Posted by: Diana Cassar-Uhl, MPH, IBCLC | March 29, 2011

Breastfeeding in pregnancy


My son was a few weeks from his 3rd birthday, and lingering congestion and a cough weren’t passing.  He started running a fever and was nursing non-stop, which was starting to wear me a bit thin, since, at that point in my pregnancy (about 30 weeks), there wasn’t much milk and my breasts were very, very sensitive.  I made the rare decision to see a pediatrician.

The doctor confirmed that Simon’s right ear had his first ear infection.

Simon climbed into my lap and began nursing while the doctor prattled on about the antibiotic and other medications.  The doctor stopped in mid-sentence and his eyebrows shot skyward.

“What on EARTH is going on HERE?” he asked, clearly shocked.

“Umm … he’s nursing.  It seems to help him feel better,” I answered, figuring this guy had never seen a preschooler breastfeed before, and feeling rather pleased to be the one to expose him to it (I already had a bit of a rogue reputation in this small Army hospital).

“Do they know upstairs that you’re DOING THAT?”

Ah.  He was incredulous, not because of the older child on the breast, but because of the giant pregnant lady letting the child breastfeed.  By “upstairs,” he meant the doctors in the OB/GYN clinic, who had already thrown me in the crazy pile.

“Yes, they’re aware that I’m breastfeeding through this pregnancy.”

The doctor went on to warn me about all of the consequences that might result from my behavior.  Pre-term labor, small baby, psychological problems in the older child (yes, he really said that) … I smiled and nodded, then let him know that the boy on my breast had an older sister, not quite two years older.  She nursed when he was in the womb, and he arrived one day before 40 weeks gestation, barrel-chested and sturdy at 9 pounds, 4 ounces.  And the big sister was all too happy to share the return of the robust milk supply with her new brother.  I explained that we did something called “tandem nursing” and that we weren’t the only ones in the world who ever had.  I wish I could say I educated that doctor that day, but I think, more likely, it was all too much for him to accept.

I was confident in my decision to breastfeed through my second two pregnancies because I had done lots of research.  I was really fortunate that just 6 months before I became pregnant with Simon, La Leche League International had published Adventures in Tandem Nursing by Hilary Flower .  This book explained for me why breastfeeding through a pregnancy was OK for most mothers in uncomplicated pregnancies and helped me prepare for what I might expect as my pregnancy progressed.

For starters, I knew that I wasn’t in the small population of mothers for whom breastfeeding during a pregnancy was a bad idea; I had no issues with pre-term labor, cervical dilation, and there was no need for me to be on pelvic rest.  I learned that oxytocin, the “love hormone” that is secreted when I breastfeed, during orgasm, and in labor, does cause uterine contractions (which is why some people try nipple stimulation during labor if contractions are slow or not productive); however, in an uncomplicated pregnancy, the uterus is not receptive to these surges of oxytocin, whether triggered by sex or breastfeeding/nipple stimulation.  Until the baby is ready to be born, my uterus wouldn’t care so much that all this contraction-causing hormone was flowing around.

Knowing all of this was a huge comfort to me, because I did experience contractions in the late 2nd and 3rd trimesters.  They weren’t strong and I didn’t feel like I was endangering my growing baby, but I definitely felt them and they were definitely a result of the nursing session.  As well, by just after the midway point, my milk had mostly dried up and breastfeeding my toddler had become rather unpleasant.  We got through the rest of the pregnancy by limiting the length of the nursing sessions throughout the day (both of my older children were receptive to these compromises) and by me adopting some escapist mental techniques to get me through the bedtime nursing, which was always longer.

The first time I breastfed through a pregnancy, I did it because I didn’t have any idea how I might go about weaning my young toddler (she was 13 months old when I became pregnant with her brother) nor did I have any real desire to wean her.  I wondered if having an older nursling might help bring in a robust milk supply more quickly than I had the first time around (which would have come in handy in our situation of severe abnormal newborn jaundice/hemolytic disease of the newborn, experienced to some degree by all three of my children), or if my toddler could help relieve some of the engorgement of those early days.  I imagined that still being allowed to breastfeed might alleviate feelings of jealousy my older child might feel toward the new baby.  I felt certain, above all else, that breastfeeding through my pregnancy and tandem nursing would bring more benefits than sacrifices.

I was correct, but just barely.  Breastfeeding through pregnancy ranks pretty high on the list of the hardest things I’ve ever had to do in motherhood.

Thankfully, though, immediately after the baby was born (literally within the hour), breastfeeding the older child was no longer excruciating.  She did help bring in lots of milk and she also was happy to handle some of my engorgement, saving her brother from what would have likely been a few uncomfortable days or weeks.  I was surprised and amused by how GIANT my once-baby now felt in my lap and at my breast, compared with the newborn sibling, but the pain and unpleasant feelings were gone instantly.  I learned that this is because, upon delivery of the placenta, the progesterone level in the mother’s body plummets to approximately 10% of where it remained during pregnancy.  You know that tenderness you might feel in your breasts during the second half of your menstrual cycle?  Progesterone.  Now imagine that times 10 and you get some idea of what breastfeeding through pregnancy feels like for some mothers.  It’s totally understandable why many just won’t do it.  Other mothers have a different experience; some toddlers are a lot more amenable to weaning than I think mine would have been, as well.  There are so many factors and what works for one dyad may or may not be the best option for another.

As Anna, my eldest, approached her 4th birthday and Simon was nearly 2, we started to feel ready for a 3rd baby in our family … but I was pretty certain I would not want to tandem nurse through a pregnancy (though I knew a few mothers who had done this and survived).  She weaned in plenty of time before I became pregnant, and, while still unpleasant, breastfeeding Simon was easier than breastfeeding Anna had been during his pregnancy.  Perhaps it was because I knew better what to expect, or maybe it was because he was a year and a half older than Anna had been when I was pregnant with him, and breastfeeding less frequently than she had been.  The duration of tandem nursing was much shorter the second time around, too, because Simon is more than three years Gabriella’s senior.

We have some precious video of Simon after Gabriella was born.  I was on the bed, Gabriella was dressed and we were breastfeeding some more.  I was joking that she had to know what she was doing, given that I had earned most of my required continuing education credits for the IBCLC exam during her pregnancy!  Simon leaned in really close to observe Gabriella’s latch.

“Do you need to queeze it?” (Simon couldn’t yet pronounce his S-dipthongs … “queeze” meant “squeeze.”)

“No, sweetie, she gets the milk on her own.”

“Is she going to drink ALL OF IT?”  Simon asked urgently.

“No, Simon.  There will be plenty left for you when she’s done.”

The look of relief on his face was a priceless affirmation that I had made the right choice for us.  Anna remembers sharing her “bock” with Simon; Simon remembers sharing his “uns” with both of his sisters; Gabriella doesn’t remember that she ever had to share her “milkies” with Simon because he weaned before she had her first birthday.  She’s my last baby, and I won’t be breastfeeding through another pregnancy, but the experience of having done so is one I’m eager to share with mothers and healthcare providers who aren’t aware that it’s an option.

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Responses

  1. “Is she going to drink all of it?” So sweet! That will be a nice story to share about a unique kind of sibling rivalry.

    Lovely post – so many mothers just have no idea at all that they can do this if they and their children want to. Glad to see the reference to “Adventures in Tandem Nursing” in there – it’s ALWAYS out of our LLL group library (which tells you, I guess, that more mothers do this than we think!).

  2. Thanks so much, Michelle! I know if I had just left things up to the knowledge of my doctors, I would never have breastfed through a pregnancy or tandem nursed and things would have worked out very differently for my family. I think, though, this is just another of those issues that healthcare providers aren’t able to keep up with (they have to know so much about so many things, don’t they?) and breastfeeding falls victim as a behavior that’s something other than normal.

  3. [...] Originally posted here: Breastfeeding in pregnancy « normal, like breathing [...]

  4. This is so lovely. I never go to tandem nurse because of my crazy spacing. This is great for me to share, especially with my Toddler Meeting.

    • Thanks, Leigh Anne. I’m glad you liked it. I definitely have no regrets about how things worked out for us, but I’m also glad to be able to remember my experiences as they were — amazing, but also difficult at times.

  5. Thank you SO much! My nursing relationship with my 19mo daughter is still going VERY strong and we’re TTC. I’m worried about nursing through pregnancy and honestly hoping my milk DOESN’T dry up. I’ve read several different experiences, with varying results.

    I agree that weaning during pregnancy sounds counter-productive for encouraging closeness between siblings. I could see where it might breed resentment. Whereas tandem nursing gives the little ones one very special thing to share!

    Thanks again!

  6. Great post!! Nursing during pregnancy was so tough for me too…it was painful at times, uncomfortable at others. Now I’m going through the emotional highs and lows of tandeming. It’s so great hearing the experiences of other moms…it has definitely given me the motivation to keep going!

  7. Thank you sooooo much for this article. I am going to look more into that book. I have been wondering a lot about this since I don’t want to wean my daughter before 2 years old but I may be pregnant

  8. I needed to hear this. I’m nursing an 11 month old and am 5 months pregnant. It’s super tough, and my milk supply seems to be dropping rapidly :( This was just the encouragement that I needed to stick it out. I’m praying my milk supply will go back up soon, because I feel guilty that I’m selling my 11 month old short. She still nurses about every 2.5 to 3 hours. I do have the book too! Anyway, thank you! Thank you! Many blessings!

  9. Wow! Thank you!! I have a just made 2 year old and am almost 6 months pregnant. I wondered why the “majestic” feeling I used to have when my son nursed turned into an almost sickening, “yuck” kind of feeling. I was SO close to weaning him, but I just couldn’t do it. He loves it SOOO much — even though he couldn’t possibly be getting much milk out of the deal! Most times it seemed to be all about the comfort and closeness, so I literally and figuratively just “bared it” .. and use some mental getaways too!

    I would hate to think that my son would get jealous over not having anymore “boobie” or feeling like he lost out to it to his sibling. I just feel the need to hold on…

    I had never heard to not bf while pregnant, though many of my friends had been given that info. I always wondered why. Great article. Feels good to hear another mom’s perspective. I sometimes have to be reminded that I’m not alone!!!

  10. I nursed through my twin pregnancy this past summer. It was in a word awful. I feel bad saying that, but it was incredibly uncomfortable and awkward holding a toddler (she was almost 2) that was nursing along with being pregnant with 2! I did make the decision to wean her just prior to her 2nd birthday. At that point I was almost 37 weeks pregnant in my twin pregnancy. But, I had absolutely no problem nursing and being pregnant, even with twins! :)

  11. […] until a few weeks before she started her 2nd year of preschool; she was almost 4. This meant that I had been tandem nursing her and her younger brother for nearly two years—he was born before her 2nd birthday. About 7 […]


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