Breastfeeding during pregnancy is safe, if…

A mother who discovers she is pregnant again while still breastfeeding may have many questions. Will breastfeeding affect the growth of her unborn baby, or interfere with the pregnancy? She may also be concerned about whether she has enough milk the older child or find it entirely uncomfortable to nurse as her breasts change in response to the pregnancy. VERA ONANA addresses these questions with inputs from experts and reports.

A disheveled mother dashed into the paediatric hospital clutching a bubbling baby to her chest. She spoke mostly in gibberish as she attempted a conversation with the hospital attendant who tried desperately to calm her down. She demanded to see the doctor on duty immediately, claiming it was an emergency. “I had my baby eight months ago. I took a pregnancy test and it was positive. What can I do, I am afraid,” the visibly shaking mother cried out.

Traditional myth has it that breastfeeding during pregnancy is a taboo and may expose both the baby and the fetus to a number of ills. However, science has revealed otherwise through research findings published in several medical journals that a mother may not panic if such a situation arises as it commonly does.

Family physician at the Vine Branch Medical Centre, Ibadan, Dr Oyebola Olawuyi, attests to this: “there is not any untoward medical effect on a child or the fetus.”

Olawuyi stated that mothers should be encouraged to continue breastfeeding even when it is discovered that a mother is accidentally pregnant, which is something that happens often.

“We say don’t stop breastfeeding because we know the numerous benefits of breast milk for a baby and we will not want to cut that off suddenly because the mother gets pregnant. We won’t advise termination of the pregnancy either. However, breastfeeding during pregnancy may be physiologically demanding on the mother. It is very stressful to be pregnant and lactating at the same time. We therefore advice that a mother should continue for as long as she can cope. Based on the pregnancy, she may not be able to breast feed for the advocated duration of two years.”

The physician added that the fetus is not in any way affected by breastfeeding and is not in any form of imminent danger. “Breastfeeding during pregnancy does not bring about miscarriage or preterm labour as is erroneously believed. It is true that a woman’s body produces one hormone called oxytoxin during breast feeding which causes milk ‘let down reflex’. This hormone at the same time is capable of causing uterine contractions but the effect of this will not be as profound as to cause miscarriage or a preterm labour.”

While breastfeeding during pregnancy is generally safe and poses no adverse effects to the baby or the fetus in the womb, Consultant Obstetrician and Gyneacologist at St. Nicholas Hospital, Lagos, Dr Ayodeji Adeloye, explained that a mother may experience a number of challenges while breastfeeding during pregnancy.

“A mother may have to face some challenges which may include the stress of dealing with a nursing child and early pregnancy symptoms simultaneously. Also, she may have sensitive and tender nipples which may be responsible for discomfort associated with breast feeding during this period.”

The consultant advised that mothers considering breast feeding while pregnant should be prepared for changes the nursing child might notice.

“Although breast milk continues to be nutritionally sound throughout pregnancy, the content of the breast milk may change and this might change the way the milk tastes. In addition, milk production is likely to decrease as pregnancy progresses. These factors could lead the nursing child to wean on his or her own before the baby is born.” He stated explicitly that diarrhea in babies is not a problem caused by breast feeding during pregnancy as is the general misconception.

Dr Adeloye cautioned that breastfeeding mothers in pregnancy must be adequately nourished to be able to meet the demands of the pregnancy and the nursing child. In the same vein, the family physician, Dr Olawuyi, stressed that breastfeeding during pregnancy puts an extra demand on the mother and the mother must be nutritionally fortified to meet the very high demands.

“Breastfeeding during pregnancy is very physiologically challenging for the mother’s body. The issue actually lies in the ability of the mother to cope with breast feeding one baby and providing nourishment for the fetus. It is a whole lot of work to dedicatedly breast feed one child, mother has to have a satisfactory diet pattern but then being pregnant while breast feeding puts double demand on the mother.

“The more the pregnancy advances, the more the demand so a mother could continue for up to like five or six months till the pregnancy gets into the third trimester and then she can stop. Actually, the first 12 months are the most important times the child needs breast milk. The benefit is most expressed within that period.”

“Notwithstanding, there are certain medical scenarios in which breast feeding during pregnancy is not encouraged,” Dr Olawuyi added. While breastfeeding during pregnancy is generally considered safe, in some cases weaning may be advisable:

• If you have a high-risk pregnancy or are at risk for preterm labor
• If you have high blood pressure or diabetes
• If you are carrying twins
• If you have been advised to avoid sex while pregnant
• If you are having bleeding or uterine pain

The only one in imminent danger in the triangle is actually the mother, not the sucking child or the fetus. So, breast feeding during pregnancy is safe as long as the mother can cope,” she said.

Eating well while breastfeeding during pregnancy

According to experts, if a mother decides to breast feed while pregnant, it is essential that she eats well for the health of her nursing and unborn children. Her calorie intake will depend on how old the nursling is. She may need around 500 supplemental calories per day if the child is eating other foods besides breast milk or 650 more calories if the child is less than six months old.

This is in addition to the 350 extra calories she needs during the second trimester and the 450 extra calories she needs during the third trimester. If in the first trimester and a mother finds it difficult to eat due to nausea, she can be relieved to discover that no additional calories are required during the first trimester according to health and nutrition experts.