03 March 2009

My newest article 2 of 3

I just had published my 2nd of 3 series articles published in the BAMBI magazine. It's the main pregnancy and parenting magazine for expats in Bangkok. So exciting to open it up and see it in print!

Here it is:

Breastfeeding During Pregnancy
By Erin Kannon

One day as I was breastfeeding my son, I realized he was not a baby anymore. I began thinking about babies, wanting more, and realized, “wait a minute, I missed my period this month, could I be pregnant?” The next morning, two pink lines on the pregnancy test stick revealed that I was definitely pregnant. During the next month, my nipples hurt some and I wondered if I should stop breastfeeding my son, who was definitely no longer the baby since there was a new baby on the way.

Welcome to breastfeeding during pregnancy. If you read my article “Breastfeeding Your Toddler” you know that there are many benefits of breastfeeding your child well past the first six months and on into his second, third, or fourth year of life. Breastfeeding is intended for years and not months, continues attachment with your child, and has unique nutritional and immunological benefits. A new baby does not need to end the breastfeeding relationship that you have with your older child. The dynamics of breastfeeding during pregnancy are a little different, and as an expecting mother, you will need to take care of yourself and your growing baby inside.

Breastfeeding during pregnancy will most likely require a little bit of determination and a whole lot more of extra food. This should not be a problem as most pregnant women love to eat! If you are still nursing a very small baby exclusively you will need about 300 extra calories for pregnancy and another 350 for breastfeeding. If your child is older you will need about 200 extra calories. If you find that you are not gaining enough weight, increase the amount of calories you consume, especially in protein. Protein builds breastmilk and protein builds your growing baby. If you are hungry or feel fatigued, eat more! Remember that you will need extra fluids as well.

When breastfeeding during pregnancy it is common to have some nipple discomfort. You may or may not have sore breasts and this can change during the months of pregnancy. You might also feel a little nauseated, restless or “creepy-crawly” during the feed. This is your chance to practice those breathing exercises for birth! Try to remember your motivation for wanting to breastfeed your toddler and make some breastfeeding “rules” for him if needed. Check that your child has a good latch to help with your comfort level. Fatigue is also common, especially if you are chasing a toddler all day. Take care of yourself and make sure that you are having restful nights and a nap during the day if possible. Try lying down to breastfeed your toddler and nap together.

Your milk will change during pregnancy. Many women notice a change in production, and about 70% of women will have a decrease of supply. Your toddler will most likely notice a reduced let-down reflex and a more salty taste. You can explain these changes to him and he may continue to want to breastfeed even if your supply drops or goes away. There are no known safe options, pharmaceutical or herbal, to help your supply during pregnancy. Some foods, such as oats may help. If your milk goes away, your child can still “dry nurse” if it is not too uncomfortable for you. Expect him to switch back and forth between breasts trying to find more milk! Your body begins producing colostrum by your 20th week of pregnancy and he may want to breastfeed for longer periods of time again.

As your pregnant belly grows, your toddler will run out of room on your lap during breastfeeding. Expect to find yourself using new positions and your toddler experimenting with “nursing gymnastics”. Some breastfeeding positions that you can try while navigating over your bump are the cradle-hold (modified), football hold, toddler standing, seated side by side, back-lying, side-lying, or any which way!

At some point during your pregnancy, you may consider weaning your toddler. Many toddlers choose to wean due to the change in taste or supply. Some wean gradually and others abruptly. An older child is more likely to want to wean, though once the new baby has arrived, he may show interest in breastfeeding again. Weaning is common during pregnancy as your hormones change. Studies have shown that of those breastfeeding and pregnant, 57% weaned. Your decision to wean or not will come down to how you are feeling (body wisdom), cultural preferences, if you want to tandem feed, and what feels the most natural to you. Your needs are just as important as your child’s needs.

Is breastfeeding during pregnancy safe for your unborn baby? Research shows that breastfeeding does not cause premature labor or dilating contractions. The hormone oxytocin that is produced from nipple stimulation does not have an effect during pregnancy due to interaction with other hormones and oxytocin receptors in the uterus. If your healthcare provider tells you to wean because you are pregnant, ask for the reasons why. As long as you have no major health concerns, you are gaining enough weight, and you feel well, there is no reason to stop breastfeeding. One advantage of breastfeeding a toddler is that if you do have a premature baby, you already have a milk supply going. Breastfeeding during pregnancy does not affect the milk supply after the birth.

I continued to breastfeed my son during the first three months of my third pregnancy. I then learned that I was carrying twins and was told that I should immediately wean him. An abrupt weaning would have been devastating for us both, but I knew that weight gain would be of utmost importance for a twin pregnancy. I slowly weaned him as my supply diminished and by my 6th month, he had weaned though he never stopped asking to breastfeed and would occasionally dry-nurse. I was relieved and so happy that he remembered how to latch on correctly after the twins were born. This helped him during those first few months of craziness with new babies and gave us some very special sharing time.

For further information:
Mothering Your Nursing Toddler by Norma Jane Bumgarner © 2000 (in the BAMBI library)
Adventures in Tandem Nursing by Hilary Flower © 2003 (in the BAMBI library)
http://www.kellymom.com/ (general research-based information and forums)
http://www.mothering.com/ (articles and breastfeeding forums)

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