Pregnancy and breastfeeding

If you’re still breastfeeding and become pregnant, your mature breastmilk will transition back to colostrum around the end of the first trimester in preparation for whenever the new baby is born. By 4 months gestation, the placenta is large enough to suppress most milk production. Your body will prioritize your fetus over your nursling in terms of milk and produce the appropriate milk for the more vulnerable child. Colostrum is a high protein, laxative milk to help newborns poop out meconium. It is saltier in taste and thicker in consistency. Many older babies don’t care if it tastes different, but some will and may wean themselves. The supply is not likely to be able to support an infant 10 months old and younger. But if the older infant (11+ months) or toddler is eating solids and drinking other liquids, those babies may not care if they are getting milk or “dry nursing” until the next baby comes. Some choose to supplement younger babies with donor milk or may transition to formula until the new baby arrives and then continue to tandem feed with their own breastmilk again. 

Pregnancy hormones can make breasts and nipples more sensitive and uncomfortable. And these sensations often will make one want to wean or experience a nursing aversion. Toddlers may still aggressively want to nurse and it’s ok to put boundaries on your nursing. 

The typical things recommended to increase supply (additional feeding/pumping, herbs and supplements, etc.) are not appropriate and are ineffective since the placenta will continue to increase in size. Hormones supported by the placenta are what impact milk production and there’s not much you can do to combat the hormone shift as it’s needed to support the pregnancy. 

Sudden breast milk supply drop

Breastfeeding going well and all of a sudden you feel like your milk is gone? Go pee on a stick. A drastic drop in milk supply when breastfeeding has been going well can be a sign of pregnancy, even if your period hasn’t come back yet. Research shows it is safe to continue breastfeeding while pregnant and does not increase the risk of miscarriage. So there no reason to wean unless you’re a high risk pregnancy (if you are told by your health care provider that you can’t have sex, you shouldn’t breastfeed. If it’s safe to have sex, it’s safe to continue breastfeeding.) If so you are not alone—far from it.

Key points to remember when breastfeeding and pregnant:

• Milk will shift from mature milk back to colostrum around 14-20 weeks of your pregnancy to prepare for the birth. Babies under 6 months may not get enough milk from the breast alone while toddler eating solids may do fine. Monitor weight gain for babies under 1 year

• Colostrum is saltier than mature milk. Some nurslings are fine with the taste shift and others may self wean

• Aim for a total of about 600 to 800 extra calories — 300 for the fetus and 300 to 500 for milk production.

• Nipples may become extremely tender during pregnancy, especially at the beginning, due to hormone changes

• Breastfeeding aversion while pregnant is normal (feelings of stress or anxiety or wanting to stop breastfeeding)

• If your toddler always nurses to sleep, you may want to find other sleep routines to make putting older one to sleep easier when you have the new baby.

• As your belly grows, you may need to experiment with new breastfeeding positions.