Newly Pregnant -- OB/GYN says I have to wean

[famille_huggins]

This is cross-posted on a BFing thread in the April 2011 DDC.

I just discovered I'm pregnant and am now a little over 5 weeks. This is my first time to be a pregnant nursing mom. Historically, I've had an issue with progesterone levels in pregnancy, and as a result, I have a history of recurrent loss. During my last pregnancy, my OB/GYN took a very aggressive approach to my care, and in addition to the progesterone supplementation I'd been prescribed in the past, I had my blood levels checked and my supplementation adjusted accordingly throughout the first trimester. His plan is to take the same aggressive approach with this pregnancy and any future pregnancies, which is fine with me.

When I checked in with my OB/GYN to confirm this pregnancy and to begin my bi-weekly progesterone blood checks, his nurse insisted that I had to stop nursing immediately. Our little one is 12mo, and while she still nurses, she nurses maybe twice during the day and nuzzles/nurses on and off all night while we cosleep. She eats loads of solids, so I cannot imagine she's nursing for nutritive purposes, but our relationship is still so very important to us.

I've been trying to research why I'd be told to quit breastfeeding. When I asked the nurse, she said the OB/GYN tells everyone to stop. I had her ask him if that would apply to me since I'll be supplemented and closely monitored anyway, and it does. The only information I can find online is a possible connection between low progesterone levels in nursing moms (especially moms in their mid-30's like me) which would potentially cause a miscarriage, but I ALREADY struggle with low progesterone. If I'm ALREADY at a high risk of loss because of low progesterone, and if I'm ALREADY going to have my progesterone supplemented, and if I'm ALREADY going to have my blood drawn every 3-4 days for the first 12 weeks to ensure those levels remain stable, why then should we wean?

I don't want to intentionally risk this new baby -- of course -- but I also don't want to neglect or deny the baby in my arms. I planned to nurse her for another year at the very least and let her lead the weaning, then again, I know I'd do anything to protect and care for this new baby. I am absolutely not one to do something a doctor says just because he says to do it, but I really honestly don't know what the right choice is here. If my little is just nursing for comfort, I could try comforting in other very close ways, but if I wean and lose this baby anyway (which is very possible), I know I would regret weaning. Then again, if I don't wean and miscarry, I'll wonder if things might have been different if I'd have followed doctor's orders. UGH. I'm so torn and troubled.

Does anyone have experience with or information about potential progesterone issues in relation to nursing? Honest thoughts? Seriously, let me have it...

[rightkindofme]

I had multiple losses before this pregnancy. I am still nursing my almost 27 month old. I'm a week out from my due date.

The first OB/GYN I saw this pregnancy told me I had to wean immediately. I then went and talked to my midwife and she said there isn't actually medical evidence that shows that breastfeeding is a problem unless you are on complete pelvic rest. Breastfeeding does stimulate your uterus, but so does almost everything else. I'm reading through Adventures in Tandem Nursing and I highly recommend it. I don't specifically know about progesterone supplementation with regards to nursing but I'd be surprised if it is a big issue. Most doctors are simply devoid of education with regards to breastfeeding and I just don't trust their advice on this issue.

[PatioGardener]

Originally Posted by rightkindofme

The first OB/GYN I saw this pregnancy told me I had to wean immediately. I then went and talked to my midwife and she said there isn't actually medical evidence that shows that breastfeeding is a problem unless you are on complete pelvic rest. Breastfeeding does stimulate your uterus, but so does almost everything else. I'm reading through Adventures in Tandem Nursing and I highly recommend it. I don't specifically know about progesterone supplementation with regards to nursing but I'd be surprised if it is a big issue. Most doctors are simply devoid of education with regards to breastfeeding and I just don't trust their advice on this issue.

http://kellymom.com/nursingtwo/faq/01safety.html

nak

[ChinaDoll]

Originally Posted by rightkindofme

The first OB/GYN I saw this pregnancy told me I had to wean immediately. I then went and talked to my midwife and she said there isn't actually medical evidence that shows that breastfeeding is a problem unless you are on complete pelvic rest. Breastfeeding does stimulate your uterus, but so does almost everything else. I'm reading through Adventures in Tandem Nursing and I highly recommend it. I don't specifically know about progesterone supplementation with regards to nursing but I'd be surprised if it is a big issue. Most doctors are simply devoid of education with regards to breastfeeding and I just don't trust their advice on this issue.

I agree.

I'd had a previous loss and some heavy spotting in early pregnancy while nursing ... I still didn't wean. My nursling was 12 months old and still nursing quite a bit, and DH and I decided that our first commitment was to her. (And I didn't have any problems with that pregnancy, she continued to nurse, and we tandemed for almost 2 years).

[fyrwmn]

I second 'Adventures in Tandem Nursing'! we went thru recurrent losses while trying to have our 2nd child. At one point, I actually had a dr tell me it was my fault because I was still nursing dd . This after I had already checked with the midwife I'd been seeing and been told that it was perfectly safe. My biggest regret is that I allowed that dr to scare me into weaning dd, who was 2 at the time. it took us an additional year of actively trying to concieve ds, time i could have spent nursing dd. none of my loss testing came up with any answers, so the dr had us supplementing progesterone "just in case".

By the time we concieved ds, we had switched to a new practice anyways. no midwives but very supportive dr's. i had also done alot of research and come across a midwifery study on the use of B6 leading to easier conception and aiding in the preventionof m/c. i gave it a try figuring it couldn't hurt, and was surprised to find myself pg the 1st month i tried that. we also supplemented progesterone to be on the safe side. my pg with ds was completely textbook.

We got pg with this babe when ds was 8 months old. while i was feeling very cautious, i knew he was nowhere near ready to wean, and i didn't want that either. i took B6 supplements again, as well as supplemented progesterone for the 1st trimester. at that point, ds was still nursing every 2-3 hours around the clock. my dr's were more than supportive, and not once was i told i had to wean. i'm now 28 wks along with a healthy babe and things have been pleasantly uneventful. ds is down to nursing twice most days, though some days he asks for more. i anticipate tandem nursing him and the new babe, and have been amazed at the support i've goten fom the dr's on that front as well. i won't lie, the first trimester was nerve racking and i often second guessed whether i was putting the new babe in danger, but i did my best to trust my body and trust that all the studies on bf not being a cotributing factor to m/c were right. i wish you a happy and healthy 9 months!!!!!

[maddymama]

Hi Mama,
The pps have given you some great advice. I second the idea that you shouldn't automatically wean in your situation. Maybe you could seek a second opinion on whether or not to wean by seeing a MW or another OB in your area (check that the OB knows alot about BFing..).
Maybe ask your local LLL members if they know of an OB or MW who is pro-BFing during pregnancy and would still be knowledgeable about your situation.
Good luck!
~maddymama