1. Many women do not produce enough milk. Not
true! The vast majority of women produce more than enough
milk. Indeed, an overabundance of milk is common. Most
babies that gain too slowly, or lose weight, do so not
because the mother does not have enough milk, but because
the baby does not get the milk that the mother has. The
usual reason that the baby does not get the milk that is
available is that he is poorly latched onto the breast. This
is why it is so important that the mother be shown, on the
first day, how to latch a baby on properly, by someone who
knows what they are doing.
2. It is normal for breastfeeding to hurt. Not true!
Though some tenderness during the first few days is
relatively common, this should be a temporary situation
which lasts only a few days and should never be so bad that
the mother dreads nursing. Any pain that is more than mild
is abnormal and is almost always due to the baby latching on
poorly. Any nipple pain that is not getting better by day 3
or 4 or lasts beyond 5 or 6 days should not be ignored. A
new onset of pain when things have been going well for a
while may be due to a yeast infection of the nipples.
Limiting feeding time does not prevent soreness. (See
handout #3 Sore Nipples).
3. There is no (not enough) milk during the first 3 or 4
days after birth. Not true! It often seems like that
because the baby is not latched on properly and therefore is
unable to get the milk. Once the mother's milk is abundant,
a baby can latch on poorly and still may get plenty of milk.
However, during the first few days, the baby who is latched
on poorly cannot get milk. This accounts for "but he's been
on the breast for 2 hours and is still hungry when I take
him off". By not latching on well, the baby is unable to get
the mother's first milk, called colostrum. Anyone who
suggests you pump your milk to know how much colostrum there
is, does not understand breastfeeding, and should be
politely ignored.
4. A baby should be on the breast 20 (10, 15, 7.6)
minutes on each side. Not true! However, a distinction
needs to be made between "being on the breast" and
"breastfeeding". If a baby is actually drinking for most of
15-20 minutes on the first side, he may not want to take the
second side at all. If he drinks only a minute on the first
side, and then nibbles or sleeps, and does the same on the
other, no amount of time will be enough. The baby will
breastfeed better and longer if he is latched on properly.
He can also be helped to breastfeed longer if the mother
compresses the breast to keep the flow of milk going, once
he no longer swallows on his own (Handout #15, Breast
Compression). Thus it is obvious that the rule of thumb that
"the baby gets 90% of the milk in the breast in the first 10
minutes" is equally hopelessly wrong.
5. A breastfeeding baby needs extra water in hot weather.
Not true! Breastmilk contains all the water a baby needs.
6. Breastfeeding babies need extra vitamin D. Not
true! Except in extraordinary circumstances (for example, if
the mother herself was vitamin D deficient during the
pregnancy). The baby stores vitamin D during the pregnancy,
and a little outside exposure, on a regular basis, gives the
baby all the vitamin D he needs.
7. A mother should wash her nipples each time before
feeding the baby. Not true! Formula feeding requires
careful attention to cleanliness because formula not only
does not protect the baby against infection, but also is
actually a good breeding ground for bacteria and can also be
easily contaminated. On the other hand, breastmilk protects
the baby against infection. Washing nipples before each
feeding makes breastfeeding unnecessarily complicated and
washes away protective oils from the nipple.
8. Pumping is a good way of knowing how much milk the
mother has. Not true! How much milk can be pumped
depends on many factors, including the mother's stress
level. The baby who nurses well can get much more milk than
his mother can pump. Pumping only tells you have much you
can pump.
9. Breastmilk does not contain enough iron for the baby's
needs. Not true! Breastmilk contains just enough iron
for the baby's needs. If the baby is full term he will get
enough iron from breastmilk to last him at least the first 6
months. Formulas contain too much iron, but this quantity
may be necessary to ensure the baby absorbs enough to
prevent iron deficiency. The iron in formula is poorly
absorbed, and most of it, the baby poops out. Generally,
there is no need to add other foods to breastmilk before
about 6 months of age.
10. It is easier to bottle feed than to breastfeed.
Not true! Or, this should not be true. However,
breastfeeding is made difficult because women often do not
receive the help they should to get started properly. A poor
start can indeed make breastfeeding difficult. But a poor
start can also be overcome. Breastfeeding is often more
difficult at first, due to a poor start, but usually becomes
easier later.
11. Breastfeeding ties the mother down. Not true! But
it depends how you look at it. A baby can be nursed
anywhere, anytime, and thus breastfeeding is liberating for
the mother. No need to drag around bottles or formula. No
need to worry about where to warm up the milk. No need to
worry about sterility. No need to worry about how your baby
is, because he is with you.
12. There is no way to know how much breastmilk the baby
is getting. Not true! There is no easy way to measure
how much the baby is getting, but this does not mean that
you cannot know if the baby is getting enough. The best way
to know is that the baby actually drinks at the breast for
several minutes at each feeding (open—pause—close type of
suck). Other ways also help show that the baby is getting
plenty (Handout #4, Is my Baby getting enough milk?).
13. Modern formulas are almost the same as breastmilk.
Not true! The same claim was made in 1900 and before. Modern
formulas are only superficially similar to breastmilk. Every
correction of a deficiency in formulas is advertised as an
advance. Fundamentally they are inexact copies based on
outdated and incomplete knowledge of what breastmilk is.
Formulas contain no antibodies, no living cells, no enzymes,
no hormones. They contain much more aluminum, manganese,
cadmium and iron than breastmilk. They contain significantly
more protein than breastmilk. The proteins and fats are
fundamentally different from those in breastmilk. Formulas
do not vary from the beginning of the feed to the end of the
feed, or from day 1 to day 7 to day 30, or from woman to
woman, or from baby to baby... Your breastmilk is made as
required to suit your baby. Formulas are made to suit every
baby, and thus no baby. Formulas succeed only at making
babies grow well, usually, but there is more to
breastfeeding than getting the baby to grow quickly.
14. If the mother has an infection she should stop
breastfeeding. Not true! With very, very few exceptions,
the baby will be protected by the mother's continuing to
breastfeed. By the time the mother has fever (or cough,
vomiting, diarrhea, rash, etc) she has already given the
baby the infection, since she has been infectious for
several days before she even knew she was sick. The baby's
best protection against getting the infection is for the
mother to continue breastfeeding. If the baby does get sick,
he will be less sick if the mother continues breastfeeding.
Besides, maybe it was the baby who gave the infection to the
mother, but the baby did not show signs of illness because
he was breastfeeding. Also, breast infections, including
breast abscess, though painful, are not reasons to stop
breastfeeding. Indeed, the infection is likely to settle
more quickly if the mother continues breastfeeding on the
affected side. (Handout #9, You can still breastfeed).
15. If the baby has diarrhea or vomiting, the mother
should stop breastfeeding. Not true! The best medicine
for a baby's gut infection is breastfeeding. Stop other
foods for a short time, but continue breastfeeding.
Breastmilk is the only fluid your baby requires when he has
diarrhea and/or vomiting, except under exceptional
circumstances. The push to use "oral rehydrating solutions"
is mainly a push by the formula (and oral rehydrating
solutions)manufacturers to make even more money. The baby is
comforted by the breastfeeding, and the mother is comforted
by the baby's breastfeeding. (Handout #9, You can still
breastfeed).
16. If the mother is taking medicine she should not
breastfeed. Not true! There are very very few medicines
that a mother cannot take safely while breastfeeding. A very
small amount of most medicines appears in the milk, but
usually in such small quantities that there is no concern.
If a medicine is truly of concern, there are usually equally
effective, alternative medicines which are safe. The loss of
benefit of breastfeeding for both the mother and the baby
must be taken into account when weighing if breastfeeding
should be continued (Handout #9, You can still breastfeed).
Handout #11. Some Breastfeeding Myths. Revised January
1998 Written by Jack Newman, MD, FRCPC
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