By Jill Wilson, IBCLC

Many parents choose to continue breastfeeding their older child while pregnant and may continue to tandem nurse after the new baby is born. You may have concerns whether it is safe to continue breastfeeding while pregnant and how to manage nursing more than one child.

Breastfeeding during pregnancy:

-If your pregnancy is uncomplicated, research shows that is safe to continue breastfeeding and there is no increased risk for pre-term labor. However, if you have a higher risk pregnancy, such as multiples, history of pre-term labor, or have any concerns, speak to your OB or midwife.

-You may experience increased nipple tenderness and soreness due to pregnancy hormones. Take care to make sure your child has a good latch to help keep soreness to a minimum. You may also find it helpful to apply a nipple balm for extra relief.

-Milk supply will drop, generally in the 4^th or 5^th month, sometimes earlier. Again, this is due to pregnancy hormones. There’s not much you can do to increase milk production, such as additional pumping, as the decrease in supply is related to hormones. If you are nursing a baby under 12 months of age, who is still dependent on breast milk for their nutrition and calories, you will need to monitor your infant’s weight gain and possibly need to supplement feeds with donor human milk or formula.

-Between the fourth and eighth month of pregnancy, your milk will change to colostrum to prepare for your new baby. This change may alter the taste of your milk, possibly leading to your current nursling to self-wean. Additionally, colostrum has a natural laxative effect and may cause your nursling to have looser, more frequent stools. This is temporary.

-If you are experiencing nausea and fatigue, nursing in laid-back or side lying positions might be most comfortable for you (and may accommodate your growing belly).

Breastfeeding after you give birth:

-Your mature milk may transition faster and you may experience engorgement. Applying cold compresses several times a day will help to relieve discomfort due to fullness. Nursing your older child may also help to relieve extra full breasts.

-Prioritize your newborn’s needs by allowing your baby to nurse first. They can also nurse at the same time, letting older child feed on the side that baby has already fed from.

-You may have an over abundant supply. This is due to now providing breastmilk for two children.

-You may feel “touched out”. This is common and very normal. Look to your support system to give rest and breaks when needed.

If you have questions, please contact the Breastfeeding Center at 412-246-4726.