By Dr Ananya Mandal, MD
Breastfeeding during a pregnancy or getting pregnant during breastfeeding a baby may seem like a challenge especially to a new and first time mother but does not harm either the breastfeeding baby or the unborn baby.
There may, however, be some complications. Some of the points to be kept in mind include:-
There are nerve-endings present on the nipples of the breast that are connected to the brain and may trigger a hormonal response. This may trigger uterine contractions.
There may be a fear of preterm or early labour induction if nipples are stimulated by the breastfeeding baby.
The American Academy of Family Physicians states that “If the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman's personal decision.”
However, breastfeeding does release certain hormones like oxytocin into the bloodstream. Oxytocin is a hormone that sends signals to the breast tissue to contract and eject milk (the milk ejection reflex). Oxytocin also stimulates uterine contractions. After childbirth this helps the uterus to get back in its pre-pregnancy state. This means that women who breastfeed during pregnancy may experience uterine contractions. However, these may be too mild to notice.
Studies have shown that for the first 38 weeks of healthy pregnancies (a complete pregnancy is of 40 weeks), the uterus has special safeguards that prevent the effects of oxytocin on the uterus. The oxytocin receptors are low and there is presence of oxytocin-blockers like progesterone. It binds directly to the oxytocin receptor sites, preventing oxytocin to bind on its receptors and stimulate the uterus to contract.
In addition, during the pregnancy less oxytocin is released in response to nipple stimulation than before pregnancy or end stage of pregnancy or after pregnancy. This means breastfeeding may be safe during most healthy pregnancies especially before 38 weeks.
Women who have complaints like uterine pain, vaginal bleeding, previous history of preterm labor or lack of weight gain during the pregnancy, weaning may be advised.
Weaning may also be advised to women who develop sore nipples due to breastfeeding during a pregnancy.
Excessive nausea, growing abdomen etc. are other reasons why some women may choose to wean their older babies while pregnant.
After birth of the new baby it is imperative the new baby gets his or her colostrums the initial couple of days. In addition, the new baby should receive fair share of milk required for his or her growth and development. Other foods may be added to the older child’s diet to reduce breastfeeding.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)