When we deal with an individual case, it is much harder than when we
deal with general situations.  If the mother were pregnant without this
obstetricial history, I would have no problem in saying that nursing
should continue.

I still believe this in the case with this particular mother.  The
problem is that if she does have a miscarriage, the breastfeeding will
be blamed, if not outright, at least, by the mother in the back of her
mind, and she will likely feel quite guilty. Many pregnancies end in
spontaneous abortion, probably at least 15% of all pregnancies.

I do not think there is any data to suggest that continuing nursing is
safe or unsafe for inducing spontaneous abortion in this situation.  But
the onus is on proving breastfeeding would be a problem, and I am not
convinced that nursing can cause spontaneous abortion.  After all, to
induce labour, you need to maintain high, very high levels of oxytocin
(compared to levels with breastfeeding) for prolonged periods of time,
and that, at term.  With nursing, oxytocin levels rise briefly, to much
lower levels than one ever gets with IV drips.

Jack Newman, MD, FRCPC