If you get pregnant while pregnant, will your milk disappear? To feed or not to feed: lactation during a new pregnancy

Women who breastfeed mistakenly believe that it is impossible to get pregnant during lactation. This opinion is a big misconception, since medicine knows many cases when a new conception occurred just a few months after birth. A method of contraception such as lactational amenorrhea is not reliable. Ovarian function can be restored quickly and without menstrual bleeding.

Permitted contraceptives during lactation

Protect yourself from unwanted pregnancy During breastfeeding you can use condoms. This is the most reliable way contraception, which also protects against sexually transmitted diseases.

In second place in popularity among women breastfeeding are hormonal agents, which are called mini-pills. They contain minimal doses of active ingredients that do not affect lactation. The drugs block ovulation and thicken cervical mucus to prevent conception. Such means include:

• Charosetta;
• Microlute;
• Exluton.

You can protect yourself during breastfeeding with the help of an intrauterine contraceptive - a spiral. The device is installed for a period of 1 to 5 years. As an alternative, you can use spermicides - creams and suppositories.

Signs and symptoms of pregnancy

Menstruation during breastfeeding may occur after three months or be absent until the very moment of weaning. If bleeding occurs every month, it will be difficult to miss the symptoms of pregnancy. Absence next menstruation will give rise to the idea of ​​a new conception.

If there are no periods, then you can guess the new situation by the following symptoms:

• toxicosis – morning sickness or vomiting, change in taste preferences;
• indigestion - bloating, constipation or, on the contrary, diarrhea;
• fatigue and drowsiness;
• sore nipples and breast enlargement;
• increased vaginal discharge;
• colds caused by decreased immunity in the early stages.

A clear sign of pregnancy will be positive result test. The device will show a reliable answer 2-3 weeks after conception, and the new position can be confirmed by ultrasound 4-5 weeks after the expected fertilization.

Is it possible to continue breastfeeding?

Continue breast-feeding during pregnancy it is possible if it does not interfere with the new position and does not create a threat. Many mothers practice breastfeeding at early and even later. There is no specific strict time period in which a child must be weaned.

When deciding to continue breastfeeding during pregnancy, it is necessary to understand the seriousness of what is happening. During lactation, prolactin is produced, which can block the functioning of the ovaries. During pregnancy, an increased level of this hormone is undesirable, as it can threaten miscarriage. A functioning corpus luteum supplies progesterone, which can affect lactation by reducing breast milk supply. It turns out that physiological processes such as pregnancy and breastfeeding are antagonists.

If a woman wants to keep repeat pregnancy, then doctors will recommend stopping breastfeeding. Stimulation of the nipples in the early stages causes hypertonicity of the uterus. This can lead to detachment of the ovum and the formation of a hematoma. But on long term During pregnancy, preparation of nipples for breastfeeding is mandatory. It will help avoid cracking and painful sensations when the baby first latches.

Organizing breastfeeding

If there are no contraindications to maintaining breastfeeding during pregnancy, and the woman wishes to continue lactation, then organizing tandem breastfeeding is possible. Most often, mothers of similar age children or those kids who have a slight age difference resort to it. The desire to organize tandem feeding has increased in Lately. If before kids eating mother's milk, weaned for a year and transferred to a common table, now you can more often meet mothers trying to feed until 2 and even 3 years. Preserving lactation during breastfeeding has its advantages:

• the older child feels cared for and receives adequate nutrition;
• there is no need to abruptly wean the baby, and this keeps him strong mental health V this period time;
• if lactostasis and lumps form in the chest, the older child will help to quickly cope with the problem;
• both children receive sufficient quantity antibodies, which allows them to get sick less.

The disadvantages of maintaining lactation during pregnancy include:

• increased stress on the mother’s body;
• problems arise with the order of feeding of children - for the younger one this will be a necessity, and for the older one it will be a satisfaction of desires.

Whether or not to continue breastfeeding during pregnancy is a personal decision for each woman. However, before making a decision, you need to consult a gynecologist. If the doctor sees good reasons for excluding the child, then it is necessary to listen and follow the recommendations.

Many breastfeeding mothers believe that breastfeeding is a reliable method of contraception, and are very surprised to learn about new pregnancy. And some couples are not protected in postpartum period, dreaming of similar children. In both cases, a logical question arises: “Is it possible to combine pregnancy and breastfeeding?”

Gynecologists are almost unanimous in answering the question posed: “Natural feeding needs to be curtailed urgently, otherwise...”. This is usually followed by an example dire consequences such as a lack of nutrients for the fetus or the threat of miscarriage. On the other hand, statistics from countries in which it is not customary to wean a child until he refuses it himself indicate that lactation is combined with pregnancy in 12-50% of cases. And in Rus' several generations ago, when contraception had not yet become so widespread, and breastfeeding for 1-2 years was not considered a feat or stupidity, such a “coincidence” was hardly uncommon.

Stereotypes and facts

• Nipple stimulation can lead to miscarriage or premature birth

When a newborn breastfeeds, the mother's body produces the hormone oxytocin, which causes milk to flow and the uterus to contract. There is an opinion that this can cause miscarriage or premature birth.

However, the dominant hormone during most of pregnancy is progesterone, which keeps the muscles of the uterus relaxed, so until 20 weeks of pregnancy the uterus is not sensitive to the effects of oxytocin, released when the nipples are stimulated. In addition, with established lactation, the amount of oxytocin decreases to a level that is insufficient to initiate premature lactation. labor activity.

About 15-30% of pregnancies end in miscarriage. It is possible that a small proportion of these cases coincide with feeding, but it is unlikely that it is the cause of the tragic outcome.

• Lactation will take away nutrients in the fetus

Undoubtedly, breastfeeding a child while simultaneously carrying the next one is a huge burden on the mother’s body. However, wise Nature has set priorities in such a way that the substances supplied with food are redistributed in favor of the fetus, followed by milk production, and the woman’s body is supplied on a residual basis or even “incurs losses”, giving the accumulated internal resources to the children. Complete, qualitatively and quantitatively, nutrition with the addition of vitamin and mineral complexes will allow the mother not to exhaust natural reserves.

It follows from this that if there is a lack of certain nutrients, the quantity or quality of milk, rather than the supply of the fetus, may decrease. In this case, you can transfer the baby to mixed nutrition, and if the baby is more than six months old, then reduce the number of feedings and/or introduce large quantity supplementary feeding

• Taking medications needed to maintain pregnancy can harm a baby

In defiance of this argument, it is worth mentioning that most drugs contraindicated during lactation cannot be taken during pregnancy. And the list of medications that are strictly prohibited during breastfeeding, but allowed during pregnancy, is very small.

Important! It must be emphasized that all counterarguments relate only to a normal pregnancy; in pathological cases they may lose their significance.

When is combining breastfeeding and pregnancy impossible?

Due to hormonal changes in the body caused by pregnancy, the following situations sometimes arise that prevent the continuation of breastfeeding:

• the child refuses to breastfeed due to changes in the taste and composition of milk;
• severe toxicosis in the mother causes vomiting in the baby;
• severe sensitivity of the nipples makes feeding too painful;
• milk "disappears";
• feeding causes negative emotions.

Changes in lactation caused by pregnancy

High levels of pregnancy hormones estrogen and progesterone suppress milk production and milk supply decreases. And around the middle of pregnancy, milk, regardless of the mother’s nutrition, turns into colostrum. For some mothers and babies this is a reason to stop breastfeeding, for others it is not.

After childbirth, lactation is restored with new strength, and if tandem feeding does not arouse enthusiasm in the mother, then the best solution will gradually wean your older child from the breast towards mid-pregnancy. Well, if the prospect of parallel feeding of two children does not frighten the mother, then both babies will be able to fully satisfy their needs.

The minimum gap between pregnancies should be two years. During this time female body will be able to get stronger, restore reserves of vitamins and minerals spent on bearing a child And breast-feeding. For the time being, nature will take care of postpartum contraception. The first 3-4 months from conception are protected by lactational amenorrhea - the body’s ability to suppress ovulation during breastfeeding. Then this mechanism will begin to fail, and you will need additional measures protection. But sometimes pregnancy still occurs before the young mother weans the baby from the breast. What to do in this case? Let's try to look at the situation through the eyes of all participants in the process. There are three of them - the eldest child, the youngest and one mother between them.

Pediatrician's opinion

During a new pregnancy, lactation itself does not stop, and milk continues to be as necessary and beneficial for the growing child as before. The amount of nutrients and protective factors in it is optimal for the baby. However, as pregnancy hormone levels increase, the amount of lactose in milk decreases and the amount of sodium increases, which changes the taste of the product. This is where the belief comes from that pregnant woman's milk women become bitter. It would be more correct to say that it ceases to be sweet. It is possible that the baby will not like the new taste, and he himself will refuse the breast. You need to be prepared for such a turn of events. Worry that, contrary to the mother’s plans, the baby will have to be transferred to adapted mixtures, also not worth it.

The second danger is that 70% of women who become pregnant during lactation have less milk. The child does not have enough food, and without portions artificial milk and complementary feeding is indispensable. Don't be upset, everything is for the better.

Gynecologist's opinion

At pregnancy and lactation The female body experiences enormous stress – physical, mental, hormonal. There is a complex restructuring of the work of all organs and systems.

If you have a question about the combination pregnancy and breastfeeding, you need to weigh your options and consult with your doctor. He can prescribe tests and tests to determine the body's resources. Many factors are important: the age of the pregnant woman, the characteristics of the previous and real pregnancies, gestation period, psycho-emotional development already born baby.

There are other risk factors. When a baby suckles at the breast, the hormone oxytocin is produced, which stimulates uterine contractions and could theoretically trigger miscarriage. And here the opinions of experts are divided. Some say that practice shows there is no risk: the uterus is immune to oxytocin until 20 weeks of pregnancy, which means there is no threat of miscarriage. If the woman is healthy, then oxytocin even after this period does not cause uterine contractions, which can lead to premature stimulation of labor. Any sexual activity gives a similar resonance, but most couples do not stop intimacy during pregnancy, and it is not interrupted because of this.

Other gynecologists believe that there is still a danger, and therefore feeding during pregnancy may lead to complications. This is especially true for women with fibroids, threat of miscarriage and spontaneous abortions in the anamnesis. If special medications are required to maintain pregnancy, the situation will generally reach a dead end. Many of medicines are incompatible with breastfeeding, since their ingredients (hormones) are contraindicated in infants.

The supporters of these different points of view did not come to a consensus, but developed a common strategy of behavior. In accordance with it lactation should be completed in the second trimester of pregnancy, after 22 weeks. Special rules It is worth adhering to Braxton-Hicks training contractions if they occur during feeding. It is better to interrupt the baby's meal, drink water, straighten your legs, and after that you can feed the baby a little more. The main thing is not to prolong the session, which is accompanied by training contractions.

Feeding during pregnancy: diet

If, after consulting with your doctor, you are convinced that you can continue breastfeeding, you will need to reconsider your diet. Nursing pregnant woman She should eat about the same as if she was expecting twins. This is especially important for women suffering from toxicosis in I trimester of pregnancy. Nausea and vomiting limit the menu, reducing the diet to a minimum. Useful substances have to be divided among three participants in the process, and each gets very little. First of all, the body provides for the unborn baby, then lactation, and only then feeds the mother.

Poor nutrition will affect the development of children. Both may develop vitamin deficiency and related disorders. A decrease in hemoglobin in a woman’s blood can result in iron deficiency anemia she and chronic hypoxia at the youngest toddler. To ensure that your nutritional reserves are regularly replenished, you need to monitor your menu. This is especially important in the last three months of pregnancy, when youngest child growing rapidly. There is no need to eat for three; the quality, rather than the quantity, of food consumed is much more important. It is better to eat not in very large portions, but often, and to drink as much as you want, no more and no less.

Feeding during pregnancy: pros and cons

Specialists in natural feeding defend their point of view at all costs, advocating for continuation feeding during pregnancy right up to childbirth. The ideal, in their opinion, is this option: feeding is interrupted for childbirth, but after returning from the maternity hospital, the mother begins the process again, placing two toddlers at the breast. In foreign literature on breastfeeding, this method is called tandem. If the difference between children is not more than a year, then this scheme should be considered as feeding twins. Meals can be shared - each baby suckles at his own breast - or in turns. The youngest child should be allowed to go ahead. In order to have enough milk for two, you need to empty both breasts at each feeding. There is no need to take a break, even if one of the babies is sick: the milk produces antibodies to the causative agent of the disease, which will help one baby recover and the other not to get sick.

Tandem has advantages. One of them is excellent breast condition. When starting to feed a newborn in the maternity hospital, a woman will not suffer from engorgement, sudden influxes of milk or lack of milk - the baby will immediately receive as much food as he needs for normal development, and even in excess. He will not have to make any effort, milk will literally pour into his mouth - the milk ducts in the developed breast are filled instantly. There should also be no painful cracks in the nipples, but still make sure that the youngest child takes the breast correctly.

However, breast problems will still appear. Due to pregnancy, she will become very sensitive and the nipple area will become painful. This condition does not require any treatment. Perhaps to second trimester of pregnancy hormonal background will change and painful sensations will disappear, but this cannot be promised.

The second argument in favor of the tandem is psychological. Weaning for a child, if he is not ready for this, it can result in stress. And the appearance of a rival toddler in the family, who will “get” his mother’s breast, will only intensify the experience. Watching how the mother's breast - a symbol of love and protection - is used without restrictions by someone else and as yet unknown, the baby may feel abandoned, deprived and useless to anyone. Which will be reflected in his behavior. The baby will become capricious, eat poorly, sleep poorly, and may even get sick.

A mother who feels guilty because her poor judgment led to a new pregnancy and weaning of her eldest may become depressed. This will lead to psychological tension in the relationship between “mother and older child” and “elder child and younger child” with far-reaching consequences. But if, upon returning home, mom masters tandem feeding– both babies will receive their share of milk and tenderness, and such problems will not happen.

How to wean

If, nevertheless, a decision is made in favor of refusing to feed, then the baby must be weaned from the breast gradually. When favorable medical indications It is better to do this no later than 1.5-2 months before giving birth. It is believed that during this time the older child will have time to forget about his mother’s breast and will not suffer if it is taken over. little brother or little sister.

First you need to eliminate daytime feedings, replacing them with mixtures or complementary foods. The first morning, evening and night feedings should be the last to go. Switching to a new diet can be complicated by various reasons. For example, the mixture will cause allergies in the baby. At the first sign of trouble, it must be replaced.

It is possible that the baby is not satisfied with the taste of the mixture - offer another, a third. Some toddlers are happy to switch to dairy products. If the baby is already more than six months old, to improve the taste of the mixture, you can dilute it a little baby puree. There may be this option: the child will not like to drink milk from a bottle with a nipple. Try replacing it with a special spout attachment. Do not forget that after replacing breast milk with artificial analogues, the baby must be supplemented with water.

If you put your baby to your breast less and less often, the milk will subside on its own. If this does not happen, then drugs that reduce lactation will be required.

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Until recently, breastfeeding was not very common in Russia. Only 30% of babies were breastfed until they were one year old, and after one year, breastfeeding was considered indecent and harmful. Modern recommendations WHO advises mothers to exclusively breastfeed for up to six months, and maintain partial breastfeeding (breast + “civil food”) for up to 2 years and longer, if this suits the mother and baby.

When mothers breastfed for only 3-4 months, the situation of pregnancy while breastfeeding was extremely rare. However, now that a mother can feed her child at both 2 and 3 years old, very often next pregnancy occurs before the end of lactation.

The topic of breastfeeding has generally been studied rather poorly. Even doctors often have no idea about the physiology of hepatitis B. And where there is a gap in knowledge, many myths and fears always appear. Many of them are associated with pregnancy in a nursing mother.

Myth one: “As long as a woman is breastfeeding, she cannot get pregnant.”

Indeed, in most women, during intensive breastfeeding, ovulation is suppressed and pregnancy is impossible. However, after six months, children begin to eat not only breasts; accordingly, the frequency of feedings decreases, the mammary glands are stimulated less often, and prolactin levels drop. Once prolactin drops below a certain level, ovulation and fertility return. Some women are able to conceive within 1-2 months after birth, although in most nursing mothers, ovarian function is restored later - approximately when “civilian” food in the baby’s diet begins to prevail over breast milk.

The second and most common myth: “Breastfeeding contributes to miscarriage.”

Even obstetrician-gynecologists often believe in this myth, so it brings a lot of anxiety to nursing pregnant mothers. It is based on two facts. Firstly, during breastfeeding, the hormone prolactin is increased, which suppresses ovarian function in non-pregnant women. This suggests that it can also suppress the work corpus luteum, which secretes hormones that maintain pregnancy (primarily progesterone). Secondly, breastfeeding stimulates the release of oxytocin, a hormone that causes uterine contractions and, consequently, childbirth, incl. and premature. To “justify” these hormones, let’s look at the action of each of them in more detail.

Prolactin. In terms of the number of target organs, this hormone ranks first in the body, especially in the body of a woman. Currently, about 60 different biological effects of prolactin are described. This is not only an effect on the mammary glands, providing preparation for lactation and lactation itself. Not only the effect on the sex glands, suppressing the production of sex hormones. This is also the regulation of pain sensitivity. This is to ensure orgasm and a feeling of satisfaction after sex. This stimulates the immune system during illness, ensuring normal functioning nerve fibers, regulation of hair growth. During pregnancy, prolactin ensures normal water-salt exchange between mother and baby, regulates the amount and composition amniotic fluid. It protects the baby from the mother’s immune cells, provides normal development his nervous system.

Indeed, prolactin suppresses ovarian function. But from the moment the fertilized egg is implanted into the uterus, the work of the ovaries is “directed” not by the mother’s body, but by the child’s body: human chorionic gonadotropin(HCG) of the baby stimulates the development of the corpus luteum of pregnancy and the release of all the necessary hormones. Increased level progesterone blocks the connection of prolactin with receptors in many organs (otherwise milk would flow from the breast from the first weeks of pregnancy). Therefore, if the work of the ovaries is suppressed, it is not prolactin (or some other mother’s hormone) that is “to blame” for this, but most often the baby himself (in case of genetic defects and other diseases, hCG is not released enough, the ovaries do not produce enough progesterone - this leads to miscarriage ).

It should be noted that in women with hyperproactinemia not associated with lactation, various pregnancy disorders are indeed more common. However, a pathological increase in prolactin rarely occurs in isolation; it is usually associated with many other disorders: insufficiency thyroid gland, metabolic syndrome, obesity, etc. Often prolactin increases in people exposed to chronic stress, with insufficient rest and sleep, alcohol abuse and treatment with certain drugs. In these cases, problems during pregnancy are caused not so much by prolactin itself, but by the diseases that caused its increase. Accordingly, it is necessary to treat first of all not hyperprolactinemia, but the disease that led to it.

In nursing mothers, if their babies are older than 3 months, prolactin levels are not necessarily elevated. In half of the cases it will be normal, because prolactin does not increase around the clock, but “intermittently,” mainly at night.

From the eighth week of pregnancy, prolactin increases in both lactating and non-breastfeeding women. By the end of pregnancy, the level of prolactin exceeds the “non-pregnant” level by 5-10 times. Therefore, there is no point in being afraid of prolactin in itself: hyperprolactinemia is dangerous only when it is a symptom of some disease.

Oxytocin. This hormone is also called the love hormone because of its extensive effect on the human nervous system. During feeding, oxytocin helps milk release. During childbirth, it enhances uterine contractions, helping the birth of the fetus and stopping postpartum hemorrhage. Oxytocin increases during sexual arousal (and not only during sexual intercourse, but also when viewing erotic pictures and stories), it is involved in the formation of orgasm and causes contraction fallopian tubes and “absorption” of sperm into the uterus. Thus, oxytocin promotes conception. In addition, this hormone causes a feeling of affection, trust, openness in communication, and calmness in the presence of a loved one.

Most often, mothers worry about the effect of oxytocin on the uterus. However, look at how often oxytocin is released in the body. If you forbid pregnant women to feed, then logically you need to forbid them to make love, watch movies with kisses, hug their husbands and just be close to him. And also drink warm drinks, eat chocolate and listen to pleasant music, because with all these actions, oxytocin is also released, and sometimes even in large quantities.

Why doesn’t miscarriage happen to everyone, since oxytocin increases so often in the body? The fact is that to expel the baby from the uterus, uterine contractions alone are not enough; the cervix also needs to be open and “release” ovum. Oxytocin does not affect the cervix. Accordingly, if no other reasons (genetic defects, infections or due date) open the cervix, oxytocin will be safe. However, it can speed up miscarriage that was caused by other reasons.

In addition, the sensitivity of the uterine muscles to oxytocin is not the same in different time. The uterus becomes truly sensitive only in the active stage of labor. That's why healthy woman There is no point in fearing the bad effects of oxytocin.

Myth three: “If a mother breastfeeds, the baby inside will not have enough nutrients for normal development.”

This myth grows from the time when mothers did not feed longer than a year, and, therefore, a woman could only be pregnant and, at the same time, breastfeeding if she became pregnant shortly after giving birth. Pregnancy greatly depletes a woman’s body, because she needs to get 3-4 kilograms of living matter from somewhere, several liters of water, not to mention hormonal changes. Usually a woman, even if she eats well, needs several months to recover. Therefore, even if the mother does not breastfeed, an early second pregnancy will be difficult for her: the risk of anemia, problems with bones and joints, low fetal weight, etc. will increase. If the mother breastfeeds, then this is intensive feeding: the child in the first year can eat more than a liter of milk per day. Milk production requires about 800 kcal and many macro- and microelements.

Pregnancy goes completely differently if from birth to... next conception at least 9 months have passed. In this case, the body has already more or less recovered, and the hepatitis B itself is not as intense as in the first months. After a year, the child eats 1-2 glasses of breast milk per day, which is not so stressful for the mother

Therefore, it is not breastfeeding, but an early new pregnancy that can lead to nutritional deficiencies. The better the postpartum period goes, the greater the chances of carrying the next baby normally and easily.

Over 7 years of work (both as a breastfeeding consultant and as an obstetrician-gynecologist), I have repeatedly observed pregnancy in nursing mothers (including my own). Of about two dozen pregnancies, there was not a single case of premature birth or fetal growth retardation. The number of other problems did not differ from the average (or rather, it was even less than the average, since these mothers usually take special care of their health, try to eat well and lead healthy image life). The weight of the babies was usually even a little more than that of their older brothers and sisters (which, in general, is normal, even for non-lactating multipregnant women).

Despite the fact that breastfeeding does not harm pregnancy, pregnancy against the background of breastfeeding has its own characteristics

Nipple sensitivity.

This is the main “problem” of a pregnant woman who is breastfeeding.

Many mothers report sensitivity or even pain in their nipples when feeding. This can cause discomfort and even cause you to stop breastfeeding. Really, nervous system a pregnant woman undergoes significant changes: both the excitability of nerve receptors and emotional perception own feelings. Particularly difficult to bear discomfort in the chest when they are combined with toxicosis or other uncomfortable conditions of pregnancy.

It is worth noting that many children (especially if they are older than 1.5-2 years) themselves refuse to breastfeed if their mother is pregnant. This is due to the fact that the child feels the mother’s condition and tries with all his might to adapt to it. If the mother is subconsciously afraid of every feeding, the baby can meet her halfway and wean himself off the breast.

No one has the right to blame a mother if she stops breastfeeding due to sore nipples. However, if a mother wants to continue breastfeeding, it is very important to support her in this.

Firstly, it is important for mom to remember that the period hypersensitivity ends. Usually it is limited to the first trimester, although here different women everything can be very individual.

Secondly, Special attention need to be given correct application baby. Normally, the baby does not touch the nipple when feeding, because he grasps the areola far enough from it. But adult babies are often distracted, turn their heads when sucking and “move” towards the nipple. It is important to prohibit them from doing this: taking the breast and giving it correctly. It would also be a good idea to feed in a quiet, familiar environment, so that there are fewer reasons to be distracted.

It is very important to pay attention to nipple hygiene and crack prevention. It can be useful to arrange your breasts air baths, wear soft natural underwear. Some women lubricate their nipples with softening oils: cedar, olive (but not sea buckthorn - it can increase sensitivity).

Itchy nipples.

Some women experience peeling and itching of the nipple during pregnancy. This is due to more intensive renewal of the epithelium and changes in the functioning of the parapapillary glands. To alleviate the condition, you can use the same softening oils. And here special ointments It is better not to use for itching, because most of them contain steroid hormones, which are not very beneficial for both babies.

Nutrition for a nursing pregnant woman.

A nursing pregnant woman should eat well, but not “for three” in terms of quantity. Should be avoided harmful products, eat both fruits, vegetables, cereals and animal products. It is recommended to use vitamins and dietary supplements only according to strict indications: if there are signs of a deficiency of one or another element in the body. It is advisable to eat more often, but in small portions: this way nutrients are better absorbed.

The amount eaten does not increase much. Usually, it is better for a woman to focus on the feeling of hunger, and not “forcibly eat up” extra pounds.

What if you need to take medications?

Most medications that can be prescribed to a pregnant woman are compatible with breastfeeding. However, it's better here once again warn the doctor who prescribed the drug that you are feeding. In addition, it is worth discussing how breastfeeding affects the course of a particular disease. If your doctor is unsure or cannot answer your questions, you can also consult a lactation consultant (in in this case it is better to contact a consultant who has medical education, - their coordinates can be found on the AKEV website). However, remember that the breastfeeding consultant does not have enough information about you, so you should not ask him to diagnose you and prescribe treatment - he will only assess the compatibility of the medications, and you decide the need to take them only with the doctor who sees you.

To excommunicate or not?

The decision to wean or tandem feed should be made solely by the mother. Quite a lot has been written about tandem feeding, but I want to note only one nuance. After childbirth, milk changes its composition and adapts to needs youngest child. During the first 3 days, colostrum is released from the breast. The more intense the sucking, the faster the colostrum will be replaced by transitional milk. It is very important for a newborn to receive as much colostrum as possible, so during these three days it is advisable not to breastfeed the older one or give it as rarely as possible.

Different specialists (gynecologists, pediatricians, psychologists) disagree on the optimal interval between pregnancies. Usually the figures range from 9 months to 4 years. But the last word In any case, it remains with the mother. The main thing is to remember that breastfeeding cannot become a reason for termination of pregnancy, and pregnancy is not an absolute indication for completing breastfeeding. Feeding during pregnancy has its own characteristics (sometimes difficulties). But in itself it does not harm pregnancy. And - most importantly - all problems can be solved, as long as there is a desire to solve them.

obstetrician-gynecologist, breastfeeding consultant

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Many women who have recently given birth find out about their new pregnancy while breastfeeding. Of course, sometimes this is planned, but most often the mother perceives the birth of a new life as a surprise, since she relied on the natural contraceptive effect during lactation. In any case, the woman faces a serious question: whether to continue breastfeeding her older child or interrupt the process. Will lactation harm a new pregnancy?

What is the lactation period in pregnant women

The ability to breastfeed during pregnancy, in general, is inherent in the female body by nature itself. Our distant ancestors did not even think about this issue.

Today, doctors believe that the optimal break between two pregnancies for a woman should be at least two years. This time is needed to fully recover after childbirth and replenish the nutritional costs associated with breastfeeding. If the mother finds herself in the “position” earlier than the specified period, then her body is forced to work in an enhanced mode, spend additional resources to support the new life that has arisen in it, and at the same time also support the lactation process. However, in life it is impossible to plan everything in advance, and many breastfeeding women soon after giving birth find out that there will soon be a new addition to their family.

Of course, it is optimal to maintain an interval between two pregnancies of at least two years, but in life it is impossible to plan everything

Meanwhile, the problem of the possibility of lactation during pregnancy is relevant, as a rule, in developed countries. In modern third world states, characterized by poverty and low level With the development of medicine, women, as in ancient times, still successfully combine breastfeeding with childbearing.

Thus, according to statistics, in Guatemala half of pregnancies coincide with breastfeeding. On the island of Java this figure is 40%, in Senegal - 30%, in Bangladesh - 12%.

Breastfeeding during a new pregnancy has its own characteristics. Mothers who have encountered this note the following nuances:

1. Excessive nipple sensitivity, general breast soreness. This is due to natural hormonal changes during pregnancy (especially if the woman has always experienced similar sensations before the arrival of menstruation). You can reduce discomfort with various home remedies: cooling the nipples with ice cubes, wetting them with herbal infusions, for example, oak bark. In addition, the nipple needs to be placed deeper into the baby’s mouth - this will reduce pain.
2. Fatigue, fast fatiguability. It is especially pronounced in the early stages and is again associated with a hormonal factor (but not with the feeding process). Therefore, it is very important for a pregnant woman with a small child to have time to sleep or simply relax in those moments when the baby is sleeping. As the gestational age increases, the woman's condition will improve.
3. Change in the taste of breast milk. Under the influence of pregnancy hormones, the amount of lactose in the nutrient fluid decreases and, conversely, the amount of sodium increases. Of course, infants feel these changes, but many of them do not refuse the breast, but still willingly take it.
4. Problems with choosing a position for feeding. When the mother already has an impressive tummy, it can be difficult to attach the baby to the breast: here you have to experiment.

Photo gallery: nuances of lactation in pregnant women

During pregnancy, a woman's breasts become overly sensitive, including the nipples, so feeding can cause discomfort for the mother. When the mother already has big belly, it may be difficult to choose a position for feeding. In the early stages of pregnancy, a nursing mother gets tired quickly, so she just needs to rest when the baby sleeps

Is it possible to feed breast milk during pregnancy: pros and cons

Rejection of breastfeeding during pregnancy is associated with a number of arguments that are not justified upon closer examination:

1. During lactation, the level of the hormone oxytocin increases, which can cause miscarriage or premature birth. By stimulating the release of milk from the mammary glands, this substance simultaneously increases the contractility of the uterus. This is why the uterus of nursing mothers quickly returns to its normal state. However, the state of the organ at the beginning of pregnancy differs significantly from its postpartum condition: the uterus contains much fewer receptors that absorb oxytocin (their number increases 12 times only by the 3rd trimester). Therefore, in the first half of pregnancy, even high concentrations of the hormone do not pose a danger. In addition, the level of oxytocin is very high only in the first time after childbirth, when lactation is established. Then the body adapts and produces less of it: thus, there is no particular danger for abortion during lactation even at long term
2. gestation. The only thing that a nursing mother should not do in order to avoid artificial contractions while carrying another child is to regularly and for a long time stimulate her breasts with a breast pump. Elevated levels of the hormone progesterone reduce milk production. Indeed, many pregnant women notice this early in their pregnancy. And theoretically, lactation should fade away closer to childbirth. However, wise nature has made the process of milk synthesis reflexively dependent: if the breasts are stimulated, then a nutrient fluid will be produced in the mammary glands. In addition, the mother should maintain lactation to the best of her ability: balanced diet
3. , taking vitamins, etc. It is necessary to monitor the child’s height and weight in order to introduce supplementary feeding in case of a lack of milk.
4. Under the influence of hormones before childbirth, mature milk will be replaced by colostrum, but this is not a reason to stop breastfeeding. After the birth of another baby, it will be possible to feed the children in tandem.

Thus, in most cases, a mother who becomes pregnant again can continue to breastfeed her older child without endangering the unborn child.

In this case, lactation can be gradually completed by the time of birth or not done so that you can then feed two children in tandem.

Lactation may not be completed by the time of delivery, so then both children can be fed in tandem at once The age of the older child and his state of health play an important role.

It is advisable to breastfeed a baby longer if he was born premature, took antibiotics, is prone to allergies, has problems with the gastrointestinal tract, or is developmentally delayed (physical or psychomotor). In any case, even if the child is healthy, it is good to extend the lactation period to at least six months. Of course, a breastfeeding woman who finds out about a new pregnancy should think carefully. Mom must realize that her body still places an additional burden. Therefore, it is extremely important for her to have opportunities for proper rest (helpers are of great importance here, which not everyone has), eat very well, go for walks. fresh air , have a positive psychological attitude

. After all, children first need a healthy mother.

Before deciding to continue or end lactation during a new pregnancy, a woman should think carefully and evaluate her capabilities.

Contraindications to breastfeeding during pregnancy

1. The decision to continue or stop breastfeeding should be made together with the attending physician who is caring for the pregnancy.
2. After all, there are a number of contraindications to continuing lactation during pregnancy:
3. Woman's age (pregnancy too early or late)..
4. The general health of the mother, the presence of chronic diseases (for example, diabetes).
5. Multiple pregnancy
6. Previous miscarriages or premature births.
7. Pronounced toxicosis with weight loss in the mother.
8. Preeclampsia.
9. Threat of miscarriage.
10. Isthmic-cervical insufficiency (dilation of the cervix with increasing load ahead of schedule).
11. Applying a suture to the cervix.
12. Low hemoglobin levels in a woman (anemia), which increases the risk of intrauterine hypoxia in the fetus.

Taking certain medications.

Abdominal pain that worsens during feeding. Photo gallery: some contraindications for breastfeeding during pregnancy During pregnancy, the female body is very depleted, so it will be difficult for her to breastfeed the baby. Multiple pregnancy - and so increased load for the body, so you shouldn’t additionally breastfeed an older child
If a pregnant mother has low hemoglobin, it is better not to breastfeed her older baby

Video: pregnant mother talks about her experience of breastfeeding during pregnancy (features of each trimester)

How to stop breastfeeding without harming your pregnancy

If a mother has decided to wean her older child, it is best to do it gradually. In this case, the process of stopping feeding for the baby will be psychologically painless, and the amount of milk in women's breasts will be mammary glands will decrease naturally, without causing lactostasis and other problems.

First of all, a woman should consult her doctor. After all, during pregnancy, not all methods of suppressing lactation are allowed. For example, seemingly harmless herbal infusions and decoctions can pose a threat developing fetus and even cause a miscarriage.

Before stopping breastfeeding, a pregnant mother should definitely consult with her doctor.

The principle of gradual completion of lactation (the most optimal method during pregnancy) – a consistent reduction in the number of feedings.

First, the mother removes one daytime breastfeeding (replacing it with formula or other food), then another, etc., leaving only nighttime ones. After that they disappear too. At the same time, the woman reduces the time of each feeding. Thus, the female body will not experience severe stress, milk production will gradually decrease, and eventually disappear completely. Likewise, the weaning process will go smoothly for the baby.

You need to wean your baby from the breast gradually, sequentially eliminating feedings, first during the day, then at night. As for more radical methods, then during pregnancy they can be dangerous. For example, tightening your breasts with an elastic bandage can lead to the development of mastitis. This means mandatory antibacterial therapy , extremely undesirable during pregnancy. Chemicals

(for example, Dostinex) in the early stages can seriously harm the embryo. During the period of bearing a child, compresses on the chest using alcohol and camphor oil are not allowed (you can only use cabbage leaf

It is not advisable to wean your baby before 12 weeks of gestation. This will avoid a hormonal “surge” in the body and its consequences (termination of pregnancy). If your health allows, you need to feed the child for at least this period.

It is psychologically easier to wean a baby from the breast if he is still very small. An older baby (especially after a year) already realizes his “loss”: after all, he already needs not only food, but also close contact with his mother. He can for a long time remember with regret breastfeeding and try to resume your favorite way of eating.

If the mother does not plan tandem feeding, then she needs to stop feeding the older child before giving birth (at least a couple of months) so that the baby has time to forget about the mother’s breast.

If this is done after the youngest is born, then problems may arise: the appearance of a brother or sister will be associated in the toddler’s mind with a negative thing - weaning from his favorite food. The appearance of a “competitor” will be very difficult for a child to perceive.

If the mother does not plan tandem feeding, then the older child should be weaned before birth to avoid child competition It should be remembered that sometimes even without such a bone of contention as breastfeeding, with the appearance younger brother or sister, jealousy awakens in the older child. For example, when my husband was born, he elder sister When she was two years old, she was very upset that now all the attention in the family was switched to him. And one day the parents saw the girl trying to hit infant

with a bottle of perfume - this is how she tried to get rid of her “rival”. Of course, over time, the jealousy passed, but I can imagine how it would have worsened during that period if the fight for my mother’s breast had also been involved.

Experts' opinion Many modern pediatricians and lactation consultants fully accept the possibility of breastfeeding during pregnancy. So, Nina Zaichenko believes that this can be done unless the mother has medical contraindications and there is no discomfort when applying the baby ( severe pain in nipples, etc.). The specialist explains that a tandem is normal phenomenon

, laid down by nature itself (after all, it’s not for nothing that every woman is given about 300 eggs).

Doctor E. Komarovsky is of the opinion that although an older child can be fed during a new pregnancy, it is better to complete this process before childbirth.

...the truth is somewhere in between “quit immediately” and “feed for up to 6 months.” That is, you really should stop feeding, but do it gradually - over 1-2 months: reduce the number of feedings, reduce the length of time the baby stays at the breast, and under no circumstances pump.

E. Komarovsky

http://www.komarovskiy.net/faq/beremennost-i-kormlenie-grudyu.html

If a young mother finds out about her new pregnancy, she does not have to stop breastfeeding her older child. A woman just needs to be more attentive to her well-being and follow some rules. Meanwhile, in some situations that pose a threat to pregnancy, lactation must be completed. This should be done only in permitted ways and delicately towards the older child.