What Should I Expect While Tandem Nursing?

QUESTION

Dear Lactation Consultant,
I just found out I am pregnant with my second child. I have a 10-month-old son who is happily breastfeeding and I don't want to have to stop. What kind of issues should I be concerned about for breastfeeding while pregnant and then breastfeeding a toddler and a newborn?

ANSWER

I have worked with many women who have breastfed during pregnancy and tandem nursed (breastfeeding children who are not twins). One common issue is discomfort during breastfeeding. About half of women who breastfeed during pregnancy experience sore nipples due to hormonal changes. This passes as soon as the baby is born.

Another common concern is whether a mother can short-change the unborn baby nutritionally by nursing the older baby during pregnancy. There is no evidence that this can occur. In well-nourished mothers, no link has been found between nursing during pregnancy and the new baby's birth weight.

Once the new baby is born, many mothers are concerned about how to make sure the newborn gets the milk he needs when the older sibling is also nursing. An easy way to handle this is to plan to nurse the newborn first or to restrict the older baby to one breast at a feeding, alternating breasts at each feeding to keep milk supply even. Because milk is produced according to supply and demand, there should be plenty of milk for both.

Some mothers report an unexpected advantage to tandem nursing: the older baby often helps prevent or relieve engorgement more quickly during the first week of nursing.

-- Nancy, IBCLC

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.