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Last Updated:
Feb 11th, 2008 - 22:09:03
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Question
I am in desperate need of advice on the subject of pregnancy, breastfeeding and miscarriage. Within the last three months I have had 2 miscarriages, the first at 5 weeks+1 and the other at 5 weeks+5 gestation. I still breastfeed my 20 month-old daughter, currently about 3-4 times daily. I know that there is no evidence that breastfeeding causes miscarriage, but I am now wondering if breastfeeding is responsible for low progesterone levels, which could affect the outcome of pregnancy. My gynecologist was not willing to do any testing, but just suggested weaning, even though she claimed that breastfeedig shouldn't have an effect on my progesterone levels. I have an appointment with an endocronologist next month, but until then would like to know if breastfeeding actually does cause low levels of progesterone and whether I can safely supplement with natural progesterone the next time I become pregnant.
There seems to be little support from doctors for mothers who breastfeed long-term, and it sure would be nice to get some advice other than "why not just wean".
Kind regards,
Jenny
Answer
Dear Jenny,
Breast feeding cam profoundly affect hormone levels and this can lead to miscarriage from low estrogen and progesterone levels, even if a woman is ovulating. Whoever told you there is no evidence that breastfeeding can cause miscarriages is completely wrong. Some younger women can "get away" with breast feeding and a concurrent pregnancy, but many older ones cannot. For optimal hormonal support and nutrition for a new pregnancy, it is better if the last baby is weaned before attempting the new pregnancy.
There is much variation among different women's hormone levels during breastfeeding. For an individual woman, there also can be a big difference between early, exclusive breastfeeding with frequent night and day feedings, versus late breastfeeding with additional foods and sleeping through the night. So a few women are able to sustain a pregnancy early in breastfeeding, and more can do it later in breastfeeding, but many, especially in the 30's and older, cannot.
If you have had two miscarriages (with or without breastfeeding) you need a workup for treatable causes of miscarriage. This would include thyroid, luteal phase estrogen and progesterone levels, tests for ureaplasma and mycoplasma infection, tests for thrombophilias (antibodies which cause miscarriages) and a workup for glucose intolerance/insulin levels.
It is fine if you want to breastfeed your baby for a long time, but you should not assume that you will be able to achieve adequate hormone levels to sustain a new pregnancy at the same time. You probably need to make a realistic choice between continuing to breastfeed and avoiding pregnancy, or weaning to have the best chance for having a successful new pregnancy.
Mary L. Davenport, M.D.
Dr. Mary Davenport is an obstetrician-gynecologist in private practice in El Sobrante, California.
She graduated from Tufts University School of Medicine and completed her residency at the University of California, San Diego.
Dr. Davenport is also a Fellow of the American College of Obstetrics and Gynecology.
She has an NFP-only medical practice and is a Medical Consultant in Natural Family Planning.
She is a board member for CANFP and the American Association of Pro-Life OBGyn's.
© Copyright 2005 by CANFP
The information on this page and web site is for informational purposes only,
and is not a substitute for medical diagnosis and treatment by a physician.
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