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Pregnant with second; still nurse first?
Q: I am 41 years old and pregnant with my second child, due in January. I'm currently nursing my 20-month-old, who is almost finished cutting her molars and has no interest in weaning. How bad is it, at my age, to continue to nurse while pregnant? My daughter nurses fully first thing in the morning and before bedtime; if we're home, she usually prefers a little "bubby" after her meals/snacks, and always if she's upset or feeling insecure or crabby. I'm a stay-at-home mom and finding it very difficult to turn her down—it seems so mean to take nursing away from her just because another baby is on the way. I will admit, though, that I have no desire to "tandem nurse." Any suggestions would be most appreciated.
A: Dear Roseann,

While I can appreciate your desires to continue nursing your daughter while you are pregnant, it does raise some concerns. First, it may be more physically and nutritionally demanding to be nursing and pregnant at the same time. You need an extra 500 calories a day to nurse, and 300 calories for your pregnancy. Your diet should be well-balanced with special care to take adequate calcium and liquids. In addition, nursing can stimulate contractions; if you are at any risk for preterm labor, you should be avoiding suckling as it may provoke early labor. Fatigue may become more of an issue as your pregnancy progresses, as well. Being 41 years old, pregnant, and caring for a toddler may be exhausting without the added stress of breastfeeding. Speak to your doctor about whether nursing poses any special risks for your pregnancy.

The other issue is when to wean your daughter. If you wean her before the new baby arrives, she will not associate weaning with the presence of the baby. And that may help decrease her jealousy and difficulty weaning if it can be done before meeting her new sibling. From my own personal experience of trying to wean my 2½-year-old when I had my second child, it was very difficult and caused tremendous jealousy and resentment.

When you choose to wean your daughter, allow it to be a gradual process. Each week, eliminate one feeding a day, substituting another loving activity for breastfeeding, such as reading a book together, doing puzzles or singing special songs. It may take several weeks to completely wean your daughter, but this gradual process will help your daughter adjust, and it will make it easier for your body to transition, as well.
Laura E. Stachel M.D. Obstetrician & Gynecologist