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More and More Breastfeeding Myths
Handout #14. More and more breastfeeding myths.
Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005
1. Nursing mothers cannot breastfeed
if they have had X-rays.
Not true!
Regular X-rays such as a chest X-ray
or dental X-rays do not affect the milk or the
baby and the mother may nurse without concern.
Mammograms are harder to read when
the mother is lactating, but can be done and the mother should
not stop breastfeeding just to get this done. Furthermore, there
are other ways of investigating a breast lump.
Newer imaging methods such as CT scan
and MRI scans are of no concern, even if contrast
is used.
And special X-rays using contrast media?
As long as no radioactive isotope is used there is no concern
and the mother should not stop even for one feed. Herein are included
studies such as intravenous pyelogram, lymphangiogram, venogram,
arteriogram, myelogram, etc.
What about studies using radioactive nucleotides
(bone scans, lung scans, etc.)? The baby will get a little
radioactive nucleotide. However, as we often do these very same
tests on children, even small babies, and the potential loss of
benefits if the mother stops breastfeeding are considerable, the
mother should, in my opinion, continue breastfeeding. If you feel
you must stop for a period of time, express milk in advance so
that the baby can be fed your milk and not formula. After two
half lives, 75% of the compound will be out of your body. This
is surely waiting long enough (the half life of technetium, which
is used in most radioactive scans is only six hours, so that 12
hours after the injection, 75% of it will be out of your body).
The exception is the thyroid scan using I-131.
This test must be avoided in breastfeeding mothers.
There are many ways of evaluating the thyroid, and only very occasionally
does a thyroid scan truly have to be done. If the scan must be
done, doing it with I-123 requires the mother
to stop nursing for 12 to 24 hours only depending on the dose.
Check first before taking the radioactive iodine—the test
can wait until you know for sure. In many cases where the scan
must be done, it can be put off for several months. Incidentally,
lung scans with radioactive contrast no longer is the best test
to rule out a lung clot. CT scan is now the preferred test to
prove or disprove the diagnosis.
[See also handout #9a You
Should Continue Breastfeeding-1)
2. Breastfeeding mothers' milk
can "dry up" just like that.
Not true! Or if this can occur, it must be
a rare occurrence. Aside from day to day and morning to evening
variations, milk production does not change suddenly. There are
changes which occur which may make it seem as if milk
production is suddenly much less:
The birth control pill may decrease your milk supply. Think
about stopping the pill or changing to a progesterone only pill.
Or use other methods. Other drugs that can decrease milk supply
are pseudoephedrine (Sudafed), some antihistamines, and perhaps
diuretics.
If the baby truly seems not to be getting enough,
get help, but do not introduce a bottle that may only make things
worse. If absolutely necessary, the baby can be supplemented, using
a lactation aid that will not interfere with breastfeeding. However,
lots can be done before giving supplements. Get help. Try compressing
the breast with your hand to help the baby get milk (Handout #15,
Breast Compression).
3. Physicians know a lot about
breastfeeding.
Not true! Obviously, there are exceptions.
However, very few physicians trained in North America or Western
Europe learned anything at all about breastfeeding in medical school.
Even fewer learned about the practical aspects of helping
mothers start breastfeeding and helping them maintain breastfeeding.
After medical school, most of the information physicians
get regarding infant feeding comes from formula company representatives
or advertisements.
4. Pediatricians, at least, know
a lot about breastfeeding.
Not true! Obviously, there are exceptions.
However, in their post-medical school training (residency), most
pediatricians
learned nothing formally about breastfeeding, and what they picked
up in passing was often wrong. To many trainees in pediatrics, breastfeeding
is seen as an "obstacle to the good medical care" of hospitalized
babies.
5. Formula company literature
and formula samples do not influence how long a mother breastfeeds.
Really? So why do the formula companies work
so hard to make sure that new mothers are given these samples, their
company's samples? Are these samples and the literature given out
to encourage breastfeeding? Do formula companies take on the cost
of the samples and booklets so that mothers will be encouraged to
breastfeed longer? The companies often argue that, if the mother
does give formula, they want the mother to use their brand. But
in competing with each other, the formula companies also compete
with breastfeeding. Did you believe that argument when the cigarette
companies used it?
6. Breastmilk given with formula
may cause problems for the baby.
Not true! Most breastfeeding mothers do not
need to use formula and when problems arise that seem to require
artificial milk, often the problems can be resolved without resorting
to formula. However, when the baby may require formula, there is
no reason that breastmilk and formula cannot be given together.
7. Babies who are breastfed on
demand are likely to be "colicky".
Not true! "Colicky" breastfed babies
often gain weight very quickly and sometimes are feeding frequently.
However, many are colicky not because they are feeding frequently,
but because they do not take the high fat milk as well as they should.
Typically, the baby drinks very well for the first few minutes,
then nibbles or sleeps. When the baby is offered the other side,
he will drink well again for a short while and then nibble or sleep.
The baby will fill up with relatively low fat milk and thus feed
frequently. The taking in of mostly low fat milk may also result
in gas, crying and explosive watery bowel movements. The mother
can urge the baby to breastfeed longer on the first side, and thus
get more high fat milk, by compressing the breast once the baby
sucks but does not drink. (Handouts #3 Colic
in the breastfed baby and #15 Breast
Compression). See videos at www.thebirthden.com/Newman.html
8. Mothers who receive immunizations
(tetanus, rubella, hepatitis B, hepatitis A, etc.) should stop breastfeeding
for 24 hours (3 days, 2 weeks).
Not true! Why should they? There is no risk
for the baby, and he may even benefit. The rare exception is the
baby who has an immune deficiency. In that case the mother should
not receive an immunization with a weakened live virus
(e.g. oral, but not injectable polio, or measles, mumps,
rubella) even if the baby is being fed artificially.
9. There is no such thing as nipple
confusion.
Not true! The baby is not confused, though,
the baby knows exactly what he wants. A baby who is getting slow
flow from the breast and then gets rapid flow from a bottle, will
figure that one out pretty quickly. A baby who has had only the
breast for three or four months is unlikely to take the bottle.
Some babies prefer the right or left breast to the other. Bottle
fed babies often prefer one artificial nipple to another. So there
is such a thing as preferring one nipple to another. The
only question is how quickly it can occur. Given the right set of
circumstances, the preference can occur after one or two bottles.
The baby having difficulties latching on may never have had an artificial
nipple, but the introduction of an artificial nipple rarely improves
the situation, and often makes it much worse. Note that many who
say there is no such thing as nipple confusion also advise the mother
to start a bottle early so that the baby will not refuse it.
Questions?
see
my book Dr. Jack Newman's Guide to Breastfeeding (called
The
Ultimate Breastfeeding Book of Answers in the USA)
Handout #14. More and 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
