Breastfeeding while pg: how do the nutrients get distributed?

[LROM]

[X-posted in Breastfeeding]

Hi mommas, I'm so tired and a bit stressed out, I'm not even sure if I've asked this question already but I know I haven't seen any responses (and I don't think I did ask). But apologies if I did!

I'm still BF my 19 mo old, as well as being about 11 weeks pregnant with #2. I am VERY VERY nauseous this pregnancy (including throwing up but mostly just feeling really crappy all the time) and eating and drinking regular, healthy foods and amounts is proving a REAL challenge. I can't even take all my prenatal vitamins every day consistently (though I do my best).

I'm really concerned that maybe I'm depriving my fetus of some key vitamins and nutrients (and definitely water!) because of whatever is going out to DD in breastmilk? Is it really possible to eat maybe 1 decent meal a day (sometimes not that) and not drink nearly enough liquids (usually about 10 or 15 oz of liquid TOTAL in a day) and still be getting enough to your fetus?

Re: the nausea, I'm on zofran but my nausea seems to be much worse this time and the zofran seems to be less effective this time. I spend a huge amount of the day just feeling like crap and not wanting to eat or drink anything (and often throwing up because I'm not eating, though I try).

Any advice/thoughts/miracle cures? Soooo appreciated if you do!

[MaerynPearl]

everything goes to the fetus first, then anything left over goes to your breast milk. If there is anything left after that, your body gets it.

So the one being deprived is you, not your baby.

Taking prenatal vitamins consistently will help a LOT especially because you cannot eat right now.

Luckily your 19mo probably doesn't need a horrible large amount of nutrition from breastmilk with eating other foods too.

[finnegansmom]

I've nursed a few times (3) while pregnant and can say, I noticed a big dip in milk supply, especially when my nursling was older (my first was 13 months at the beginning).
I think that cutting back on milk production might be a way your body is helping the fetus.
You are last in line - so your baby, your nursling - then you. Drink water, juice, gatorade, ginger ale, whatever you can force into yourself. Being nausous + nursing + being pregnant = all bets are off. I find myself requiring those bottled Vitamin Waters, normally I don't buy those types of drinks but I bought a ton of them this time around.

Try to eat the foods you can stomach that are high in liquids.... fruit, applesauce, oatmeal, soups, whatever and stay away from caffiene.

Don't beat yourself up over not taking the prenatals everyday....they can be such a nightmare to keep down, I'm 13 weeks now and still dry heave and gag on them even though most of my MS is gone...it's just an association thing now but they are just gross, if I miss a day or two a week, I still consider that a win.

[Ellen Griswold]

Originally Posted by MaerynPearl

everything goes to the fetus first, then anything left over goes to your breast milk. If there is anything left after that, your body gets it.

So the one being deprived is you, not your baby.

Taking prenatal vitamins consistently will help a LOT especially because you cannot eat right now.

Luckily your 19mo probably doesn't need a horrible large amount of nutrition from breastmilk with eating other foods too.

Yes to all of this!

But I wanted to add that that is a very very low amount of liquid that you mentioned. Be super careful of getting dehydrated - something that would be stressful to all of you.

[MaerynPearl]

FWIW... staying well hydrated is enough to keep some women from even getting sick! Not myself, but my DHs cousin who is due the same day as me found that as long as she drank some every time she woke up at night and as soon as she got up, plus throughout the day, she would not get nauseous or dizzy.

[rparker]

Nutrients go to 1) fetus 2) lactation 3) you. So the only way your fetus is being deprived of nutrients is if your nausea is severe enough that you're not keeping enough down to meet those needs; it's the same as if you weren't nursing.

I'm sorry the Zofran isn't helping you very much. It's probably the one thing that let me keep down enough food/water to have the energy to keep nursing my two year old during this pregnancy. (I lost twice as much weight during my first pregnancy during which I didn't take Zofran.) There are other medication options for nausea that you could discuss with your HCP, but you'd probably want to double check a reference like Hale's to see if they're breastfeeding compatible. Unisom actually seems to help some women more than Zofran but for some reason (which I've yet to get a clear answer on) isn't recommended while breastfeeding.

[finnegansmom]

I've actually read that Unisom (doxylamine succinate) is OK while nursing for MS.
I guess not enough even gets transferred to the BM? I don't have a hale's book but let me see if I can get references...

You can at least take b6...I took it for the first couple of months and seemed to help.

[rparker]

Originally Posted by finnegansmom

I've actually read that Unisom (doxylamine succinate) is OK while nursing for MS.

Amazon allows a free search of the 2004 edition of Hale's (not the most current) which lists Unisom as an L4, but it doesn't give a whole lot of info. Based on the little it does say and my husband's theories (he's a pediatrician) it has to do with the possibility of any amount of Unisom causing apneas in newborns/infants.

So the warnings probably aren't applicable to nursing toddlers but (for me personally) it's still kind of scary to take something that Hale says is an L4. Anecdotally, I did take it for a week during this pregnancy before I read a warning about it (on MDC) and observed no adverse effects in my 2 year old. My milk supply, however, did seem to decrease that week. I know that that can also be caused by pregnancy, but it seemed to rebound after I quit taking the Unisom. (Other antihistamines have no effect on my supply.)

[Peony]

Just an FYI, 2010 Hale's has Unisom listed as an L3.

[LROM]

First off, THANK YOU SO MUCH for your responses!!! It is **so** comforting to know the fetus is 1st in the pecking order for where nutrients go... I feel a lot better knowing that. And yes, DD is probably doing fine with the food she's eating regardless of breastmilk (although on weekend days when I'm with her all day she's still nursing more than eating solid food...). But she seems fine and her Ped isn't worried so I won't worry either.

And thanks to whoever suggested I try drinking a bit at night every time I wake up. I've even thought of trying to keep a granola bar or something by the bed as well, but the truth is for some reason I am even LESS inclined to eat at night than I am during the day. But maybe I just need to push through that and see how I feel.

I'd also forgotten that gatorade and vitamin waters helped a bit during pg #1 so i will try those again as ways to try to get more liquids/water in me.

You all are the best, thanks so much for the info. And I'll talk to my doc about whether to try something other than zofran. I could also experiment with not taking zofran for a couple days cuz maybe it's working a lot better than I think it is... but that experiment sounds really scary!

Thanks!

[finnegansmom]

Originally Posted by Peony

Just an FYI, 2010 Hale's has Unisom listed as an L3.

Is it listing Unisom or is it listing doxylamine succinate?
Unisom Sleeptabs contain doxylamine succinate while the others contain something else (diphenhydramine HCl) which is also an antihistimine. I know when I went to look for the unisom during my last pregnancy to take because I was SO sick, I couldn't find the "right" kind.

Regardless, having contimplated using the combo (like Diclectin in Canada) I was surprised to hear it was pulled from the US market in the 80s because of allegations of fetal limb defects...(yikes)

http://drugsafetysite.com/doxylamine/

You should definatley try to take even just the b6...I've been pregnant 4 times and always have really bad morning sickness/nauseau and this time I really really made an effort to take my prenatals as often as I could tolerate (usually I just bag them for the first trimester) as well as 100mg of b6 and I found myself feeling better (not great, but not as horrible) as I had in the past. One of the Vitamin Waters has a bunch of Bs in it...maybe revive?