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.