Breastfeeding is greatly encouraged and has proven to provide short and long term benefits to both mother and baby. It should ideally continue until the child reaches the age of two. This is in line with policies from the World Health Organisation (WHO) and the Ministry of Health, Malaysia. However, breastfeeding mothers often get pregnant before completing the breastfeeding period for their previous child. The decision to continue breastfeeding or not becomes a dilemma to these mothers.
Breastfeeding during pregnancy has become a topic for debate among medical practitioners. This is because several factors need to be taken into consideration, namely the risk of miscarriage, pre-mature contractions and the fetus’ growth and development.
Breastfeeding and risk of miscarriage
Miscarriage during early pregnancy occurs due to many actors, for example genetic abnormalities, poorly controlled blood glucose levels in diabetic patients and congenital viral infections. Theoretically, breastfeeding stimulates the production of the hormone oxytocin, which is responsible for the production of breast milk, through the baby’s suckling. This hormone also causes uterine contractions, which could result in miscarriage. However, most studies do not find any direct relationship between breastfeeding while pregnant and miscarriages.
Breastfeeding and the fetus’ growth
During pregnancy, a balanced diet needs to be taken seriously especially if the mother wants to breastfeed while pregnant. An oft heard myth is that breastfeeding during pregnancy has a negative impact of the fetus’ growth. A study conducted in Guatemala showed that there is no significant difference between the birth weight of the newborns from a group of mothers who breastfed during pregnancy and those who did not breastfed during pregnancy. In another study conducted in Peru, it was found that less food intake from the animal protein group could cause low birth weight in infants regardless of whether the mothers breastfed during pregnancy or not.
Breastfeeding and premature contractions
There are a variety of hormones that could influence the pregnant mother’s bounty, including prolactin and oxytocin. However, these hormones are usually in balanced amounts till delivery and, subsequently, the start of breastfeeding. The concern is that breastfeeding during pregnancy will increase oxytocin levels that will then trigger premature contractions.
Many studies do not find any relationship between breastfeeding during pregnancy and contractions or premature birth, although there are pregnant mothers who have felt contractions during breastfeeding. The contractions typically dissipate once the breastfeeding session is complete. However, mothers need to be vigilant and on the alert for signs of frequent and incessant premature contraction persistent in between breastfeeding – urgent medical attention may be needed. Mothers with a history of premature birth, are pregnant with twins or are at risk of premature birth are advised to stop breastfeeding while pregnant.
Breastfeeding during pregnancy from the perspective of Islam
Islam is a beautiful religion that eases matters. A pregnant woman is permitted to continue breastfeeding her child for as long as it does not endanger herself, the child in the womb and the breastfeeding child. In a hadith narrated by Muslims whereby Judama binti Wahab Al-Assadia heard the Prophet Rasulullah S.A.W decreed:
“I have initially intended to prohibit “al-ghilah” (breastfeeding during pregnancy) until I was informed that the Romans and Persians do it and there was no detrimental effect on their children (I then desisted to prohibit it)”
According to scholars, al-ghilah carries two different meanings, the first of which is intercourse between the husband and the breastfeeding mother, and the second is breastfeeding during pregnancy. This hadith demonstrates that Rasulullah did not prohibit breastfeeding during pregnancy and has clarified the justification for it.
In conclusion, breastfeeding during pregnancy is safe and can be continued if the mother and child in the womb are both healthy, and there are no complications during pregnancy. However, it is better if the breastfeeding period is completed first to achieve good spacing between pregnancies.
Dr. Nurjasmine Aida Binti Jamani is a Specialist/Lecturer in Family Medicine. This article was translated by Suzanna Zainal Abidin from https://www.mmgazette.com/adakah-penyusuan-ketika-hamil-selamat-dr-nurjasmine-aida-binti-jamani/
References:
- HD Flower. Breastfeeding during pregnancy: Moving from fear to instinct. Midwifery Today.2003
- Irene Cetin, Paola Assandro, Maddalena Massari et al. Breastfeeding during Pregnancy: Position Paper of the Italian Society of Perinatal Medicine and the Task Force on Breastfeeding, Ministry of Health, Italy.J Hum Lact 2014
- Breastfeeding while pregnant. (May 2004). Retrieved from http://islamweb.net/Breastfeeding while pregnant
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]