Determining pregnancy while breastfeeding is challenging because many early symptoms overlap with postpartum recovery and lactation. Hormonal shifts during this period can mimic or mask common pregnancy signs.
Typical Pregnancy Signs and Breastfeeding’s Influence
Common early signs of pregnancy include a missed menstrual period, breast tenderness, fatigue, and nausea. A missed period is often the first indicator for many, but for breastfeeding individuals, this sign can be unreliable. The hormone prolactin, which supports milk production, can suppress ovulation and delay the return of menstruation for months or even years after birth.
Breast changes, such as increased tenderness or soreness, commonly occur in early pregnancy due to hormonal fluctuations. However, breastfeeding itself can cause sore nipples or general breast discomfort from factors like latch issues, engorgement, or infections. Pregnancy hormones can intensify existing nipple sensitivity, making it difficult to discern if tenderness is due to pregnancy or lactation.
Fatigue is another frequently reported symptom in early pregnancy. Yet, new parents, particularly those who are breastfeeding, often experience significant tiredness due to disrupted sleep patterns, the metabolic demands of milk production, and the effects of hormones like prolactin and oxytocin. This overlap means general fatigue alone may not be a clear indicator of pregnancy.
Nausea, or “morning sickness,” can also signal pregnancy. While pregnancy hormones are a likely cause, some individuals find that breastfeeding sessions, especially during milk let-down, can trigger or worsen feelings of nausea.
Key Indicators When Breastfeeding
Despite the overlapping symptoms, certain signs can be more indicative of pregnancy when a person is breastfeeding. One of the most common and noticeable changes is a decrease in milk supply. Hormonal shifts during pregnancy can lead to a significant drop in milk production, often around the fourth or fifth month of pregnancy, but it can occur earlier. The composition of breast milk also begins to change, transitioning towards colostrum, the first milk produced for a newborn.
Increased nipple sensitivity or pain during nursing, beyond typical discomfort, can also be a specific clue. Pregnancy hormones can make nipples extremely tender and painful, a sensation often intensified by the act of breastfeeding.
Changes in the nursing child’s behavior may also signal pregnancy. A baby might become fussy at the breast, nurse less frequently, or even self-wean due to the decreased milk supply or changes in the milk’s taste and composition.
Worsened fatigue, beyond the exhaustion typically associated with caring for a baby, could also point to pregnancy. While general tiredness is expected, sudden, overwhelming exhaustion that impairs daily functioning is a stronger indicator. Additionally, a sudden onset or intensification of nausea or morning sickness, particularly if it differs from any pre-existing nausea, can be a more reliable indicator of pregnancy.
Confirming Pregnancy and Next Steps
If pregnancy is suspected while breastfeeding, using a home pregnancy test is a practical first step. These tests are generally highly accurate. Following a positive home test, or if symptoms persist despite a negative result, consulting a healthcare provider for confirmation is important. A medical professional can provide a definitive diagnosis and initiate early prenatal care.
Continuing to breastfeed during pregnancy is typically considered safe for most healthy pregnancies. Studies indicate it does not usually increase the risk of miscarriage or preterm birth in low-risk pregnancies. However, discuss your situation with a healthcare provider, especially if there are risk factors such as a history of recurrent miscarriages, preterm labor, or if you are carrying multiples.
During this time, nutritional needs increase to support both the developing fetus and the nursing child. Pregnant and breastfeeding individuals require additional calories and nutrients, including increased intake of folic acid, iron, and calcium. A healthcare provider can offer guidance on managing milk supply changes and discuss options for tandem nursing, which involves breastfeeding both children, or planning for weaning.