Re: Breastfeeding during pregnancy
I can't answer the question about research " that nursing through a
subsequent pregnancy interfered with uterine lining development."
(Please share references if you get any.) Here are some references on
breastfeeding during pregnancy, which may be of interest.
I have been looking into the question of breastfeeding during
pregnancy, as we have WIC clients who are breastfeeding during
pregnancy and I was interested in learning more about recommendations
to make to them, especially about nutrition needs. I was also asked
to speak on this topic at a conference this summer. It was difficult
to find references. Some of the following references were shared by
Grace Marquis from the University of Alabama.
Breastfeeding during pregnancy is more common than many realize.
Despite this, we really don't know a lot about the effects of
breastfeeding during pregnancy. In addition to references cited
below, I talked with several friends/acquaintances/WIC clients who
breastfed through a pregnancy and had full-term babies of good
birthweight.
I was concerned about advice at both ends of the spectrum--some women
had been essentially told "no problem" with no investigation of their
diet or information on what we don't know. Other women had been told
"not a good idea", again, apparently on the opinion of their health
care provider.
Here is some of what we don't know:
*How does pregnancy affect breastmilk composition?
*How does lactation affect pregnancy?
*How do studies done in marginally nourished populations translate to
recommendations for well nourished women?
*Effect of oxytocin--can it lead to premature labor in some women? If so, who?
*Effects of breastfeeding during pregnancy on mother, fetus, and breastfeeding
child, especially if intake of calories or other nutrients inadequate.
*What are the nutrient needs to support pregnancy and lactation? Are
they additive? Are there factors which spare calories?
*Is/are there any reason(s) to recommend not breastfeeding while pregnant?
If so, what?
There are many good reasons why women wish to continue breastfeeding
while pregnant. In my opinion, until more research is available, we
need to assess the variables for the pregnant woman and her nursing
child, and the fetus. This information should be discussed with the
woman, so she can make a decision based on informed choice. We also
need to discuss the need for adequate nutrient intake/weight gain, and help her
plan for an adequate diet.) (If history of pregnancy loss/prematurity,
uterine pain or bleeding, or continued weight loss, prudent to
encourage weaning, again, in my opinion--considering needs of fetus.)
References:
Breastfeeding During Pregnancy in: Mohrbacher, N, Stock, J. The
Breastfeeding Answer Book. 1990. La Leche League International,
Franklin Park, Illinois.
Garza C. Lactation during pregnancy. IN: Gleicher N (ed.).
Principles of medical therapy in pregnancy. 1985. New York: Medical
Book Company. 263-268.
Siega-Riz, M, Adair, L. Biological determinants of pregnancy weight
gain in a Filipino population Am J Clin Nutr 1993;57:365-72.
Merchant K, Martorell R, Haas J. Maternal and fetal responses to the
stresses of lactation concurrent with pregnancy and short recuperative
intervals. Am J Clin Nutr 1990;52:280-8.
Moscone SR, Moore MJ. Breastfeeding during pregnancy. J Hum Lact
9(2)1993:83-88.
Kendall-Tackett, K, Sugarman, M. The social consequences of long term
breastfeeding J Hum Lact 11(3) 1995:179-83.
Newton N, Theotokatos M. Breastfeeding during pregnancy in 503 women:
does a psychobiological weaning mechanism exist in humans?
Proceedings of the Fifth International Congress on Psychosomatic
Obstetrics and Gynecology. London: Academic Press. 1979. pp 845-49.
(These are some of the primary references. There are other articles,
many of which are referenced in the sources above.)
It's difficult to find this informaton with a literature search. If
anyone has additional references (or opinions), please share them with
me.
Mary Johnson/Minnesot Department of Health/WIC
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