Navigating pregnancy and breastfeeding simultaneously can bring up a whirlwind of questions and concerns for many moms. Just as you’re getting comfortable with breastfeeding, the news of another pregnancy can leave you wondering: Can I continue breastfeeding? What about breastfeeding two babies? Will it affect the new baby? 

It’s natural to feel anxious or uncertain in this situation. While the decision to breastfeed, while pregnant isn’t always clear-cut, gaining insight into the risks and benefits, can guide you toward the best choice for you and your baby.

Read on for expert advice on whether or not you can breastfeed while pregnant.

Can you breastfeed while pregnant?

According to the American Pregnancy Association, most women are concerned about breastfeeding while pregnant because it can cause mild contractions. However, you need not worry about these contractions causing preterm labor in a healthy pregnancy.

Oxytocin is a hormone that stimulates contractions during childbirth, and it’s also released when you’re breastfeeding. When you’re pregnant and breastfeeding your older baby, oxytocin is released, but in such minute quantities that it is not enough to cause preterm labor.

Furthermore, these contractions are usually harmless to the fetus.

Another concern is whether or not pregnancy hormones can pass to your breastfeeding baby. The answer is yes, a small quantity of pregnancy hormones can pass through your milk to your breastfeeding child, however, they will not harm your baby.

Should you wean your baby off breastfeeding if you’re pregnant?

It is usually safe to continue breastfeeding while pregnant, but in some rare cases, you may want to consider weaning your baby.

As per the American Pregnancy Association, you should speak to your doctor about weaning for your health, as well as the health of your baby whom you’re breastfeeding and your unborn child.

Please seek your doctor’s guidance if:

1. You are at risk of preterm labor or have a high-risk pregnancy. As per Dr. Vyas, “Caution is advised if there is a history or an identifiable risk of potential preterm birth if choosing to breastfeed during pregnancy.”
2. You are pregnant with twins or triplets.
3. Your doctor has advised you to avoid sex during pregnancy.
4. You are experiencing uterine pain or bleeding.

Additionally, in some instances, your older child weans naturally as pregnancy causes your body to produce colostrum which changes the taste of your milk and is a natural laxative. So, if you notice your little one’s poop is runnier than normal, don’t worry, it’s probably because of the colostrum in your breast milk.

Are you and your child ready for weaning?

According to the American Pregnancy Association, during the fourth and fifth months of pregnancy, your milk supply will lessen and change in taste. At this stage, as mentioned before, your child might wean naturally.

However, in some cases, babies are too attached to breastfeeding to be weaned. They may be breastfeeding for comfort or nutrition. Moreover, weaning depends on your baby’s age, nursing patterns, personality, and physical and psychological response to your pregnancy.

For instance, some babies may become more clingy or fussy during your pregnancy, making the weaning process more challenging.

It is also important to consider how you feel about weaning your baby. Most mothers are concerned about how pregnancy will affect their relationship with their nursing baby.

Babies older than six months of age who have begun eating solid food may have no trouble being weaned as your milk supply decreases. However, if your baby is below six months of age and relies exclusively on breastmilk for nutrition, you need to monitor their development and health closely. Do so in consultation with your pediatrician.

What are the challenges of breastfeeding while pregnant?

Thankfully, there are not many challenges when it comes to breastfeeding while pregnant. The American Association of Pregnancy says 75% of women experience sore nipples when breastfeeding. According to UT Southwestern Medical Center, fatigue and decreased fluid and calorie intake due to morning sickness are also common challenges, particularly in the first trimester.

Dr. Vyas states, “Challenges include maintaining adequate nutritional intake for the mother and appropriate rest. Since many women are breastfeeding longer, there is a likelihood of breastfeeding during the next pregnancy, so it’s best to discuss the decision with your physician to ensure a healthy pregnancy.”

Breastfeeding while pregnant may present the following challenges:

1. Breast tenderness

Hormonal changes during pregnancy can cause increased breast sensitivity and tenderness, making breastfeeding uncomfortable for some women. With breast tenderness, most women endure the discomfort rather than actively trying to alleviate it.

2. Decreased milk supply and morning sickness

As pregnancy progresses, hormonal changes can decrease milk production, potentially resulting in insufficient milk for the nursing child.

To deal with morning sickness and ensure your milk supply stays regular for longer, follow a schedule to eat and drink. Eating and drinking regularly and on time can help your health, ensure you get enough calories, and reduce nausea.

3. Nipple sensitivity

Similar to breast tenderness, increased sensitivity in the nipples can make breastfeeding uncomfortable or even painful for some women.

To combat sore nipples, however, UT Southwestern Medical Center advises women to take acetaminophen for severe soreness and try a warm compress for swelling and pain. However, you should always consult your doctor before taking any medication.

4. Fatigue

Pregnancy itself can be physically demanding, and adding the demands of breastfeeding may increase fatigue levels for some mothers. For fatigue, the best thing you can do is ask for help while scheduling rest time.

Your partner, family members, or friends can assist with childcare or housework while you get some rest. Furthermore, don’t give in to the temptation of coffee or energy drinks, as these can dehydrate you.

5. Increased risk of contractions

Breastfeeding releases oxytocin, which can trigger uterine contractions. While typically harmless, these contractions may be concerning for women at risk of preterm labor.

6. Nutritional needs

Pregnancy and breastfeeding both require significant nutritional support. Balancing the nutritional needs of both the mother and the developing fetus can be challenging.

According to UT Southwestern Medical Center, pregnant women require at least 300 to 400 additional calories to help their growing baby. If your older child is exclusively breastfeeding, you need at least 500 additional calories a day.

Combined, that is almost 1000 extra calories if you’re pregnant and breastfeeding to meet the needs of both your babies. Consider consulting your doctor or lactation consultant about your calorie intake during this time when deciding whether or not to breastfeed while pregnant.

7. Emotional and psychological factors

Balancing the needs of the breastfeeding child with the physical and emotional demands of pregnancy can be emotionally challenging for some women.

8. Weaning considerations

Deciding when and how to wean the breastfeeding child before or after the birth of the new baby can be a complex decision influenced by various factors, including the age and temperament of the child and the mother’s health.

Lastly, if you choose to breastfeed while pregnant, and as your belly grows, you may have to reposition your baby during nursing. Find a position that is comfortable for you and your little one. Some mothers opt to lie down with their baby or have their baby stand during feeds.

Tandem breastfeeding when the baby arrives

Once the new baby arrives, many mothers prefer to continue breastfeeding their older baby. To save time and have your babies bond, you may be tempted to feed both at once. However, it is better to allow your newborn to feed first because they are new to breastfeeding and may need more time to adjust. Your older child, however, will be a pro and could quickly drain your breast.

When pregnancy and breastfeeding coincide, it usually boils down to feelings and preferences. You may consider what’s best for your unborn baby, your nursing baby, and your feelings. Ultimately, you decide, but consult your doctor to ease any concerns you may have.