"She gets pregnant, but then miscarries, as has just happened for the third
time
since her first child was born . . . I know that most things I have read
over the years do not link
breastfeeding with miscarriage, but in this case, do any of you feel that it
might
be?"
-------

This is by no means a professional medically researched opinion, but rather
my general sense of things based on very limited experience (in a patient of
mine and in my own personal case of repeated losses while nursing an older
toddler).

We know that lactation is associated with a lessened liklihood of a regular
monthly ovulatory cycle, and that this leads to a certain degree of
infertility (desired or not) in many women.  Yet ovulation is only one
factor which is required for a woman's body to establish and maintain a
healthy pregnancy.  Sustaining a pregnancy requires a complicated balance in
multiple systems of a woman's body, including (and certainly not limited to)
both the immune and endocrine systems.

It seems to me that it is very possible that a lactating woman may have a
balance of hormones that does enable her to ovulate and achieve a pregnancy,
but at the same time, does not allow her to fully maintain the pregnancy.
Perhaps there is a subtle change in her "hormonal mileau" that prevents the
continuation of the pregnancy, despite the fact that things weren't so "far
off" that she was unable to ovulate and conceive.

By the way, in my own case, after two first trimester losses while
lactating, my son weaned himself just before I found out I was pregnant
again (with my daughter) and I carried that pregnancy to term.  One could
argue that the pregnancy continued because he weaned, or one could argue
that this pregnancy was somehow "healthier" than my miscarried pregnancies
to begin with, and that this pregnancy itself led to a decreased milk supply
or changed taste of my milk that caused him to wean.  Alternatively, his
weaning and the continued pregnancy could have been unrelated coincidences.
It's impossible to know.  I did do a reasonale search of the medical
literature at the time, and found frustratingly few answers.

By the way, none of the above theory should preclude seeking a thorough
evaluation for other causes of repeated spontaneous losses in this woman (eg
thrombophilic state)

Just my two cents . . .

Jayne R. Charlamb, MD, LLLL
Breast Care Center
Syracuse, NY

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html