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More Breastfeeding Myths
Handout #12 More breastfeeding myths. Revised
January 2005
Written by Jack Newman, MD, FRCPC. © 2005
1. A breastfeeding mother has to be obsessive
about what she eats.
Not true! A breastfeeding mother should try
to eat a balanced diet, but neither needs to eat any special foods
nor avoid certain foods. A breastfeeding mother does not need to
drink milk in order to make milk. A breastfeeding mother does not
need to avoid spicy foods, garlic, cabbage or alcohol. A breastfeeding
mother should eat a normal healthful diet. Although there are situations
when something the mother eats may affect the baby, this
is unusual. Most commonly, "colic", "gassiness"
and crying can be improved by changing breastfeeding techniques,
rather than changing the mother's diet. (Handout #2 Colic
in the breastfed baby).
2. A breastfeeding mother
has to eat more in order to make enough milk.
Not true! Women on even very low calorie diets
usually make enough milk, at least until the mother's calorie intake
becomes critically low for a prolonged period of time.
Generally, the baby will get what he needs. Some women worry that
if they eat poorly for a few days this also will affect their milk.
There is no need for concern. Such variations will not affect milk
supply or quality. It is commonly said that women need to eat 500
extra calories a day in order to breastfeed. This is not true. Some
women do eat more when they breastfeed, but others do not, and some
even eat less, without any harm done to the mother or baby or the
milk supply. The mother should eat a balanced diet dictated by her
appetite. Rules about eating just make breastfeeding unnecessarily
complicated.
3. A breastfeeding mother has to
drink lots of fluids.
Not true! The mother should drink according
to her thirst. Some mothers feel they are thirsty all the time,
but many others do not drink more than usual. The mother's body
knows if she needs more fluids, and tells her by making her feel
thirsty. Do not believe that you have to drink at least a certain
number of glasses a day. Rules about drinking just make breastfeeding
unnecessarily complicated.
4. A mother who smokes is better
not to breastfeed.
Not true! A mother who cannot stop smoking
should breastfeed. Breastfeeding has been shown to decrease the
negative effects of cigarette smoke on the baby's lungs, for example.
Breastfeeding confers great health benefits on both mother and baby.
It would be better if the mother not smoke, but if she cannot stop
or cut down, then it is better she smoke and breastfeed than smoke
and formula feed.
5. A mother should not drink alcohol
while breastfeeding.
Not true! Reasonable alcohol intake should
not be discouraged at all. As is the case with most drugs, very
little alcohol comes out in the milk. The mother can take some alcohol
and continue breastfeeding as she normally does. Prohibiting alcohol
is another way we make life unnecessarily restrictive for nursing
mothers.
6. A mother who bleeds from her nipples
should not breastfeed.
Not true! Though blood makes the baby spit
up more, and the blood may even show up in his bowel movements,
this is not a reason to stop breastfeeding the baby. Nipples that
are painful and bleeding are not worse than nipples that are painful
and not bleeding. It is the pain the mother is having that is the
problem. This nipple pain can often be helped considerably. Get
help. (Handout #3 Sore
Nipples and #3b Treatments
for Sore Nipples and Sore Breasts). Sometimes mothers have
bleeding from the nipples that is obviously coming from inside the
breast and is not usually associated with pain. This often occurs
in the first few days after birth and settles within a few days.
The mother should not stop breastfeeding for this. If bleeding does
not stop soon, the source of the problem needs to be investigated,
but the mother should keep breastfeeding.
7. A woman who has had breast augmentation
surgery cannot breastfeed.
Not true! Most do very well. There is no evidence
that breastfeeding with silicone implants is harmful to the baby.
Occasionally this operation is done through the areola. These women
do have often have problems with milk supply, as does any woman
who has an incision around the areolar line.
8. A woman who has had breast reduction
surgery cannot breastfeed.
Not true! Breast reduction surgery does decrease
the mother's capacity to produce milk, but since many mothers produce
more than enough milk, some mothers who have had breast reduction
surgery sometimes can breastfeed exclusively. In such a situation,
the establishment of breastfeeding should be done with special care
to the principles mentioned in the handout #1 Breastfeeding—Starting
Out Right. However, if the mother seems not to produce
enough, she can still breastfeed, supplementing with a lactation
aid (so that artificial nipples do not interfere with breastfeeding).
9. Premature babies need to learn
to take bottles before they can start breastfeeding.
Not true! Premature babies are less stressed
by breastfeeding than by bottle feeding. A baby as small as 1200
grams and even smaller can start at the breast as soon as he is
stable, though he may not latch on for several weeks. Still, he
is learning and he is being held which is important for his wellbeing
and his mother's. Actually, weight or gestational age do not matter
as much as the baby's readiness to suck, as determined by his making
sucking movements. There is no more reason to give bottles to premature
babies than to full term babies. When supplementation is truly required
there are ways to supplement without using artificial nipples.
10. Babies with cleft lip and/or
palate cannot breastfeed.
Not true! Some do very well. Babies with a
cleft lip only usually manage fine. But many babies with cleft palate
do indeed find it impossible to latch on. There is no doubt, however,
that if breastfeeding is not even tried, for sure the baby won’t
breastfeed. The baby's ability to breastfeed does not always seem
to depend on the severity of the cleft. Breastfeeding should be
started, as much as possible, using the principles of proper establishment
of breastfeeding. (Handout #1 Breastfeeding—Starting
Out Right). If bottles are given, they will undermine the
baby's ability to breastfeed. If the baby needs to be fed, but is
not latching on, a cup can and should be used in preference to a
bottle. Finger feeding
occasionally is successful in babies with cleft lip/palate, but
not usually.
11. Women with small breasts produce
less milk than those with large breasts.
Nonsense!
12. Breastfeeding does not provide
any protection against becoming pregnant.
Not true! It is not a foolproof method, but
no method is. In fact, breastfeeding is not a bad method of child
spacing, and gives reliable protection especially during the first
six months after birth. It almost as good as the pill if
the baby is under six months of age, if breastfeeding is
exclusive, and if the mother has not yet had a normal menstrual
period after giving birth. After the first six months, the protection
is less, but still present, and on average, women breastfeeding
into the second year of life will have a baby every two to three
years even without any artificial method of contraception.
13. Breastfeeding women cannot take
the birth control pill.
Not true! The question is not exposure to female
hormones, to which the baby is exposed anyway through breastfeeding.
The baby gets only a tiny bit more from the pill. However, some
women who take the pill, even the progestin only pill, find that
their milk supply decreases. Estrogen containing pills are more
likely to decrease the milk supply. Because so many women produce
more than enough, this often does not matter, but sometimes it does
even in the presence of an abundant supply, and the baby becomes
fussy and is not satisfied by nursing. Babies respond to rate of
flow of milk, not what's "in the breast", so that even
a very good milk supply may seem to cause the baby who is used to
faster flow to be fussy. Stopping the pill often brings things back
to normal. If possible, women who are breastfeeding should avoid
the pill, or at least wait until the baby is taking other foods
(usually around 6 months of age). Even if the baby is older, the
milk supply may decrease significantly. If the pill must be used,
it is preferable to use the progestin only pill (without estrogen).
14. Breastfeeding babies need other
types of milk after 6 months.
Not true! Breastmilk gives the baby everything
there is in other milks and more. Babies older than six
months should be started on solids mainly so that they learn how
to eat and so that they begin to get another source of iron, which
by 7-9 months, is not supplied in sufficient quantities from breastmilk
alone. Thus cow's milk or formula will not be necessary as long
as the baby is breastfeeding. However, if the mother wishes to give
milk after 6 months, there is no reason that the baby cannot get
cow's milk, as long as the baby is still breastfeeding a few times
a day, and is also getting a wide variety of solid foods in more
than minimal amounts. Most babies older than six months who have
never had formula will not accept it because of the taste.
Questions?
see
my book Dr. Jack Newman's Guide to Breastfeeding (called
The
Ultimate Breastfeeding Book of Answers in the USA)
Handout #12 More breastfeeding myths. Revised
January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further permission,
on
the condition that it is not used in any context in which
the WHO code on the marketing of breastmilk substitutes is violated
