Breastfeeding while pregnant: is it possible?

A good diet will help meet everyone's needs — the foetus, the breastfed baby, and your own. It is simply a matter of ensuring that the diet is appropriate, with or without nutritional supplements. A normal weight gain should be observed, and you should consume foods that are sufficiently nutritious for everyone.

One analysis showed that continuing to breastfeed during pregnancy did not affect foetal development [2].

However, it is advisable to take a pregnancy vitamin, at the very least B9, to ensure that high nutritional needs are covered. 

Your milk is still nourishing, even if its composition changes with pregnancy, particularly towards the end.

Milk supply can indeed decrease, to varying degrees depending on the individual. However, this reduction is most commonly seen towards the end of pregnancy.

After the first trimester (around week 16), your milk may gradually change. It can transition into colostrum, which may have a mild laxative effect on the breastfed child [3]. However, if your child is over 6 months old and has started weaning onto solids, they will not be affected. If they are under 6 months, their growth should be monitored. Do not hesitate to consult an IBCLC if you have any concerns!

Regarding the presence of growth hormones in breast milk, these are only found in very small quantities. Newborns are in fact exposed to the same hormones, present in the blood at considerably higher levels [4].

According to the WHO, it is preferable to continue breastfeeding during a new pregnancy, whilst improving dietary intake, particularly if appropriate weaning foods are not available [5]. 

One of the main concerns about continuing to breastfeed while pregnant is that nipple stimulation through breastfeeding could trigger uterine contractions.

Few scientific studies have been conducted on this topic, but it appears that breastfeeding concurrently with a pregnancy does not constitute an additional risk to its outcome [6].

The risk of miscarriage is not increased 

Another clinical study from 2009, conducted in Japan, observed 110 mothers whose breastfeeding and pregnancy periods overlapped and 774 others for whom this was not the case. They found that the risk of miscarriage was 7.3% among those who were pregnant and breastfeeding simultaneously, and 8.4% among those who were pregnant but not breastfeeding at the same time — a non-significant difference [7].

Breastfeeding is not a risk factor for premature birth

Although nipple stimulation is used to promote cervical ripening and induce labour at the end of pregnancy, there is no evidence that the oxytocin (which generates contractions) released during breastfeeding can induce labour prematurely or cause a miscarriage [8]. This is because the oxytocin peak is not sufficient and, above all, because the uterine oxytocin receptors are not fully developed until the end of pregnancy [9]. It appears that the uterine muscle is insensitive to oxytocin until around 38 weeks, which protects the baby during pregnancy [10]. One study found that even a high dose of synthetic oxytocin (Pitocin) is unable to trigger labour until the woman has reached full term! [11]

The situation may be different for those with a history of miscarriage or premature birth, or who are carrying a multiple pregnancy, but no data exists on the subject.

Also pay attention to what you consume. If you are taking a breastfeeding food supplement, make sure it is also compatible with pregnancy. The galactagogue foods are not recommended during pregnancy. At Jolly Mama, our breastfeeding snacks and our breastfeeding herbal tea are not recommended for pregnant women. 

While breastfeeding can continue during pregnancy without risk, it is true that continuing to do so can sometimes be uncomfortable for the mother.

Nipple pain

Hormonal changes can indeed cause increased sensitivity in the nipples, or even sharp pain. 

Decrease in milk production

There may also be a reduction in milk production, meaning the infant will suckle without actually consuming milk. This can lead to wean baby, generally during the second trimester [12]. In two studies of mothers who became pregnant while breastfeeding, the majority of babies (57% and 69% respectively) had self-weaned during the pregnancy [13]. However, it is not uncommon for them to resume nursing after the birth.

Mood changes

Pregnancy can bring about mood changes, which may cause irritability during breastfeeding. 

In an analysis of over 500 breastfeeding mothers during their pregnancy, it was found that 74% of them experienced nipple pain to varying degrees, 65% noticed a decrease in their milk supply, and 57% felt some discomfort or irritation during feeds [14].

That said, continuing to breastfeed during pregnancy can also be done without any particular concern.

And if things feel more difficult: never forget, a happy mum means a happy baby! So don't put pressure on yourself, and do what feels best for you and your baby.

In these situations, the "supply and demand" production principle acts as a compensatory mechanism. It ensures that milk production remains available regardless of how many babies are nursing [15]. Our bodies are truly remarkable — just as they can adapt to nourish several babies in the case of multiple births, they can adapt to co-feeding!

It is important, however, to seek support. Physical and emotional difficulties, as well as a lack of support, are generally greater obstacles than any inability of our bodies to produce milk.

Galactagogues are ingredients that help boost milk secretion. They are not essential — the most important thing is to put your newborn to the breast on demand — but they can be a helpful addition. Our breastfeeding range contains many nutrients to support you throughout your breastfeeding journey.

During the first days of the post-partum period, colostrum is produced. It is rich in immunological components and developmental factors. It will be better suited to the newborn and should therefore be prioritised for them (though after the first few days, this is rarely a significant concern).

After that, the milk produced is "mature" and will be suitable for both children, produced in sufficient quantities to meet their needs. You are therefore free to decide how to manage your co-breastfeeding: together or separately. 
An older infant is generally more efficient at the breast and will help relieve engorgement [16].  

The only specific contraindication in the context of breastfeeding arises when an older child has oral herpes. In that case, they should not be put to the breast until the infection has healed. In the case of oral thrush, you may consider assigning a specific breast to each child.