April 22, 2009

Breastfeeeding during pregnancy?

Is it safe to nurse during pregnancy?
Yes, in most cases. At this time no medical study has been done on the safety of breastfeeding during pregnancy so it is impossible to list any definitive contraindications. If you are having a complicated pregnancy, such as lost weight, bleeding, or signs of preterm labor, you should problem-solve your individual situation with your caregiver. Depending on your individual situation and feelings you may decide that continued breastfeeding, reduced breastfeeding, or weaning is for the best.

Mother's health
There is no evidence that a well nourished mother who nurses during pregnancy is at risk nutritionally. Breastfeeding does not increase a mother's risk for osteoporosis, even when the mother nurses during pregnancy. Breastfeeding reduces the mother's risk of breast cancer.

Nursing's health
Your child will benefit from breastfeeding into the second year and beyond. The milk is just as safe during pregnancy, but pregnancy can cause milk to dwindle and can also motivate mother and child to wean. Thus if pregnancy does cause a child to receive less milk, the child will receive proportionally fewer of milk's health advantages. Indeed, weaning before two years increases the risk of illness for a child, according to the American Academy of Family Physicians.

Is it safe to use a breastpump during pregnancy?
It is often stated that a woman should not use a breastpump when pregnant. However, there is considerable reason to believe that pumping, like breastfeeding, will not trigger preterm labor in a healthy pregnancy.

When contemplating pumping during pregnancy, it is important to consider your motives for doing so. In general, when it comes to pumping during pregnancy, your efforts are best directed elsewhere unless you are pumping to provide milk for your current nursling.

If you are pumping to provide milk for your current nursling when you are separated, this should not pose more of a problem than breastfeeding. Many working moms continue to pump through pregnancy, although pumping output will decrease due to the hormonal changes of pregnancy. Aim to keep your pumping in scale with what you were doing before pregnancy, or in scale with your baby's normal breastfeeding. Sustained and intense pumping is more of an unknown and is not recommended.

If you wish to put some expressed milk in the freezer for your unborn child, keep in mind that pumping is not likely to be very productive during pregnancy. Milk supply and pumping output will decrease due to the hormonal changes of pregnancy.
Pumping prior to birth will not increase milk production for your unborn child or otherwise enhance lactation after birth.

If you are hoping to induce labor, it is known that nipple stimulation at term (38+ weeks) can be helpful for ripening the cervix and inducing labor.

Will nursing affect the nutrition of my unborn child?
This concern is valid for malnourished mothers, but it does not appear to be grounded for well-nourished mothers. Although we do not yet have a medical study that can speak directly to the question for well-nourished mothers, we have two reasons to be quite encouraged:

-A survey of 57 mothers who had breastfed during some or all of pregnancy recorded that the babies born to these mothers had healthy birth weights (birth weights averaged 7 lb 9 oz, and ranged from 5 lb 9 oz – 10 lbs 14 oz). (Moscone 1993)
-A recent review of the available research on breastfeeding and pregnancy as separate events revealed that as long as the mother is eating enough calories of a basic mixed diet, and as long as she is gaining weight within healthy parameters, there is ample reason to believe she can provide well for herself, her fetus and her nursling. (Adventures in Tandem Nursing, 2003)

Mom Special Dietary Considerations
If a mother is reasonably well-nourished her body can continue to meet her own needs and the needs of both her unborn child/infant and the older nursling. This is especially true if the older nursling is at least a year old when mom gets pregnant. In some cases, the health care provider may recommend that the mother consume more calories and/or take prenatal vitamins (but it’s unwise to take more than one a day).

The only mothers who are likely to need special dietary consideration would be those who fall into the following categories:

If the mother is... Consider...
anemic iron
dairy-free calcium
vegan vitamin B12
taking supplemental iron adding zinc, too, but at a different time of day
unable to consume enough calories using supplements to increase calorie intake,
and decide if reduced breastfeeding would be

Pregnant and/or nursing mothers do not need additional calcium other than that normally required for their age group. The Institute of Medicine recommends that nursing mothers over the age of 18 consume 1,000 mg. of calcium daily -- the same as other adults.

Nursing and pregnant
Most mothers find that if they simply eat to satisfy their increased hunger they can easily consume enough calories to support the pregnancy and continued lactation. Let your hunger and thirst dictate how much you take in. If you feel hungry, then you need to eat, regardless of how large the amounts may seem. Some mothers notice a decrease in appetite when milk supply decreases later into the pregnancy.

Tandem nursing
A tandem nursing mother may need considerable calories, and the exact number will vary due to several factors:

-The percentage of breastmilk in the diets of the infant and older child. The more milk you are making, the more calories you will need. The Institute of Medicine estimates that a mother who is exclusively breastfeeding and does not have spare fat reserves will need an additional 650 calories; this same mother would need 500 additional calories for a baby aged 6-12 months who is getting solids. When nursing an older child who is getting less milk, calorie requirements would be proportionally less.

-Mom's activity level, weight and nutritional status. A mother who is less active, has more fat stores from pregnancy, and/or eats foods higher in nutritional value may need fewer calories than a mom who is more active, has fewer fat stores, and eats more processed foods.

As during pregnancy, let your appetite be your guide. If you are hungry, don’t be afraid to eat two of every meal and snack constantly. Fatigue can be a sign of not getting enough calories.

Source: www.kellymom.com

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