Does pregnancy affect milk supply

How will my milk change when I am breastfeeding through pregnancy? • KellyMom.com

• Milk supply during pregnancy
• Changes in milk composition
• Will I produce colostrum?
• Colostrum and stool changes in the older nursling
• Milk changes after birth
• Will I have enough milk for two?

Milk supply during pregnancy

Most mothers who are nursing through pregnancy notice a decrease in milk supply by mid-pregnancy, but sometimes as early as the first month. During pregnancy, the mature milk is also making a gradual change to the colostrum which is present at birth. Supply may increase toward the end of pregnancy as colostrum production kicks in.

Why does milk production usually decrease during pregnancy? Progesterone levels gradually rise during pregnancy. One theory for the cause of decreased milk supply during pregnancy (Flower 2003) is that the progesterone makes the alveoli permeable, or “leaky,” so they can’t store milk well. At birth (the delivery of the placenta) progesterone levels drop dramatically, allowing prolactin to take over. Prolactin makes the alveoli impermeable, thus setting the stage for the return of copious milk production.

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The production of breastmilk depends upon adequate emptying of the breasts, but the supply and demand regulation of milk supply does not usually hold up when faced with the hormonal changes of pregnancy. The decrease in milk production usually occurs despite continued or increased nursing frequency, although a minority of pregnant mothers do not experience a decrease in milk supply. Obviously if your child does decrease demand, that will further decrease supply.

When your milk supply begins to decrease, your nursling may respond by increasing or decreasing nursing frequency. Your child will most likely make up for decreased milk intake by eating more solids (indeed, increased solid food intake is one way that pregnant moms might track a decrease in milk supply). You can go ahead and encourage increased solid foods – just keep in mind that if your baby is under a year, milk should be his/her primary source of nutrition. As long as your baby is gaining weight adequately and nursing at least 3-4 times a day, he/she is unlikely to need an additional source of milk (see Is my older baby getting enough milk?).

Many moms claim that eating oatmeal once a day helps their milk supply. There are also a number of herbs that can help to increase milk supply, but experts are generally not in agreement when it comes to safe use during pregnancy.

Changes in milk composition

One study compared changes in the milk of two lactating pregnant mothers through the first two months of pregnancy to daily changes in the milk of two women who were gradually weaning (Prosser, Saint & Hartmann 1984). Milk composition and volume changes during pregnancy were similar to those during gradual weaning, but the changes during pregnancy occurred despite continued or increased nursing, rather than in response to a decrease in nursing frequency.

The changes that accompany the decrease in milk supply would be expected to affect the taste of the milk, and indeed some nursing toddlers mention the change in taste to mom. Once the milk is mostly/fully colostrum, the taste may change again. Some nurslings don’t like the taste change (particularly when combined with the concurrent reduction in milk supply) and may wean as a result. Some love it. Others either don’t seem to notice the change, continue nursing despite the change, or simply don’t mind.

Will I produce colostrum?

Yes. The changeover between mature milk and colostrum production begins, on average, between the 4th and 8th month of pregnancy, but some mothers start producing colostrum somewhat earlier than that. Many mothers who nurse through pregnancy have noted that their milk contains mostly colostrum during the last month before baby is born. You will continue to produce colostrum throughout the latter part of your pregnancy – your older nursling cannot “use it up.”

Colostrum and stool changes in the older nursling

If your older nursling is getting a good quantity of colostrum (either before or after birth), the natural laxative effect of the colostrum may cause him/her to have looser and more frequent stools. The stools should return to normal once your colostrum is completely replaced with mature milk.

Milk changes after birth

At birth, the sudden decrease in progesterone and estrogen levels (and resulting surge in prolactin levels) that occurs with the birth of the placenta causes colostrum production to kick into high gear and signals your milk to “come in.” Once your baby is born, the amount of time you produce colostrum is limited, since your mature milk will begin to come in within a few days.

See also: Does my newborn always need to nurse first?

Will I have enough milk for two?

Both research and anecdotal evidence assure us that a mother breastfeeding two or more children (whether nursing siblings, twins, or more) has the capability to produce large amounts of milk (see Saint, Maggiore & Hartmann 1986). In one study a tandem nursing mother produced a double supply of milk for the entire 7 months that her older child nursed alongside the newborn (see Prosser 1984). As with any nursing relationship, factors like breast reduction surgery or adoption can affect the amount of milk produced, but the only supply concern generally reported by tandem nursing mothers is oversupply, rather than undersupply. See Got Milk? for more information on maintaining and increasing milk supply.

Breastfeeding During Pregnancy and Tandem Nursing • KellyMom.com

PDF version (great for printing)

By Hilary Flower, author of
Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond, published by La Leche League International in July 2003

You have probably heard most of these common statements circulating about breastfeeding during pregnancy and tandem nursing. I set out to test their veracity, and was surprised by what I found! Test the currency of your own knowledge: which statements are myth, fact, or simply unknown?

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1. “At 24 weeks gestation, the uterus changes in such a way that breastfeeding goes from being safe to risky.

Myth. Oxytocin is a hormone released during breastfeeding that causes uterine contractions, usually too mild to notice. This fact has raised concern that breastfeeding could contribute to preterm labor in an otherwise healthy pregnancy. The uterus starts out pregnancy fairly insensitive to oxytocin, and somehow the rumor got started that it increases in sensitivity in mid-pregnancy. Research does not support this. Instead, the first marked increase occurs after the 37th week—with little or nothing happening before that time.

2. “When you are breastfeeding during pregnancy, your body gives first to the fetus, then to the nursling, and then what’s left over goes to your own daily needs and reserves.” …MYTH or FACT?

Myth. If your body fat is already perilously low, you will want to note that malnourished women yield some body fat to contribute to fetal weight gain. But we have no research to tell us whether the fetus or nursling gets priority in times of shortage. More importantly, we have no reason to believe that anyone needs to come up short unless the mother is malnourished. Follow your appetite, eat enough calories of a basic mixed diet, and gain weight within the same parameters as if you weren’t breastfeeding, and your body will do the rest.

3. “The newborn always needs to nurse first.” …MYTH or FACT?

Myth. Your newborn may need “first dibs” on colostrum since it is in limited supply in the first day or two. The sensation of your milk “coming in” indicates that your supply has exceeded your children’s demand; you can now count on plenty for both nurslings. Indeed, if you experience engorgement or an overly strong milk flow, your newborn may have an easier time if you nurse your toddler first!

4. “Most mothers experience a significant drop in milk supply during pregnancy.” …MYTH or FACT?

Fact. 70% of mothers notice a significant drop in supply during pregnancy. Still, a minority of mothers continue to produce an abundance of milk throughout pregnancy.

5. “Tandem nursing mothers can make a double supply of milk—just like mothers nursing twins.” …MYTH or FACT?

Fact. In one study a tandem nursing mother made a double supply of milk for the entire seven months that she tandem nursed (and her newborn was well above average in growth!). The only supply concern generally reported by tandem nursing mothers is oversupply.

6. “A majority of children self-wean during their mothers’ pregnancies.” …MYTH or FACT?

Myth. It is true that a majority of children do wean during their mothers’ pregnancies; the question is: who’s idea is it? In one study of La Leche League mothers breastfeeding during pregnancy, 26% of children self-weaned, 28% of the mothers led weaning, and the other 46% went on to tandem nurse.

7. “If you enjoy nursing your child before pregnancy, there’s no reason to believe that pregnancy would change that.” …MYTH or FACT?

Myth. It’s important to note that pregnancy does tend to change “breastfeeding as usual” for many mothers. Some mothers find that nursing during pregnancy causes pain, agitation, or nausea, and such problems can affect their feelings about continuing. (Similarly some toddlers don’t like the changes in flavor and supply of milk.)

8. “Tandem nursing will ensure a smooth sibling adjustment for your older child.” …MYTH or FACT?

Myth. Your older child may experience a range of emotions, from fear of displacement–to anger at you–to delight in the new baby. And remember that sibling relationships tend to have their own rhythms of bonding and fighting, and both can happen at your breast! Realistic expectations, lots of mama love, open communication and a sense of humor will help you move through any challenges that arise.

9. “Breastfeeding reduces morning sickness.” …MYTH or FACT?

Unknown! This appears to be true for many mothers (myself included) but only a scientific study could tell us whether statistics will bear this out or not. On the other hand, some unlucky moms do experience isolated bouts of nausea specifically during breastfeeding sessions.

10. “Tandem nursing mothers are martyrs.” …MYTH or FACT?

Myth. It is true that nursing two children is a big commitment. On the other hand, weaning a reluctant child is no easy task either, particularly if you are pregnant or caring for a new baby. Each mother must choose the option she is most prepared to follow through on.

BONUS QUESTION: “Tandem nursing is rare.” …MYTH or FACT?

Myth. Many mothers are careful about whom they tell, but this invisibility masks a common practice. In one study of 179 mothers who had breastfed at least one child for at least six months, 61% had breastfed during pregnancy, and 35% had tandem nursed.

For more information, see Nursing During Pregnancy and Tandem Nursing: The Official FAQ or read a chapter from Adventures in Tandem Nursing.

REFERENCES

1. Flower, 2003, pp. 223-230; Kimura T, et al. Expression of oxytocin receptor in human pregnant myometrium. Endocrinology 1996; 137:780-85.
2. Flower, 2003, pp. 248-49; Hamosh M, Dewey KG, Garza C, et al: Nutrition During Lactation. Institute of Medicine, Washington, DC, National Academy Press, 1991.
3. Flower, 2003, pp. 76-78.
4. Moscone [sic] SR, Moore MJ. Breastfeeding during pregnancy. J Hum Lact. 1993 Jun;9(2):83-88.
5. Flower, 2003, pp. 233-234; Prosser CG, Saint L, Hartmann PE. Mammary gland function during gradual weaning and early gestation in women. Aust J Exp Biol Med Sci. 1984 Apr;62 (Pt 2):215-28.
6. Flower, 2003, pp. 166; Moscone [sic] IBID.
7. Flower, 2003, pp. 39-66.; Moscone [sic] IBID;
8. Flower, 2003, pp. 192-199.
9. Flower, 2003, 263-64.
10. Flower, 2003, pp. 8-10.
11. Flower, 2003, p.16; Kendall-Tackett, K. Unpublished Data.

New pregnancy while breastfeeding - what to do?

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You are pregnant while breastfeeding. You are faced with a difficult choice: you do not plan to terminate the pregnancy, and the first-born is still too small to wean him from the breast. How to be? Is it possible to breastfeed during pregnancy? What is it fraught with?

Breastfeeding pregnancy - heart of the matter

Even 300 years ago there was no question of stopping breastfeeding during pregnancy. The woman had no choice - a small child needs food, and there were practically no alternatives to mother's milk.

Today, a pregnant woman can receive a categorical recommendation from doctors as a matter of urgency to wean the firstborn from the breast. Yes, sometimes the completion of breastfeeding is dictated by the interests of pregnancy . But more often than not, it's overkill. Unless there is a clear medical indication, whether or not to feed during pregnancy, and if so, for how long – decision of parents , not doctors and relatives.

The medical side of the issue

Very cautious The decision to continue breastfeeding during pregnancy is worthwhile for women who have experienced preterm labor, recurrent spontaneous miscarriages, or are currently at risk of preterm labor . Here it is important to carefully weigh all the pros and cons, listen to the opinion of your doctor.