Medicine today 

Pregnant and lactating given. The likelihood of a new pregnancy while breastfeeding

Today we are discussing breastfeeding during pregnancy with Daria Degtyareva, Breastfeeding Consultant (article edited by Anna Shkryabina, obstetrician-gynecologist).

If it so happened that a mother became pregnant when her eldest baby is still breastfeeding, and if, moreover, he is still very small, of course, mother thinks about feeding during pregnancy. With older children, the mother also has such a question, although less often (usually it is a question: how to wean), but still this material will be useful for them.
Is it possible to breastfeed during pregnancy? Doesn't it threaten miscarriage?
You can feed with UNCOMPLICATED PREGNANCY!!!

That is, if there is one of the factors or a combination of them, it is better to stop breastfeeding:
uterine pain
bleeding or spotting
history of miscarriage and/or preterm birth
multiple pregnancy
first delivery by caesarean section
abnormalities in the condition of the fetus and / or placenta by ultrasound
abnormal position of the placenta (low, cervical)
Thus, if nothing bothers, breastfeeding is POSSIBLE !!

Oxytocin:
Everyone knows that oxytocin during childbirth and immediately after helps the uterus to contract.
BUT, the uterus before and after childbirth, and the uterus at the beginning of pregnancy is significantly different, namely in the number of oxytocin receptors.
So, between the 1st and 3rd trimesters, their number increases 12 times!! And after 37 weeks to give birth another 2-3 times!!!
That is, the uterus at the beginning of pregnancy NOT SENSITIVE TO OXYTOCIN!!!
When we feed a very young baby, a few months after birth, the level of the hormone oxytocin is still quite high, BUT when these are grown-up babies, the level of the hormone is already quite small.
Sex also gives the release of oxytocin, this is the hormone of love, but few people limit themselves to this during pregnancy))

During pregnancy, the hormone progesterone is actively working, which affects smooth muscles, relaxing them. It protects the uterus, but at the same time, it really relaxes the muscles of the gastrointestinal tract, blood vessels, etc., which often leads to negative consequences for the mother, such as constipation, varicose veins, etc.
Braxton Hicks contractions, or training contractions, often occur almost from the very beginning of pregnancy (from 6 weeks) and are present until childbirth. For mothers of the second baby, be more careful with them, since at the end of pregnancy they are very easy to confuse with real ones and vice versa.
If the issue of safety is clear to you, and you decide to continue to feed, you need to understand that there are both pros and cons of feeding during pregnancy, and then in tandem feeding.

PROS:
Mom has more reason to rest, especially if the baby is feeding lying down.
it is easy to calm the baby, cope with all crises, teething, illnesses and any stress
communication between mother and baby is very easy to maintain, mother does not need to do anything))
if you saved breastfeeding for childbirth, then tandem breastfeeding will very easily help the older one adapt to the younger one, reduce the likelihood of jealousy
the elder does not lose all the benefits of milk
while maintaining HB during pregnancy, self-weaning may occur (I will write about it below)

MINUSES:
a pregnant mother on breastfeeding often feels hungry and thirsty
feeling tired, tired and irritable more often
sore nipples
the absence of a mother during childbirth can be very traumatic for a non-weaning baby (the same as leaving for a couple of days for weaning)

Milk quality:
In the 1st trimester there are no special changes in the composition.
In the 2nd trimester, the priority gradually shifts in favor of the unborn baby and the milk composition approaches colostrum.
Information from the La Leche League website:
In MOTHERING YOUR NURSING TODDLER (available from LLLI, 157-12), Norma Jane Bumgarner writes about a study that analyzed the milk of three pregnant women over several months. “About the second month of pregnancy, the milk began to change composition, similar to what happens during weaning. The concentration of sodium and protein gradually increased, while the volume of milk, the concentration of glucose, lactose and potassium gradually decreased. At weaning, these changes are caused by a decrease in suckling, but in pregnant women they occurred against the background of continued feeding in the same way, or even more, than before pregnancy.

Amount of milk:
As noted above, the amount of milk decreases. Therefore, it is very important for younger children to monitor the adequacy of nutrition (increases, pee, stool) and, if necessary, introduce supplementary feeding. For older children, increase the amount of complementary foods.
Mom's diet:
As I wrote above, mom can feel hungry more often and not casually. The "dairy plant" works and develops, and the baby grows in the tummy. Research proves that there is no harm to the baby in the womb in terms of weight gain. The fetus will take everything it needs from the mother's body. Therefore, it is recommended that mom eat fully during this period. After all, if the baby does not have enough of something in the mother's diet, he will take it at the expense of the mother's body reserves. Often, mothers are recommended a diet for pregnant twins.
Nipple sensitivity:
It is associated with hormonal changes and can cause very unpleasant sensations for the mother.
What helps:
oak bark (strong decoction): as compresses, "soaking" the breasts or in frozen ice cubes.
lanolin: astringent effect reduces the sensitivity of the nipples (for example, Medela or Pegion cream) lanolin should be almost 100% in the composition and highly purified.
Self-weaning:
It may happen that the baby can wean itself from the breast in the second half of pregnancy. This is due to a change in the taste of milk (although this will not affect some children in any way) and a decrease in its amount. If, in addition, the mother gradually reduced the number of attachments and gradually reduces their duration, then it is very easy to bring the baby to self-weaning. Even if you give a lot of tactile contact (hugs, kisses, strokes, co-sleeping, etc.), that is, to reduce the need for the breast precisely as a source of a strong connection with your mother, then this is even easier to do.

What to read additionally:
If I have conceived in you at least the thought of continuing feeding during breastfeeding, then I recommend reading additionally:
- Article from the La Leche League website (very detailed on the safety of breastfeeding during pregnancy)
https://www.llli.org/russian/nb/pregnancy.html
- a forum for nursing mothers during pregnancy: links to articles, support, communication, answers to common questions:
https://www.beremennost-gv.livejournal.com
Remember, it is up to the mother to decide on her own whether weaning or continuing to breastfeed while pregnant, given enough information about the pros, cons, and risks. To condemn her in this or that decision is not help! To give information proving one or another argument - information support. And I am not calling you, but only informing you.

Following the modern recommendations of doctors and psychologists, many women continue up to 2-3 years. With the onset of a new pregnancy, it is necessary to weigh the pros and cons of continuing breastfeeding. If the pregnancy develops safely, and the mother has the opportunity to fully eat and rest, then there are no medical contraindications to maintaining breastfeeding. The load on the mother largely depends on the age difference between the children, the frequency of attachments of the older child and the number of assistants for the pregnant mother.

Should I plan tandem feeding in advance?

Experts do not recommend consciously planning for themselves the birth of weather and tandem feeding (here tandem is simultaneous breastfeeding of children of different ages). To recover, a woman needs a break between pregnancies of 3-3.5 years. If the pregnancy occurred earlier and the birth of children with a small difference is expected, a tandem may be a good choice. An older child does not become an "adult" because he has a younger brother or sister. And at one and a half, and at two, and at three, mother's milk and communication through breastfeeding can still be very necessary and important. For some, tandem feeding may be too difficult, then you will have to wean the older child, who still needs mother's milk and mother's breast. Specially planning the birth of the weather, counting on feeding in tandem, is impractical. Tandem is a possible option for existence in a difficult situation, but it is hardly worth creating this situation on purpose.

How will the quality of milk change after the birth of a second baby?

The body of a nursing mother focuses specifically on the born baby, therefore, after childbirth, as usual, colostrum will come, and only when the baby is ready to take other food, milk will come. If the older child feeds only from time to time, then there is no need to worry that the newborn will receive less colostrum or milk. But if the older one is applied quite often, then it is recommended that each of the children single out “his own chest”, let the younger one “suck” the chest of the older child and not limit the stay of the younger child at the breast.

What are the benefits of continuing to breastfeed?

Breast milk remains useful and necessary for the child in the second and third years of life. Do not forget about the psychological component of breastfeeding, about the importance for children of the first years of life of this unique way of communicating with their mother. The younger the older child, the more important it is for him to continue breastfeeding. Therefore, if the difference between children is less than two years, it is highly desirable to continue breastfeeding and feed children in tandem. With older children, tandem feeding can help manage jealousy and make it easier to care for both.

How to painlessly wean a baby from the breast?

The most important thing is to avoid violent actions and sudden changes. If the mother is aware that the load on her is too great or doctors advise to stop feeding to save the pregnancy, then you can gently wean the older child from the breast, systematically reducing the duration and number of attachments. It is better to avoid such methods of weaning as “going to grandma”, “smearing the breast with something bitter” and other methods of abrupt cessation of feeding, as this can lead to lactostasis in the mother and excessive stress in the child, who suddenly finds himself separated from the mother for a long time. If necessary, feeding the elder can be resumed after the birth of the baby.

Will the second child have enough nutrients if you continue to breastfeed the first during pregnancy?

Feeding during pregnancy is an additional burden on the mother's body. The more often an older child is applied, the more resources are spent on milk production. should be complete, contain animal proteins and fats, and a large number of fresh vegetables and fruits, if necessary, after consulting a doctor, it is possible to use food and vitamin supplements. With a reasonably organized diet, rest, sleep and walks, both children and mother will have enough energy and nutrients.

How to organize tandem feedings?

Most often, children suckle at the same time, since the older one usually remembers the opportunity to attach to the breast when he sees the younger one feeding. First of all, you need to make sure that the newborn is comfortable to suck, and the older one will find a suitable position for himself.

Tandem feeding promotes more friendly relations in the family and reduces jealousy. In addition, the mother has moments of rest: after all, she is sure that while feeding the baby, her older baby does not spill washing powder in the bathroom, does not smear toothpaste on the carpet, does not “cook soup” in the kitchen.

In the organization of tandem feeding, much depends on the difference between children and the characteristics of children's temperament, health and emotional state. When raising children of similar age, they should be treated as twins in many ways.

Breastfeeding women mistakenly believe that it is impossible to get pregnant during lactation. This opinion is a big misconception, since medicine knows many cases when a new conception occurred within a few months after childbirth. Such a method of contraception as lactational amenorrhea is not reliable. Ovarian function is able to recover quickly and without menstrual bleeding.

Permitted contraceptives during lactation

You can protect yourself from unwanted pregnancy while breastfeeding with condoms. This is the most reliable method of contraception, which also protects against sexually transmitted diseases.

In second place in popularity among breastfeeding women are hormonal drugs called mini-pills. They contain minimal doses of active ingredients that do not affect lactation. In this case, drugs block ovulation and thicken cervical mucus to prevent conception. These funds include:

  • Charosetta;
  • Microlute;
  • Exluton.

You can protect yourself with HB using an intrauterine contraceptive - a spiral. The device is installed for a period of 1 to 5 years. Alternatively, you can use spermicides - creams and suppositories.

Signs and symptoms of pregnancy

Menstruation during breastfeeding may be established after three months or absent until the very moment of weaning. If bleeding occurs every month, then the symptoms of pregnancy will be difficult to miss. The absence of another menstruation will lead to the idea of ​​​​a new conception.

If there are no periods, then you can guess the new position by the following symptoms:

  • toxicosis - morning sickness or vomiting, change in taste preferences;
  • indigestion - bloating, constipation or, conversely, diarrhea;
  • fatigue and drowsiness;
  • sore nipples and breast enlargement;
  • increased vaginal discharge;
  • a cold caused by a decrease in immunity in the early stages.

A positive test result will be a clear sign of pregnancy. The device will show a reliable answer already 2-3 weeks after conception, and you can confirm the new position on ultrasound 4-5 weeks after the alleged fertilization.

Is it possible to continue breastfeeding

It is possible to continue breastfeeding during pregnancy, if this does not interfere with the new situation and does not pose a threat. Many mothers practice breastfeeding in the early and even late periods. There is no specific strict time period in which a child must be weaned.

When deciding on the preservation of HB during pregnancy, it is necessary to understand the seriousness of what is happening. During lactation, prolactin is produced, which can block the work of the ovaries. During pregnancy, an increased level of this hormone is undesirable, as it can cause a threat of interruption. A functioning corpus luteum supplies progesterone, which can affect lactation by reducing the amount of breast milk. It turns out that such physiological processes as pregnancy and breastfeeding are antagonists.

If a woman wants to keep a second pregnancy, then doctors will recommend not breastfeeding. Stimulation of the nipples in the early stages causes uterine hypertonicity. This can lead to detachment of the fetal egg and the formation of a hematoma. But for long periods of pregnancy, the preparation of the nipples for breastfeeding is required. It will help to avoid cracking and pain during the first application of the baby.

Organization of breastfeeding

If there are no contraindications to the preservation of breastfeeding during pregnancy, and the woman wants to continue lactation, then it is possible to organize tandem breastfeeding. Most often, mothers of children of the same age or those babies who have a slight difference in age resort to it. The desire to organize tandem feeding has increased recently. If earlier babies fed on mother's milk were weaned a year and transferred to a common table, now you can often meet mothers who seek to feed up to 2 or even 3 years. To maintain lactation during breastfeeding, there are some advantages:

  • the older child feels cared for and receives good nutrition;
  • there is no need to abruptly wean the baby, and this keeps his mental health strong in a given period of time;
  • with the formation of lactostasis and bumps in the chest, the older child will help to quickly cope with the problem;
  • both children receive enough antibodies, which allows them to get sick less.

The disadvantages of maintaining lactation during pregnancy include:

  • increased stress on the mother's body;
  • the emergence of problems with the sequence of attachment of children - for the younger it will be a necessity, and for the older it will be a satisfaction of desires.

Whether or not to continue breastfeeding during pregnancy is a personal matter for every woman. However, before making a decision, it is necessary to consult with a gynecologist. If the doctor sees good reasons for weaning the child, then it is necessary to listen and follow the recommendations.

Your baby is growing up, lactation is established, and he continues to eat mother's milk. However, it happens that a new pregnancy during this period becomes an unexpected surprise. How to be? Stop breastfeeding or not? Is it possible to get pregnant while breastfeeding?

To begin with, let's try to clarify how great the chance of pregnancy is during breastfeeding.

In what cases can pregnancy occur while breastfeeding?

According to statistics, in the first six months after childbirth, the risk of another pregnancy is low. Especially if a woman feeds her baby exclusively with breast milk and only on demand, and the interval between feedings does not exceed three hours. Menstruation does not yet come during this period, since the female reproductive system has not yet been fully restored.

However, even if all of the above conditions are met, pregnancy during breastfeeding is quite possible. Therefore, you need to carefully listen to your body and know the signs that are characteristic of pregnancy with hepatitis B.

  • The mammary glands become especially sensitive, engorged and increase in size.
  • A woman feels uterine contractions (which, in principle, also happens if a woman is not pregnant, this is especially felt in the first month after childbirth).
  • After six months of lactation, menstruation does not come.
  • The mother notices that the child's behavior has changed (perhaps the taste of milk has changed under the influence of hormones, this may cause anxiety for the child).
It should be noted that these signs are indirect, and cannot accurately confirm the presence of pregnancy.

Is it possible to combine breastfeeding and pregnancy?

There is no doubt that breastfeeding and carrying the next child at the same time is a big burden on a woman's body. But still, you do not need to immediately resort to radical methods in the form of abortion or termination of breastfeeding. It is necessary to consult a doctor who will be able to professionally examine the picture of what is happening and make a verdict - is it possible to combine pregnancy and breastfeeding.

There are certain aspects to stop breastfeeding during this period:

  • medical indications (among them are strong uterine contractions that can provoke a miscarriage).
  • the age of the baby (if the child is more than 9 months old, then his need for mother's milk decreases, and he can easily switch to artificial nutrition).
  • if a woman feels discomfort during feeding.
These indications can serve as arguments for stopping breastfeeding.

Is it possible to continue pregnancy while breastfeeding?

A young mother may consider the onset of pregnancy a hindrance, and decide to terminate it. Perhaps the impetus for this may be the stories that the developing embryo will not receive sufficient nutrients. But one may not agree with this.

Subject to a healthy balanced diet, an established regime of rest and stay in the fresh air, a young mother should not experience any difficulties in carrying the next baby.

The surveys of women who have kept their pregnancy while breastfeeding have led to the conclusion that a healthy woman is quite capable of combining these two important events without harming herself and her unborn child.

Reality and myths that accompanied breastfeeding pregnancy

Despite the fact that today you can get any information of interest from reliable sources, many women believe in myths passed down from generation to generation.

One of them are stories about the difficulties and consequences of bearing a child during breastfeeding, they say, the process of feeding can provoke miscarriage. But studies have proven the insensitivity of the uterus until the 20th week of pregnancy to the hormones produced.

Many have heard that lactation supposedly takes away the supply of nutrients to the fetus. Part of the truth is that this statement has, but if the mother observes the correct organization of the breastfeeding process, then the supply of vitamins and nutrients will be distributed in a completely balanced way, and their lack, first of all, will affect the mother's body, which also requires vitamin supplementation.

The assertion that medications prescribed during pregnancy can harm a baby who is breastfed is unfounded: usually a medication that is allowed during pregnancy can also be taken during lactation, which can be seen by reading the instructions for it. This applies to pregnancy without pathologies. Each reverse case is individual, and requires mandatory medical supervision and consultation.

Caveats. What are the dangers of pregnancy while breastfeeding?

What causes in this state can be harmful?
It is assumed that the main argument in favor of excluding one of the processes (feeding or pregnancy) is the depletion of the female body due to recent childbirth. The ideal interval between births is an interval of two years. During this period, the woman will be able to fully recover and bear the next child with renewed vigor.

The second risk factor is the production of oxytocin by the body. This hormone is present in the mother's body in large quantities during lactation. It can cause uterine contractions, which leads to frightening conclusions about premature birth. It should be clarified that the dose of oxytocin produced is insufficient to induce labor.

However, doctors with the threat of termination of pregnancy still advise nursing mothers to stop breastfeeding.

Proper organization of breastfeeding during pregnancy

If a young mother decides to continue breastfeeding, then she should take into account that some changes await her in the form of breast hypersensitivity, reduced lactation, changes in the taste of milk, and difficulties in choosing a position when feeding. Careful observation of these changes and the child's reaction will help reduce discomfort for you and the baby.

During this period, it is very important to organize a balanced diet in order to fully provide your body with useful substances and successfully combine these two important processes - breastfeeding and pregnancy.

Your doctor may advise you to take complex vitamin preparations designed specifically for pregnant women. The same vitamins are allowed to be taken during lactation.

Equally important is a good rest. During this period, it is important to be able to organize a normal 8-hour night's sleep and try to rest during the day while the baby is sleeping.

Try to involve the rest of the family in household chores so as not to deplete your body with unnecessary chores that your husband and other household members can do.
By following all these rules, you will be able to maintain full lactation and endure a second child without problems.