In most situations, tandem nursing -- continuing to breastfeed one child while pregnant with another -- can be safe and healthy for the mother, baby and older child, before and after delivery. Ask your doctor, midwife, nutritionist or lactation consultant any questions you have.
Health Considerations
Breastfeeding during pregnancy can cause uterine contractions because suckling stimulates the hormone oxytocin, which also is released during sex and childbirth. According to Hilary Flowers' "Adventures in Tandem Nursing," these nursing-related contractions, if any, tend to be mild and harmless. Pregnancy's heightened progesterone levels protect against stronger ones. If you wish to keep breastfeeding your older child, you probably can, unless you are carrying multiple babies, or have a history of repeated miscarriages, weakened cervical muscle, preterm labor and/or related risk factors, according to "Breastfeeding and Human Lactation" by Jan Riordan.
Nutritional Needs
With adequate nutrients, calories and fluids for all, breastfeeding throughout pregnancy will not harm the mother, unborn baby or nursling. As of publication, no nutritional guidelines specifically cover the expectant lactating woman, so you will likely just need to follow the standard nutritional guidelines for pregnancy as well as those for nursing. Ask your doctor about vitamin and mineral supplementation. NursingTwo.com advises: "Most mothers find that if they simply eat to satisfy their increased hunger they can easily consume enough calories to support the pregnancy and continued lactation. Let your hunger and thirst dictate how much you take in."
Dealing With Common Issues
Pregnancy-related hormonal changes might cause sore nipples or fatigue. To ease nipple soreness, NursingTwo.com recommends readjusting your nursling's mouth latch and position, increasing your fluids or getting checked for thrush infection. As Riordan notes, fatigue often improves as pregnancy progresses. In the meantime, you can try sleeping when your nursling naps. Around the fourth or fifth month, your milk volume might diminish and alter in taste. These changes, plus your lap's increasing disappearance, might influence your older child to self-wean. This turn of events might be a disappointment, relief or both for you, but probably does not mean anything is wrong with you, your older child or your unborn baby.
Child Spacing
While the timing is up to you, the healthiest child spacing interval appears to involve conception 18 to 23 months after the last birth. Spacing of less than six months might not enable the mother to fully replenish her bodily stores of critical nutrients. If you do conceive again in less than six months, you might simply require some extra nutritional support and rest to keep nursing your older child. If you currently are nursing but not pregnant and want to stay that way, whether permanently or for the time being, you will need to take special care with your method(s) of family planning. Especially if they contain estrogen, hormonal contraceptives can interfere with your milk supply.
References
- "Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond"; Hilary Flower; 2003
- "Breastfeeding and Human Lactation"; Jan Riordan; 2005
- ChooseMyPlate.gov: Daily Food Plans for Pregnancy & Breastfeeding
- La Leche League International: Tandem Nursing
- NursingTwo.com: Nursing During Pregnancy and Tandem Nursing-FAQ
- World Alliance for Breastfeeding Action: Family Planning for the Breastfeeding Woman
