I am an LLL Leader, and I am one of the few in my chapter who has nursed through pregnancy. I receive many calls on this topic. However, I am not an IBCLC, so all of the following advice is coming from a lay counselor.
There is no evidence that weaning is indicated in a normal pregnancy. My understanding is that the mother's body gives to the fetus first, then to the nursling.
I highly reccomend Adventures in Tandem Nursing. It is the only comprehensive book written for lay people I know of on the subject.
I do know one mother who has such serious supply issues during pregnancy that she had to switch her 9-month-old over to formula. Her son became furious every time he attempted to nurse. She was devistated. Interstingly, this mother actaully has a quite abundant supply when not pg.
If the mother's supply ebbs dramatically while pregnant, I would hesitate to reccomend anything other than formula for such a young infant. I am rather militant and cranky about the marketing practices of the formula companies. HOWEVER...a closely spaced pregnancy may lead to supply issues, even in the best of circumstances. This is a situation wherein formula is a good option. Modern "scientific" formulas are better suited to an infant's digestive tract than evaporated milk. If a mother truly had supply issues related to another cause, we would reccomend formula supplimentation, right?
In my experience, I have found it helpful to do a few things. First, I reassure a mother that a normal pregnancy does not usually necessitate weaning. Next, I remind her that, although excluisve breastfeeding in the first 6 months, including night-nursing, has a very high success rate, mom can still get pregnant. 1 to 2% is still a chance of pregnancy. This may help to alleviate her guilt. I've been there, and I know how bad a mother may feel in this situation. I encourage her to find an OB or midwife who is supportive and knowledgable about tandem nursing. Just because her MD has not encountered this situation before does not mean that her or she can't learn about it (mine did)! I then let her know that pregnant nursing mothers experience a wide range of physiological and psycological resposes to breastfeeding. They may experience nipple pain throughout the pregnancy, a desire to wean thier baby or toddler, etc. Or, things may go just fine.
During the initial conversation, I act on the assumption that weaning will not be necessary. However, I think it is important to let the mother know what may happen during the pregnancy so she is not taken by suprize. I have faith in breastfeeding mothers and believe that they deserve to know what they are facing.
I try to be sure that the mother knows I am available to talk, even if she decides to wean. If that happens, I assure her that she has done her first child a great service by breastfeeding as long as she has.
--Kellie Whitney, LLLL
----- Original Message -----
From: "Claire Pipes"
To:
Sent: Thursday, June 29, 2006 11:06 AM
Subject: Breastfeeding and pregnant
Hello, I am new to the list. My name is Claire Pipes,MS,LDN,RD, I am a
Public Health Nutritionist( new to this aarena I have 20 years in the
acute care, long term care, home care & hospice settings.
Problem: I have a patient with a 6 month old solely breastfed, she is now
pregnant again- she now knows BF is not a form of birth control- Problem is
baby will not take formula at all in any way shape or form. Baby is onsomon
some food and is healthy and well nourished. The mother is in tears over
the thought of having to DC the BFing. We are limited on the WIC we can
provide and the carnation good start and goats milk is not on the list. I
don't think the Feds would approve of evaporated milk idea.
Question?? Can she continue to BF while she is Pregant ifPregnant special
instructions? Would BFing pull to much nutrition from the mother and not
have enough for the fetus if she increase Kcal,nutrition and take he
prenatal MVI's. Will the utrine contrauterinefrom BF cause spontanious
aspontaneousf the consinous is tconsensushat do we suggest she feed baby,
goats milk, carnation good start, evaporated milk and H2O -you know the old
fashioned formula?
TX's for the help.
---------------------------------
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