on-target weight gain are signs that your new arrival is getting what they need.

Your older child may wean themselves due to changes in the taste and consistency in your milk as your pregnancy progresses. It’s also possible, says Berens, that your child will have a renewed interest in breast-feeding when they see you nursing the new baby.

Will I Have Enough Milk?

No need to be concerned that there won’t be enough to go around. Your milk supply will increase to meet the demand. In other words, the more you breast-feed, the more milk your body will produce.

However, you may experience some fluctuation in supply due to pregnancy hormones. “There’s a lot of individual variation here,” says Berens. “Some women may notice a decrease in their milk supply with higher levels of pregnancy hormone, but I’ve also had patients who had a fine milk supply when they were pregnant.”

Pregnancy hormones aren’t the only cause of a decreased milk supply. As Berens point out, by 6 months, babies have typically graduated to complementary foods and are sleeping for longer stretches. As a result, the frequency of feedings diminishes and so does your milk supply.

During the latter part of the pregnancy, your milk will change to prepare for the new baby’s arrival. This thicker, less sweet milk is called colostrum and is considered to be a baby’s first vaccination. Your older child may be turned off by the taste, consistency, and decreased volume of this new milk and lose interest in nursing.

Anywhere from a few days to a few weeks after the new baby comes, your milk will transition back to the mature milk your older child was used to. At which point, they may decide to start nursing again.

Are There Any Dietary Guidelines I Should Be Following?

While you shouldn’t literally be eating for two, you will need to up your caloric intake during pregnancy, especially if you’re breast-feeding.

A good rule of thumb is to aim for 300 extra calories a day for the baby and an additional 400 to 500 calories per day for breast-feeding.

When it comes to what you consume, use common sense. A varied diet filled with plants and protein will serve you and your babies well. Try to avoid sugary drinks, limit your mercury intake, stay away from alcohol, and go easy on the caffeine. Berens advises getting plenty of iron and folate in your diet and taking a daily prenatal vitamin.

It’s particularly important to stay hydrated while breast-feeding. Have a glass of water handy during feedings and drink frequently throughout the day.

Let your body be your guide. “If you’re hungry, eat. If you’re thirsty, drink,” says Spangler. It’s as simple as that.

What If I’m Expecting Multiples?

If you’re expecting more than one baby, you may be advised to wean your nursing child. The more babies you’re carrying, the greater the risk of preterm birth. Breast-feeding may increase that risk as it can trigger uterine contractions. Likewise, you may be advised to discontinue breast-feeding if you have a history of preterm birth or are experiencing any unusual spotting or bleeding.

If you and your babies are healthy, there are no complications with the pregnancy, and you don’t have a history of preterm birth, breast-feeding during pregnancy can be perfectly safe.

Once you’ve gotten the green light from your doctor to continue breast-feeding your older child, the advice is no different than for women carrying one baby while breast-feeding.

The Takeaway

You can absolutely continue breast-feeding during pregnancy. Very rarely does a mother need to wean her child because she’s expecting.

If you do decide to wean your child, be sure to do so gradually. And, remember, as your milk changes during pregnancy, your child may decide to give up the breast on their own.

It’s important to discuss your wishes with your doctor, particularly if you are carrying multiples or have a history of preterm birth.

Ultimately, whether or not to breast-feed while pregnant is a personal decision for you and your child to make together.

Tiffany Jansen