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Wed, 2 May 2007 23:40:02 -0400 |
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Hello everyone!
I recently received a frantic call from a mom who is a (surprised) 8 wks
pregnant and is still nursing a 15 mo old (night time only). She stated that she
has had some spotting off & on. She recently noticed "cramping" when she
nurses. Her Doctor told her to wean immediately or ASAP with a deadline of 16
wks or she could "lose her baby". Mom has been attempting to wean but the
15 month old cries & cries and mom states that is killing her to deny her child
the comfort of nursing & cosleeping at night.
I have been doing a lot of research & still am not quite sure what to tell this
mom. I have never heard of a 16 wk "deadline" with pregnancy with weaning.
We all know that breastfeeding is not contraindicated with pregnancy unless
one has a history of preterm labor (this mom carried her last baby till 40 plus
wks). She went to the ER initially due to spotting & the Doc there told her she
was dilated a fingertip (which one can easily be with 2nd, 3rd pregnancies).
She does have an ultrasound scheduled to measure her cervical length
tomorrow.
From my research, I know that progesterone should be dominant in the first
trimester overriding any oxytocin effects brought on by nipple stim with
nursing. The uterus should not be effected by oxytocin until much later in the
pregnancy when it is time to go into labor i.e. receptor sites, ripeness, etc. I
am wondering if this gal is actually beginning a miscarriage not related to
nursing but just happens to feel the cramps while nursing due to a possible
low progestone level (as often noted with impending losses) hence the
oxytocin being able to overide it?
{I myself noted the hormonal shift first hand 2 yrs ago when I had a loss while
at the same time nursing a toddler. I never felt any cramps or contractions
ever while nursing until 2 days after they determined my fetus had no
heartbeat. Things changed dramatically after that & I actually felt like I was
going in to labor every time my 2 year old nursed by day 3. (I was 12 wks
preg. to the day.) My midwives said that nursing probably expediated the
process naturally & saved me from having to have a dreaded D&C. I ended up
miscarrying at home (my choice) & thanked God for still having a
nursing "baby" to get me through one of the saddest times of my life.}
I don't wish a miscarriage on anyone but my question is this... can oxytocin
truly be a miscarriage "causer" is some situations? How far along or early can
one be for oxytocin to be a risk factor? I understand if a woman is 24 wks
preg and has contractions (and/or a hx of preterm labor) that she should
wean but what about someone only 8 wks?!
My client said that SHE is "ok" with weaning now but the TODDLER does not
seem ready. She would continue nursing as long as the child likes but is torn
because she does not want to risk "losing the new baby because she couldn't
stop breastfeeding the other". On the other hand, I am thinking... what if she
is miscarrying (not related to nursing) but she goes ahead and weans thinking
it is effecting her pregnancy and ends up losing the baby along with the
comfort and relationship of nursing with the surviving child. I also don't want
her to subconsciously "blame" the 16 mos old if she does lose this pregnancy
although it obviously would not be anyone's fault. Maybe she is not
miscarrying at all - spotting & cramps can also be normal in the first trimester.
I would also hate to see her wean if all is well! Oh, I have lots of thoughts on
this!
My plan is to give this mom the info I have and I guess encourage her to
follow her gut. Any thoughts from anyone? Any experience with this? Please
respond as I could use the support.
Thanks. Jackie
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