by Alexandra Nicole Nuralam

Breastfeeding During Pregnancy? Here’s What You Need to Know

If you’ve recently found out you’re expecting again or if another pregnancy might just be around the corner, you probably have questions on breastfeeding during pregnancy. Of course, you should check with your OB-GYN and paediatrician beforehand, and do what works for your family. Your doctor may advise against it if your pregnancy is deemed high risk or you’re more susceptible to miscarry. Other circumstances include carrying twins or multiples, having uterine pain or bleeding, or if you’ve been advised to avoid sex while pregnant.

But generally, breastfeeding during pregnancy and tandem nursing — nursing both your new baby and toddler — are perfectly safe. And breastfeeding your older one through your pregnancy can come with some sweet benefits, like promoting bonding and helping boost his immunity. On the other hand, nursing while you’re pregnant can be challenging — so it’s important to get all the facts first. Here’s what you should know if you want to continue breastfeeding during your pregnancy.

What are the benefits?

Even though breastfeeding may be a little more difficult while managing your pregnancy symptoms, it still has plenty of benefits. First, your child still reaps the benefits of immunity boosts and nutritional gains while drinking breast milk. It’s also a good way to continue bonding with your older child, and helps reduce engorgement after your newborn arrives. It will also help to establish a good milk supply, which is essential especially if you’re planning to tandem feed.

How many calories should I consume if I’m breastfeeding and pregnant?

Now that you’re eating for three, you’ll need to consume more to fuel both baby growing and milk production. Be sure to eat a nutritious, well-balanced diet rich in iron, since having iron deficiency could cause your newborn to be underweight. In the second and third trimester, you’ll need 350 and 450 more calories respectively. If you’re nursing during this time, an additional 500 calories for children under a year old, and less if your child is mainly on solids. You can check with your doctor or nutritionist to ensure you’re getting all the essential calories and nutrients.

According to Dr Sarah Li, accredited OB-GYN of National University Hospital, pregnant and breastfeeding mums should maintain a balanced diet that is high in protein and vitamins. She suggests eating “40 per cent protein, 40 per cent carbohydrates and 20 per cent fat” and recommends healthy carbohydrates like wholegrains, green leafy vegetables and fruits.

What are some breastfeeding concerns I should keep a look out for?

Nipple Tenderness

Sore or tender nipples are common during breastfeeding. According to Dr Li, mothers may experience more breast and nipple tenderness because of the hormonal changes that come with pregnancy.

To help with this, make sure you have a supportive nursing bra. You can also try using lanolin, cold or warm compresses to help with the soreness. It’s also a good idea to set boundaries with your baby; stop nursing if she gets too wriggly or if she bites down on your nipple. If you prefer to wean, shift from nursing to cuddling to maintain the attachment and one-on-one time. Your baby may also self-wean if she doesn’t like the milk’s quantity and consistency. Seek your obstetrician’s advice if you do not feel well when breastfeeding.

Changes in Your Supply and Breast Milk

As your pregnancy progresses through the first and second trimesters, your breast milk supply may decrease due to the hormonal changes in pregnancy. Hence, your little one may only nurse for a short time or dry nurse, which can chafe your nipples. Dr Li adds, “It is also thought that the components of breast milk may change, causing a change in taste.” No studies indicate a significant impact on the nutrients your older child receives, but she may self-wean if she does not like the taste. Around the fourth or fifth month, you’ll start producing colostrum.

Another factor affecting breastfeeding while pregnant is morning sickness, which may impact your fluid intake, nutrition and rest. A tip to keep in mind: While breastfeeding, sit or lie down with your feet up, and nap when your child is napping.

Preterm Labour

“Breastfeeding during pregnancy is largely safe,” says Dr Li. “There is no scientific evidence to suggest that breastfeeding while pregnant increases the risk of miscarriage or preterm birth.”

While oxytocin, the hormone released during breastfeeding, can lead to mild uterine contractions, Dr Li says, “These are not strong enough to trigger labour. Therefore, breastfeeding during the first and second trimesters of pregnancy are considered safe.”

If you’re in the third trimester, she recommends discussing with your obstetrician. “Your doctor will evaluate the risk on an individual basis, especially with mothers who have a history of preterm birth,” she says.

Some symptoms of preterm labour are low backache, pelvic pressure, menstrual-like cramps or increased vaginal discharge. Other signs include four or more uterine contractions in an hour, and your uterus might also feel tight, hard and painful. If the contractions still persist after you’ve stopped nursing, start timing your contractions. Try emptying your bladder, drinking a large glass of water and relax. Either lie on your left side or recline with your feet elevated. If these do not help, call your OB-GYN immediately.

What are some breastfeeding positions I can do with a pregnant belly?

As your bump grows, you may need to change your nursing positions for both you and your little one’s comfort. Try positions like a modified football hold, where your baby’s head lies on a nursing pillow on your lap in the middle of the couch. You can also try be lying down to nurse on her toddler bed or your bed.

This story first appeared in Motherswork.