How to Recognize the Signs of Pregnancy While Breastfeeding
Breastfeeding and Pregnant?
There is a prevailing, old-fashioned belief that one can't get pregnant while breastfeeding.
Although breastfeeding may reduce a woman’s fertility, it does not prevent pregnancy.
Although new mothers usually do not ovulate before three weeks after giving birth, and a mother may not menstruate for months after giving birth, there's no way to ensure or predict exactly when her body will release its first postpartum egg, and she won't know until roughly two weeks after ovulation.
However, if she is breastfeeding her baby exclusively (no formula), day and night, she may not menstruate again for a year or even longer after delivery. In other words, the more often her baby nurses, the longer it may be before she gets her period again. ("May not" does not mean "will not," and she may get her period tomorrow, as well. The only controllable method of pregnancy prevention is contraception.)
Still, breastfeeding has been used by many mothers as a natural and effective contraceptive method. Termed the "Lactational Amenorrhea Method" (LAM), it is effective only under certain conditions. These are:
- The infant is exclusively breastfed.
- The infant is not more than 6 months old.
- The infant breastfeeds more than 6 times a day.
- Each breastfeeding session lasts at least 15 minutes.
- The mother is still amenorrheic (no menstrual flow since giving birth).
If her baby sleeps through the night at an early age, her period will probably return more quickly. The same is true if she's supplementing with formula. If some break or variation in the feeding schedule triggers ovulation, there's no way to know or predict if her body will release its first postpartum egg, and she won't find out until roughly two weeks later.
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How Does Breastfeeding Effect Pregnancy?
The stimulation of nipples that occurs during breastfeeding stimulates the hormone prolactin, which has a negative effect on the reproductive hormones. The higher the prolactin levels in the body, the less fertile one is. Prolactin restricts ovulation and prevents menstrual flow. Its levels are highest during the mother's sleep and shortly after her waking. More nighttime feedings further increase prolactin levels. Some mothers successfully stay infertile for up to 16 months by increasing their prolactin levels. Even if the above conditions have been met, it is still not a 100% effective contraceptive method.
Most women may become pregnant once their menstrual flow resumes. However, it is also possible to ovulate without any menstrual flow. The longer one remains amenorrheic, the more likely it is to ovulate without any menstrual flow. In both cases, one can get pregnant.
It is often held that breastfeeding makes pregnancy unlikely because oxytocin makes the woman's reproductive tract unsuitable for a growing embryo. Oxytocin is also one of the hormones that stimulate lactation. The uterus is thought to be contracted and unable to allow implantation and growth of an embryo. Contrary to this belief, the uterus is only sensitive to the effects of oxytocin in the 24th week of pregnancy.
Typical Baseline Prolactin Levels in Women
Not pregnant or lactating
Pregnant (at term)
7 days postpartum (lactating)
3 months postpartum (lactating)
180 days postpartum (no menstruation, lactating)
180 days postpartum (menstruation started and still lactating)
6 months postpartum (lactating)
Common Pregnancy Signs While Breastfeeding
Signs of pregnancy while breastfeeding are generally the same as those that are seen in regular pregnancy.
- The breasts become more tender than usual. Pregnancy hormones can cause the breast to be more tender. There is increased nipple sensitivity and the nipples may be sore and appear irritated. (At this point, it's important to take care of the nipples. Avoid the use of harsh soaps as they can cause dryness and increase irritation. Apply lanolin cream to moisturize, relieve soreness, and prevent cracks. It is best to air-dry nipples or pat dry with a soft towel.)
- Milk production decreases. As pregnancy hormones increase, milk production starts to decrease.
- Milk quality changes. The breast milk begins to change in quality, usually by the 3rd week of pregnancy. The milk tastes more sour or salty. The breastfeeding child may fuss about the different taste. Breast milk becomes more watery in consistency and less white in color. By the 2nd trimester, the breast milk reverts to colostrum. The mother may observe a decreased desire to feed, or the child may seem unsatisfied with breastfeeding and may need more supplemental feedings. Weaning may naturally occur at this point as the child becomes less filled and satisfied with breastfeeding.
- Implantation bleeding. This is spotting or slight bleeding caused by the implantation of the embryo into the uterine wall. It usually appears between the 6th and 12th weeks of pregnancy. This is one of the common signs of pregnancy while breastfeeding.
- Nausea and vomiting. Morning sickness is most notable during the first trimester of pregnancy. Certain food tastes and aromas can trigger nausea and vomiting. Many women report intolerance to fish. Smelling citrusy scents can help alleviate the nausea. Make sure to get enough nutrients even with the discomfort of nausea and vomiting. Eat less carbohydrate-rich food and more proteins at this stage.
- Fatigue. Breastfeeding already taxes the body's energy, and adding pregnancy will further decrease the mother's reserves. Pregnant breastfeeding mothers may notice the need for more daytime naps than usual, and there is also an overall decrease in energy throughout the day. Take more frequent naps to recharge and try to maintain a nutritious, well-balanced diet. Fruits and vegetables can help increase energy levels.
Is It Safe to Get Pregnant While Breastfeeding?
Many mothers are concerned about the safety of pregnancy while breastfeeding, but there is no real reason to worry.
For most women, breastfeeding while pregnant is a fine choice and will not harm either baby-- the one in your arms or the one growing inside. Many mothers not only continue nursing during pregnancy but continue "tandem nursing" after the new baby is born –breastfeeding both children at once.
As part of the let-down reflex related to milk production, the uterus contracts in response to the oxytocin released, so breastfeeding while pregnant may put high-risk mothers in danger of miscarriages. If the woman has a history of preterm labor, bleeding, or uterine pain, it might be wise to stop breastfeeding as a precautionary measure.
If the mother is not high-risk, then breastfeeding is generally safe during pregnancy. Of course, should a woman decide to breastfeed while pregnant, she will want to make some adjustments. Nutrition will be extremely important. Three people–the growing fetus, the breastfeeding child, and the mother–will need adequate nutrition, and dietary adjustments should be made to address the needs of all three. The diet should have more fruits and vegetables and an adequate balance of carbohydrates and proteins. Nutritional supplements like prenatal vitamins should be taken regularly.
New Baby, Unborn Baby, and Mother: How to Take Care of All Three
Nutrition. In addition to a balance diet and prenatal vitamins, the mother should add 500 to 800 calories to her normal recommended dietary allowance. Approximately 300 of those calories goes to the fetus as it grows in the uterus and from 200 to 500 calories will help her maintain adequate milk production. Increase calcium as it is needed by both the fetus and the breastfeeding child for growth and development and to avoid potential deficiencies in the mother. The fetus and nursing child extract a lot of calcium from the mother's body, which could predispose her to more cramps and even hypocalcemia.
Hydration. Drink lots of water. Keep the body hydrated throughout the day to help combat fatigue and ensure proper body processes and overall health of the fetus, child, and mother.
Rest. Fatigue may be worse than in ordinary pregnancy or in simple breastfeeding. Much energy is required to maintain the pregnancy and to provide adequate breast milk production. Get enough rest and eat more nutritionally dense foods.
Care of nipples. Due to increased nipple sensitivity occurs in response to the pregnancy hormones, estrogen and progesterone, the woman's nipples may become sore. If she's still breastfeeding, she'll need to take extra care of the nipples to reduce nipple soreness. Dryness can cause nipples to become more painful and may even lead to cracking or lead to bacterial infections. Apply nipple shields when breastfeeding, use lanolin cream. As the pregnancy progresses, the nipple soreness and breast tenderness may eventually abate.
Weaning. If the discomforts are too much to handle, it may be time to wean the child. Formula may be used to supplement breast milk and if the child is ready for solid foods, increase these with each feeding. Emotional attachment may become an issue. Deal with fussing, tantrums, or any negative reactions to weaning in a loving manner. Always assure the child of parental love. Engage in other bonding activities to let the child feel less neglected and more loved.
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