Dear Andrea,
Wanted to share some thoughts on breastfeeding during
an at-risk pregnancy...just my viewpoint.

I have been fortunate enough to spend more than 8
years working with a group of fine perinatologists
here on the west coast, caring for inpatients on our
high-risk OB floor.  They are extremely conservative
in their approach, sometimes to the point of overkill
(in the nurses' opinions!), but the high success of
their outcomes cannot be disputed.  I respect and love
them; they are a great group of people.

That said, I can tell you that they would not
recommend breastfeeding during a pregnancy at risk for
preterm labor.  Many cases of preterm labor are a
mystery; the cause is never determined.  In some
cases, though, the cause is obvious: multiple
gestation, placental problems (low-lying, previa,
accreta, etc.), structural abnormalities of the uterus
(fibroids, too, in some cases), the list goes on.  The
most significant risk factor for preterm labor/birth
is a previous history of preterm labor/birth.

In my own view, having studied breastfeeding and
having worked with high-risk patients, I think each
mother, and each pregnancy, needs to be evaluated on a
case-by-case basis.  Our patients at risk for, or with
diagnosed PTL (preterm labor), are counseled to avoid
any breast stimulation and sexual contact, since both
can trigger uterine contractions.  However, as an
example, if the reason for the PTL in the first
pregnancy was a placenta previa, and in the current
pregnancy, the placenta is not overlying the cervical
canal, why NOT continue breastfeeding?  If a problem
arises later, it can be addressed at that time (I can
see the docs I work with rolling their eyes...as I
said they are conservative!).

Any discussion on this matter always welcome!
Sincerely,
Carole Jernigan RN, BSN

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