Postpartum Consequences of an Overlap of Breastfeeding and Pregnancy: Reduced Breast Milk Intake and Growth During Early Infancy

Abstract

ABSTRACT. Objective. Despite cultural pressure to wean when a new pregnancy occurs, some women choose to continue breastfeeding. We determined the effect of an overlap of lactation and late pregnancy on breastfeeding and growth in early infancy.Methods. We studied 133 Peruvian pregnant women who were >18 years of age, had a child <4 years old, and who then had a vaginal birth with a healthy, normal weight infant. Of the 133 women, 68 breastfed during the last trimester of pregnancy (BFP), and 65 had not breastfed during pregnancy (NBFP). On day 2 and at 1-month postpartum, 24-hour intake of breast milk and other liquids was measured. Twice weekly home surveillance documented infant morbidity and dietary intakes. Anthropometry was taken at birth and at 1 month. Maternal anthropometric, health, and socioeconomic status data were collected pre-and postpartum.Results. Pregnant BFP mothers breastfed 5.3 ؎ 4.3 times/day. BFP and NBFP infants did not differ in breastfeeding behavior or in colostrum intake on day 2. BFP infants breastfed longer per feed and per 24 hours (35.2 minutes/24 hours) than did NBFP infants; however, 1-month intakes per feed tended to be lower among the BFP infants. After controlling for confounders, BFP infants gained 125 g less than did NBFP infants (about 15% of mean weight gain). A sustained decline would result in a ؊0.7 z score change in weight-for-age by 6 months.Conclusions. A lactation-pregnancy overlap had a negative effect on early infant outcomes. Additional studies are needed to determine whether the effect continues past 1 month of age. Pediatrics 2002;109(4). URL: http://www.pediatrics.org/cgi/content/full/109/4/e56; breastfeeding, pregnancy, overlap, breast milk volume, weight gain, infant feeding, Peru.ABBREVIATIONS. BFP, breastfed during pregnancy; NBFP, did not breastfeed during pregnancy; BMI, body mass index; SES, socioeconomic status; CI, confidence interval; OR, odds ratio. M any women throughout the world breastfeed for as long as possible to give their children the nutritional, immunologic, and emotional benefits of breastfeeding. When lactation overlaps a new pregnancy, some women choose not to wean their toddlers, although there may be strong cultural taboos against continuing to breastfeed. 1,2 The practice of continuing to breastfeed during pregnancy has been reported among US women but might not be discussed with health professionals because of anticipated criticism of the practice. [3][4][5] Breastfeeding during pregnancy is more common in some low-income countries than in the United States because shorter birth intervals increase the likelihood of a pregnancy-lactation overlap.It has been suggested that an overlap could produce suboptimal outcomes for both pregnancy and subsequent lactation. 6 -8 Dairy research has demonstrated that a complete overlap of lactation during pregnancy dramatically compromises the total production of mature milk during the next lactation period. 9 -14 A dry (nonmilking) period of approximately 2 months before calving is usual in the da...

Effects of continuous lactation and short dry periods on mammary function and animal health

“…Guy et al (1994) demonstrated that prepartum milking of udder halves resulted in less concentration of IgG 1 in secretions of milked glands than in dry glands from 10 days prepartum to 1 day postpartum. Similarly, an overlap of breast feeding and late pregnancy in humans was accompanied by reduced concentration of IgG in colostrum (Marquis et al, 2002). We showed that CM reduces the IgG content of colostrum compared with cows given 30-day dry period in primiparous cows, but it had no effect on colostrum IgG content in multiparous cows (Annen et al, 2004a, Collier et al, 2004.…”

Associations between reproduction and maternal body weight: examining the component parts of a full reproductive cycle

“…Breastfeeding while being pregnant is associated with different feeding practices than breastfeeding only (eg tending to provide other liquids more frequently), and with a higher proportion of infants receiving low amounts of breast milk (Marquis & Penny, 2000). The composition of colostrum may also differ (eg lower lactoferrin and higher lysozyme concentration in milk from overlapping mothers; Marquis et al, 2002).…”

Gebeli̇k Dönemi̇nde Ve İki̇ Farkli Yaşta Kardeş Emzi̇rme: Olgu Sunumlari

“…Bu da bize birlikte emzirmenin yenidoğanın alacağı süt miktarını etkilemediğini düşündürmektedir. Bu çalışmanın sonucunda da yazarlar daha uzun süren bir kohort çalışmaya ihtiyaç olduğunu belirtmişlerdir (14). Moscone ve Moore'un retrospektif olarak yaptığı anket araştırmasında, çalışmaya katılan elli yedi anneden iki tanesi ilk üç ayda , bir tanesi de son üç ayda hamilelik ve sonraki dönemde yorulduğu için emzirmeyi bıraktığını bildirmiştir (10).…”