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 often result in poor feeding and severe
weight loss, and makes it even more difficult to get the
baby to take the breast. (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, sooner or
later.
2. A woman who becomes pregnant must stop breastfeeding.
Not true! If the mother and child desire, breastfeeding
can continue. There are women who 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 nor medical necessity to do so. In fact, there are
often good reasons to continue. The milk supply may decrease
during pregnancy, but if the baby is taking other foods,
this is not a problem.
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 at 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 (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.
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 26 weeks maternity leave, the baby
can be started eating solids before the mother goes back to
her outside work. The baby can even take fluids or solids
that are quite liquidy 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 going badly 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 up to it.
Neither the medications used during anaesthesia, nor pain
medications nor antibiotics used after surgery require the
mother to avoid 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
(Handout #1 Breastfeeding—Starting Out Right). Many 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.
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 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 women 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!
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.
Handout #13. Still More Breastfeeding Myths. Revised
January 1998 Written by Jack Newman, MD, FRCPC
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