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| Adventures in Tandem Nursing, Breastfeeding During Pregnancy and Beyond By Hilary Flower
Reviewed by: Eyla Boies MD, FAAP Hilary Flower went to the bookstore when she found that she was pregnant while still nursing her two year old to find out more about nursing while pregnant. She was surprised to find no mention of the topic in books about pregnancy, however, breastfeeding books gave it a "green light." She consulted her midwife and even though there was little hard data decided to continue to breastfeed. As Ms. Flower relates in the introduction, her experience with breastfeeding while pregnant and breastfeeding two was a wild ride with a series of highs and lows. Ms. Flower's assessment of the literature is accurate in that current obstetrical texts do not address the subject of nursing while pregnant and pediatric texts do not address tandem nursing. Furthermore, most obstetricians recommend that mothers not breastfeed while pregnant due to the risk of inducing labor with the stimulation of the breast during suckling. Most women who breastfeed while pregnant usually do so without telling their obstetrician; they usually elicit the help of a friend or midwife. Most mothers who nurse both an infant and the older sibling usually do so without consulting their pediatric care provider as I learned when the mother of a four month old in for his well child visit said, "Dr. Boies you know I am still breastfeeding my 18 month old?" As Ms. Flower recognized the contradictory advice given by medical profession as she researched the scientific literature and communicated with many experts about the safety and health issues. She also sought and received tremendous input form the "mothering universe" via email and regular mail. She received input from over 200 mothers around the world and included 224 direct quotes from 97 mothers and fathers from 10 countries in the book. Just a few of the many difficult questions tackled include: |
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Hilary Flower covers all of these questions and many more in an easy to read and delightful book. It is divided into three parts with the first covering a wide range of issues and practical advice, the second covering health issues including review of some of the applicable scientific literature, and the third a compendium of mothers' stories gathered from networking. She was reassured that a healthy woman with no risk factors was probably not putting her pregnancy at risk. She was surprised when nursing became painful in the second month of her pregnancy, and that more than half of mothers committed to breastfeeding while pregnant and tandem nursing ended up weaning. Most of the "mothering universe" agrees that it is not for everyone; but if it seems right, the pregnancy is not high risk, fetus and nurslings are healthy-go for it. Ms. Flower did not write this book to be an authoritative medical reference. Rather, she wrote it to help other mothers or those helping mothers who are breastfeeding while pregnant and tandem nursing. In addition she hopes "this collection of facts, experiences, and burning questions may be of some use to future researchers who wish to push the envelope on this important but under-researched area of human experience." As more mothers are nursing for extended periods as recommended by the American Academy of Pediatrics and other health organizations, these issues will be confronted more commonly. Even though the randomized controlled clinical trial is the gold standard by which we, as medical providers, are taught to evaluate medical information; we can use works such as this to give us insight into topics not otherwise covered in authoritative texts. It is a fun read with loads of practical advice and tales from mothers with much to share and also a critical look at the limited scientific data on the issues. I recommend it for medical providers dealing with mothers who are or are contemplating nursing while pregnant and/or tandem nursing. |
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January 12-16, 2006 - Orlando, Florida, USA
2006 International Conference on the Theory and Practices of Human Lactation Research and Breastfeeding Management Sponsored by Healthy Children's Center for Breastfeeding Phone: (508) 888-8044 Email: info@healthychildren.org Website: www.healthychildren.org March 3-4, 2006 - Berkeley, California, USA
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July 12-16, 2006 - Philadelphia, Pennsylvania, USA
Wyndham Franklin Plaza Hotel ILCA's Annual International Conference and Meeting:Interdisciplinary Breastfeeding Practice: Integration through Innovation July 24-26, 2006 - San Diego, California, USA
September 19-22, 2006 - Niagara Falls, New York, USA
August 15-19, 2007 - San Diego, California, USA
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