Introduction
If you are reading this while newly pregnant, congratulations! If you are reading in preparation then we wish you the very best of luck, and hope that soon you’ll be one of our success stories!
The primary focus of this group in terms of gathering evidence is the safety of breastfeeding through fertility treatment, but where this blesses us with success, it can then lead to worries around breastfeeding during pregnancy.
Breastfeeding during pregnancy can be beautiful. It carried all the usual benefits of bonding with your child as your bump grows, and it can also lead you to a new era in breastfeeding – tandem feeding when your beautiful new baby is born.
This file will cover the common worries around breastfeeding during pregnancy; aversion, loss of supply, and the safety of continued feeding.
Supply Reduction / Loss of Supply
Pregnancy can reduce milk supply, and in many cases, it will completely dry up (this is one of the reasons treatment is not recommended in babies under 12 months. If your baby is under 12 months and you are pregnant, please ensure you have read the information on our webpage 'precautions around age'.
In normal everyday breastfeeding scenarios, low supply is something that once identified, can be investigated, and often, with appropriate breastfeeding support, it can be overcome, or a robust feeding plan put in place. However, this is not the case with low supply due to hormonal factors; whether medication related, or pregnancy related, hormonal loss of supply is a longer-term issue that cannot be redacted.
Unfortunately, there is no way to determine whether there will be any impact on supply or not with your pregnancy. As with other symptoms of pregnancy, reduction in supply and loss of supply is totally individual and asking 10 people what happened to them can offer no assurances as to what will happen to you. Breastmilk is likely to dry up completely during pregnancy. This may not be until the second trimester, but for some, it can occur very early on. This article provides some useful information.
The drying up of breastmilk does not mean that breastfeeding must end. An older baby is likely to continue to dry nurse; some happily, and some will need encouragement. This is a personal choice of what is right for you and your baby.
Nursing Aversion
It is unfortunately common to experience some form of nursing aversion during pregnancy or dry nursing. Whilst this can be difficult to cope with, there are helpful techniques that can help you manage feeds. You may find the following information helpful:
Article 1
Article 2
Article 3
Nursing manners can be helpful in making feeding manageable, and in introducing limitations around feeding. However please note that introducing nursing manners can be a way of reducing feeds, and you should be aware of this in case you do not want to do so. The following articles may be of use:
Article 1
Article 2
Safety of Breastfeeding
When treatment is unsuccessful, we look for answers, and wonder if breastfeeding is to blame, and when the worst happens and we suffer the sad loss of pregnancy, we can often wonder the same.
Many resources tell us that there is no evidence that breastfeeding poses any risk in a normal healthy pregnancy. However, that wording itself can cause us to have doubts - we think that fertility treatment means our pregnancy is not normal and healthy. We tend to carry more self-doubt and worry.
Personally, I found it incredibly helpful and reassuring when I recently had a miscarriage to focus on the reading that I’d done that there is no evidence of a link between breastfeeding and miscarriage. It helped me to take comfort in our breastfeeding relationship and cherish the moments with her that I hadn’t lost. In fact, I would go so far as to say continued breastfeeding of my daughter helped to heal me.
Although uterine contractions are experienced during breastfeeding, they are a normal part of pregnancy. Similar contractions often occur during sexual intercourse, which many couples continue throughout pregnancy.
Lesley Regan, PhD, MD, heads the Miscarriage Clinic at St. Mary’s Hospital in London, the largest referral unit in Europe, and is the author of ‘Miscarriage: What every woman should know’. Kellymom states that she was surprised to hear that anyone considers issues related to miscarriage to be reasons for weaning. She added:
“Once a pregnancy is clinically detectable, breastfeeding should pose no added risk of pregnancy loss. There isn’t any data suggesting a link between breastfeeding and miscarriage, and I see no plausible reason for there to be a link”.
Hopefully that is all very reassuring, however we are not the experts in this subject, and a fantastic collection of writing already exists for us to signpost to, so please have a read for yourself of the explanations and the studies.
Further Reading on the Safety of Breastfeeding during Pregnancy
A fantastic summary of the biology behind breastfeeding and pregnancy is available here, and there’s lots of useful and interesting studies for further reading cited at the bottom of this article too.
It may be worth your while investing in a book called ‘Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond’
The following articles also provide a useful insight into the biology of breastfeeding during pregnancy:
https://www.breastfeeding.asn.au/bf-info/breastfeeding-through-pregnancy-and-beyond
http://breastfeedingtoday-llli.org/breastfeeding-during-pregnancy-and-tandem-nursing-is-it-safe-recent-research/
http://kellymom.com/category/pregnancy/bf-preg/
If we’re wanting to look at evidence, here is a collection of studies that have looked at the outcomes of breastfeeding during pregnancy:
Kimura, T. et al. Expression of oxytocin receptor in human pregnant myometrium. Endocrinology 1996; 137: 780-785
This piece discusses that often mothers are encouraged to wean by their health care provider but asserts that it’s not necessary in most cases. This paper states that the uterus is not as responsive to oxytocin during pregnancy, and that breastfeeding pregnant mothers release less oxytocin with feeds which may cause reduced letdown.
Madarshahian, F. & Hassanabadi, M. A comparative study of breastfeeding during pregnancy: Impact on maternal & newborn outcomes. J nursing research 2012; 20 (1): 74-80
This study included 240 pregnant mums & 80 breastfeeding pregnant mums (all low risk) in Iran. It found that there was no difference in incidence of problems including infection, hypertension, & bleeding during pregnancy for breastfeeding and non-breastfeeding mums, and that mothers who breastfed were just as likely as their non breastfeeding peers to deliver at full term.
Ishii, H. Does breastfeeding induce spontaneous abortion. J Obstet Gynaecol Res 2009; 35(5): 864-869
This studied 774 pregnant women and 110 breastfeeding pregnant women in Japan. The miscarriage rate between the two group was 8.4% in the non-breastfeeding and 7.3% in the breastfeeding group; a non-significant difference. Ishii concluded that a mother should continue to breastfeed until natural weaning occurs
Albadran, M. Effect of breastfeeding during pregnancy on the occurrence of miscarriage and preterm labour. Iraqi journal of medical sciences 2010; 11.3
This study compared 288 pregnant women and 250 pregnant breastfeeding women in Iraq. The incident of preterm delivery & low birth weight was not statistically significant between the 2 groups, & the miscarriage rate in the tandem feeding group was lower. Researchers concluded that breastfeeding while pregnant did not increase the risk of miscarriage, preterm birth or affect neonatal birth weight.