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Still more breastfeeding myths
Handout #13. Still more breastfeeding myths.
Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005
1. Women with flat or inverted nipples
cannot breastfeed.
Not true! Babies do not breastfeed on nipples,
they breastfeed on the breast. Though it may be easier for a baby
to latch on to a breast with a prominent nipple, it is not necessary
for nipples to stick out. A proper
start will usually prevent problems and mothers with any shaped
nipples can breastfeed perfectly adequately. In the past, a nipple
shield was frequently suggested to get the baby to take the breast.
This gadget should not be used, especially in the first few
days! Though it may seem a solution, its use can result in
poor feeding and severe weight loss, and makes it even more difficult
to get the baby to take the breast. (See handout #8 Finger
Feeding). If the baby does not take the breast at first,
with proper help, he will often take the breast later. Breasts also
change in the first few weeks, and as long as the mother maintains
a good milk supply, the baby will usually latch on by 8 weeks of
age no matter what, but get help and the baby may latch on before.
See handout #26 When
a Baby Refuses to Latch On.
2. A woman who becomes pregnant
must stop breastfeeding.
Not true! If the mother and child desire, breastfeeding
can continue. Some continue nursing the older child even after delivery
of the new baby. Many women do decide to stop nursing when they
become pregnant because their nipples are sore, or for other reasons,
but there is no rush or medical necessity to do so. In fact, there
are often good reasons to continue. The milk supply will likely
decrease during pregnancy, but if the baby is taking other foods,
this is not a usually a problem. However, some babies will stop
breastfeeding if the milk supply is low.
3. A baby with diarrhea should not
breastfeed.
Not true! The best treatment for a gut
infection (gastroenteritis) is breastfeeding. Furthermore, it
is very unusual for the baby to require fluids other than breastmilk.
If lactose intolerance is a problem, the baby can receive lactase
drops, available without prescription, just before or after the
feeding, but this is rarely necessary in breastfeeding
babies. Get information on its use from the clinic. In any case,
lactose intolerance due to gastroenteritis will disappear with time.
Lactose free formula is not better than breastfeeding. Breastfeeding
is better than any formula.
4. Babies will stay on the breast
for 2 hours because they like to suck.
Not true! Babies need and like to suck, but
how much do they need? Most babies who stay at the breast for such
a long time are probably hungry, even though they may be gaining
well. Being on the breast is not the same as drinking
at the breast. Latching
the baby better onto the breast allows the baby to nurse more
effectively, and thus spend more time actually drinking. You can
also help the baby to drink more by expressing milk into his mouth
when he is no longer swallows on his own (See handout #15 Breast
Compression). Babies younger than 5-6 weeks often fall asleep
at the breast because the flow of milk is slow, not necessarily
because they have had enough to eat. See videos at www.thebirthden.com/Newman.html
5. Babies need to know how to take
a bottle. Therefore a bottle should always be introduced before
the baby refuses to take one.
Not true! Though many mothers decide to introduce
a bottle for various reasons, there is no reason a baby must
learn how to use one. Indeed, there is no great advantage in a baby's
taking a bottle. Since Canadian women are supposed to receive 52
weeks maternity leave, the baby can start eating solids around 6
months, well before the mother goes back to her outside work. The
baby can even take fluids or solids that are quite liquid off a
spoon. At about 6 months of age, the baby can start learning how
to drink from a cup, and though it may take several weeks for him
to learn to use it efficiently, he will learn. If the mother is
going to introduce a bottle, it is better she wait until the baby
has been nursing well for 4-6 weeks, and then give it only
occasionally. Sometimes, however, babies who take the bottle well
at 6 weeks, refuse it at 3 or 4 months even if they have been getting
bottles regularly (smart babies). Do not worry, and proceed as above
with solids and spoon. Giving a bottle when breastfeeding is not
going well is not a good idea and usually makes the breastfeeding
even more difficult. For your sake and the baby's do not try to
"starve the baby into submission". Get help.
6. If a mother has surgery, she has
to wait a day before restarting nursing.
Not true! The mother can breastfeed immediately
after surgery, as soon as she is awake and up to it. Neither the
medications used during anaesthesia, nor pain medications nor antibiotics
used after surgery require the mother to interrupt breastfeeding,
except under exceptional circumstances. Enlightened hospitals
will accommodate breastfeeding mothers and babies when either the
mother or the baby needs to be admitted to the hospital, so that
breastfeeding can continue. Many rules that restrict breastfeeding
are more for the convenience of staff than for the benefit of mothers
and babies.
7. Breastfeeding twins is too difficult
to manage.
Not true! Breastfeeding twins is easier than
bottle feeding twins, if breastfeeding is going well. This
is why it is so important that a special effort should be made to
get breastfeeding started right when the mother has had twins (See
handouts #1 Breastfeeding—Starting
Out Right and #1a The
Importance of Skin to Skin Contact). Some women have breastfed
triplets exclusively. This obviously takes a lot of work and time,
but twins and triplets take a lot of work and time no matter how
the infants are fed.
8. Women whose breasts do not enlarge
or enlarge only a little during pregnancy, will not produce enough
milk.
Not true! There are a very few women
who cannot produce enough milk (though they can continue
to breastfeed by supplementing with a lactation aid). Some of these
women say that their breasts did not enlarge during pregnancy. However,
the vast majority of women whose breasts do not seem to enlarge
during pregnancy produce more than enough milk.
9. A mother whose breasts do not
seem full has little milk in the breast.
Not true! Breasts do not have to feel full
to produce plenty of milk. It is normal that a breastfeeding woman's
breasts feel less full as her body adjusts to her baby's milk intake.
This can happen suddenly and may occur as early as two weeks after
birth or even earlier. The breast is never "empty" and
also produces milk as the baby nurses. Is the baby getting milk
from the breast? That’s what’s important, not how full
the breast feels. See videos at www.thebirthden.com/Newman.html
10. Breastfeeding in public is not
decent.
Not true! It is the humiliation and harassment
of mothers who are nursing their babies that is not decent. Women
who are trying to do the best for their babies should not be forced
by other people's hang-ups or lack of understanding to stay home
or feed their babies in public washrooms. Those who are offended
need only avert their eyes. Children will not be damaged psychologically
by seeing a woman breastfeeding. On the contrary, they might learn
something important, beautiful and fascinating. They might even
learn that breasts are not only for selling beer. Other women who
have left their babies at home to be bottle fed when they went out
might be encouraged to bring the baby with them the next time.
11. Breastfeeding a child until
3 or 4 years of age is abnormal and bad for the child, causing an
overdependent relationship between mother and child.
Not true! Breastfeeding for 2-4 years was the
rule in most cultures since the beginning of human time on this
planet. Only in the last 100 years or so has breastfeeding been
seen as something to be limited. Children nursed into the third
year are not overly dependent. On the contrary, they tend
to be very secure and thus more independent. They themselves
will make the step to stop breastfeeding (with gentle encouragement
from the mother), and thus will be secure in their accomplishment.
12. If the baby is off the breast
for a few days (weeks), the mother should not restart breastfeeding
because the milk sours.
Not true! The milk is as good as it ever was.
Breastmilk in the breast is not milk or formula in a bottle.
13. After exercise a mother should
not breastfeed.
Not true! There is absolutely no reason why
a mother would not be able to breastfeed after exercising. The study
that purported to show that babies were fussy feeding after mother
exercising was poorly done and contradicts the everyday experience
of millions of mothers.
14. A breastfeeding mother cannot
get a permanent or dye her hair.
Not true! I have no idea where this comes from.
15. Breastfeeding is blamed for
everything.
True! Family, health professionals, neighbours,
friends and taxi drivers will blame breastfeeding if the mother
is tired, nervous, weepy, sick, has pain in her knees, has difficulty
sleeping, is always sleepy, feels dizzy, is anemic, has a relapse
of her arthritis (migraines, or any chronic problem) complains of
hair loss, change of vision, ringing in the ears or itchy skin.
Breastfeeding will be blamed as the cause of marriage problems and
the other children acting up. Breastfeeding is to blame when the
mortgage rates go up and the economy is faltering. And whenever
there is something that does not fit the "picture book"
life, the mother will be advised by everyone that it will be better
if she stops breastfeeding.
Questions?
see
my book Dr. Jack Newman's Guide to Breastfeeding (called
The
Ultimate Breastfeeding Book of Answers in the USA)
Handout #13. Still 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
