Monique Rainford

Your questions answered

I received this question from a reader a few months ago and I would like to address some of her concerns which I am sure are shared by a number of women.

Dear Dr. Rainford,

I was 36 years old in February and I have two children - my son is 20 years old and my daughter is nearly 17-years-old. My partner wants to have more children but I am not sure if it is safe to do so. I didn't have any complications in any of my pregnancies but I am worried about the length of time since my last pregnancy and about my age.

Dear Reader,

I am unaware from your letter if you have any medical illnesses but, if you are a healthy woman at age 36 there are some increased risks with having a baby at an older age, it is certainly possible to have a safe pregnancy. It has been many years since your last pregnancy, therefore, in many respects, a new pregnancy could resemble, a first-time pregnancy.

Some of the risks for women age 35 years and older include: higher risk of miscarriage; difficulty achieving pregnancy, gestational diabetes (diabetes in pregnancy); hypertension in pregnancy; placenta praevia; placental abruption and pre-term delivery. I mentioned two conditions involving the placenta. It is the organ which allows the baby to get nutrition and oxygen from the mother and is attached to the womb. Placenta praevia occurs when the placenta covers the neck of the womb or the cervix. Placental abruption is the premature separation of the placenta from the womb.

Down's syndrome

Babies born to older mothers are at an increased risk for birth defects and other genetic conditions such as Down's syndrome. However, being at higher risk for a particular problem by no means guarantees that the problem will occur. Therefore, if you have decided to have another child (this would also apply to women having their first child at this age or older), I would recommend that you visit your doctor prior to pregnancy for appropriate health screening and attend all your antenatal visits during your pregnancy. I would also recommend that you exercise regularly and maintain a healthy diet including folic acid supplementation. I have been fortunate enough to deliver many healthy babies to women over the age of 35 so if you desire another baby I encourage you start taking the appropriate steps.

Dear Dr. Rainford,

My aunt sent me your article on breastfeeding because I am seven months pregnant (31 weeks). I would like to and plan on trying to breastfeed our baby. However, I am wondering if I will be able to do so. I felt the changes that my breasts went through (tenderness, darkening of areola, enlarged nipples, etc.), but they have not gotten much bigger. They've only filled out a tiny bit. In fact, I am wearing my same bra size, just with an extender at the clasp. I keep forgetting to ask my OB during visits, because I am being monitored for other issues. Should I be concerned about the size of my breast and their ability to provide milk?

Dear Reader,

Fortunately, breastfeeding is generally not affected by breast size. Even though you have not noticed any significant change in your breast size, this is not an indication of the milk that you will produce. Breast milk is usually expressed after your baby is born and the volume you produce is directly affected by the frequency of breastfeeding. Therefore, I encourage you to continue to educate yourself to help you to successfully breastfeed your baby.