Becoming pregnant while breastfeeding can cause a conundrum: should you stop nursing your child? Will breastfeeding harm the fetus in any way? Can you continue to nurse your toddler after the baby is born? Tandem nursing, the act of nursing an infant and an older sibling simultaneously, is actually a common and completely safe practice. Many moms tandem nurse behind closed doors but don’t discuss it because breastfeeding toddlers is taboo in some cultures. Also, there is deep-seated misinformation about breastfeeding that is based on old wives’ tales and ignorance that persists despite scientific studies and modern medical knowledge.
To get some answers about tandem nursing, I spoke with two experts. Jaynee Will is a Registered Nurse as well as an International Board Certified Lactation Consultant and a Registered Lactation Consultant, and Karima Khatib has been a leader of La Leche League (an international nonprofit breastfeeding advocacy group) for over 40 years.
Q: What are the benefits of tandem nursing?
Karima: Breastfeeding is a mothering tool which helps a woman achieve the nurturing relationship she hopes to have with her child. She gains a lot of close-up, eye-to-eye contact with the older baby, which she may be otherwise tempted to forget in her busy day. Tandem nursing is a practice among human beings all over the world in the past and at present. It is a natural way women mother their babies. It is an option that women should know about, and the choice should be left up to the mother and the older baby. She is the one responsible for mothering the older baby, and breastfeeding provides an excellent opportunity for her. The younger the older baby is, the more he needs to be offered this perfect nourishment and nurturing in his mother’s arms, along with his sibling.
Jaynee: The mother of a newborn may experience engorgement as her milk supply increases. If her breasts are too full, making it difficult for the newborn to latch, her toddler can help soften breast by nursing first.
Q: Is it safe to breastfeed while pregnant?
Jaynee: So many mothers and even some doctors assume that women have to wean when they become pregnant. In a healthy pregnancy, there is no need to wean. If after 24 weeks the mother experiences preterm labor, in rare cases weaning may need to take place, but can resume after delivery.
Q: Is it normal for nipples to be sore if nursing while pregnant, and if so, what can be done?
Jaynee: Nipples will likely be more tender during pregnancy. Moms can use lanolin to provide some relief. Milk supply decreases during pregnancy, so the nursing child may lose interest and nurse less, giving those sore nipples a break.
Q: Do moms need to make any changes to lifestyle or diet if breastfeeding while pregnant?
Jaynee: Unless the mother is severely malnourished, she will be able to keep up with her body’s needs, her unborn baby's needs, and produce a good milk supply. She will require more calories and more fluids. I advise my patients to listen to their bodies and eat when hungry and drink when thirsty. You want to aim for at least 64 oz. of water per day and have clear urine. Continue to take prenatal vitamins until both children are weaned. Mom's iron and Vitamin D levels should be checked by her obstetrician because, if her levels are fine, then the nursing baby won't need a supplement. Most women have low Vitamin D, especially Muslim ladies who cover so much of their skin. That's why many pediatricians automatically supplement breastfeed babies with Vitamin D. But if mom's levels are good, her breast milk levels should be fine.
Karima: I would add that the mother’s body will automatically protect the new baby, who is the most vulnerable. Thus, the milk supply goes down for the older baby to whatever level it must for the mom to provide safely for both children during pregnancy and tandem nursing. I think that this is a comfort to know. Of course, the mother must allow herself the rest she needs.
Q: What about colostrum, the antibody-rich "foremilk"? In the first day or two after the baby is born, can moms nurse their toddlers freely or does the newborn need to drink all the colostrum?
Jaynee: After delivery, for the first few days when colostrum is present, the newborn should nurse first since there is only a limited quantity of colostrum that the newborn needs. After the milk comes in, the supply will adjust to tandem nursing and there will be enough milk for both. At this point, the older child can nurse first.
Q: Can the toddler and infant nurse at different times from the same breast, or should we worry about the transfer of germs?
Jaynee: They can share breasts. Nipples secrete an antimicrobial substance. An exception to this is if one child has thrush, they should nurse from separate sides until the thrush has been treated.
The breastfeeding relationship is about so much more than milk. A child finds great comfort in his mother’s arms and a mother’s hormones respond to the suckling of her child. Weaning abruptly before a child is ready might be traumatic. It is a relief to know that expecting mothers can safely continue to breastfeed their toddler during pregnancy and after their new baby is born. Moreover, the older sibling will have a much easier time adjusting to life with a new baby if he realizes that he is not being displaced or ignored. Mom, baby, and the older sibling can enjoy relaxing moments of peace together once tandem nursing feels comfortable and easy.
The best way to tandem nurse comfortably is with a roomy, soft chair with upholstered arms. This allows mom to safely cradle the newborn on one side while the toddler sits on the arm of the chair or mom’s lap. Toddlers usually don’t nurse for very long, especially when they are also eating some solid foods, drinking from a cup, and busily exploring their environment. Sometimes a few sips of mother’s milk is all they need for reassurance.
Tandem nursing is a gift to the children, but it also can make mom’s life more peaceful. As many nursing moms know, toddler meltdowns can often be avoided or solved by cuddling and breastfeeding. It’s like a magical “calm down potion” for the child, and for the mother too! Breastfeeding stimulates the production of oxytocin, the hormone of bonding, trust, and love that increases a mother’s relaxation, decreases her stress and anxiety, and lowers her blood pressure. Tandem nursing might just be the best possible parenting hack for moms of siblings who are close in age!
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Laura El Alam is a freelance writer and editor and a first-generation American Muslim. She is the author of over 100 published articles and has written a children’s book, Made From the Same Dough, due to be released in 2023, inshaAllah. A wife and mother of five, Laura lives with her family in Massachusetts. You can visit her online at www.seaglasswritingandediting.com.