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FAQ
LIST:
• I'm
worried I won't be able to produce enough
milk to breastfeed my baby.
• I
have had breast surgery (reduction/augmentation). Can I still
breastfeed?
• My
nipples are flat/inverted. Will I be able to breastfeed?
• Is
it true that it is easier for a baby to bottle feed than to breastfeed?
• Aren't
modern artificial baby milks a faithful reproduction of breastmilk?
• If
I breastfeed, won’t I be « stuck » with my baby
24 hours a day?
• Aren't
breastfeeding mothers more tired than non-breastfeeding mothers?
• I
have to go back to work, and the thought of weaning my baby makes
me very sad. Is it possible to juggle working and breastfeeding?
• My
spouse is afraid he will feel excluded and be unable to bond with
our baby if I breastfeed.
• Can
epidurals and other pain medications during labour affect my baby's
ability to breastfeed?
• Is
it normal to have sore nipples/breasts during the first days/weeks
of breastfeeding?
• Is
colostrum sufficient for my baby during the first days of life?
• Can mixed feeding or occasional
supplements interfere with breastfeeding?
• How can I tell that my baby
is getting enough milk?
• How
long should my baby feed on each breast?
• Does my breastfed baby need
water on hot days?
• Does
my breastfed baby need Vitamin D?
• Does
formula pose a risk even if I give it to my baby only occasionally?
• Is
there really such a thing as « nipple preference »?
• If
I breastfeed, do I need to have a perfect diet?
• Do
I need to avoid certain foods/drinks?
• If I have a beer (or any other alcoholic
beverage) before breastfeeding, will my baby sleep longer?
• Will introducing solid foods help
my baby sleep through the night?
• I am a smoker. Can I still breastfeed
my baby?
• If I space out feedings, I'll have
more milk, right?
• My baby feeds more often than every
4 hours. Is there a problem with my milk supply?
• Is breastfeeding really a reliable
method of family planning?
• Does my baby still need breastfeeding
after 6 (7, 8, 9…) months?
• I am pregnant. If I continue to
breastfeed my child, am I jeopardising my unborn baby?
• If my breasts aren't engorged
between feedings and/or don't leak, does this mean I have
a low milk supply?
• Is it safe to loose weight while
breastfeeding?
• Does breastfeeding during the night
or in bed cause tooth decay?
•
I'm worried I won't be able to produce enough milk
to breastfeed my baby. [top]
This is a universal concern, though unfounded.
In fact, the inability to produce an adequate milk supply is rare,
and most mothers produce more milk than their baby needs. According
to recent studies, most babies only drink 60-65% of available
milk! Practically speaking, problems stemming from over-production
are quite common. Many factors lead mothers to think they don't
have enough milk: an inadequate latch, which prevents the baby
from getting the milk out easily, and a false interpretation
of normal baby behaviours, such as "growth spurts",
frequent/cluster feeding, not "sleeping through the night",
etc.
• I have had breast surgery (reduction/augmentation).
Can I still breastfeed?
[top]
Of course! Depending on the surgical technique
used, it is possible that your milk supply could be affected,
but there is no way to really predict this, and this does not
mean you cannot, or should not breastfeed. Your Lactation Consultant
may suggest that during the early weeks you use a hospital-grade
breast pump in addition to feeding your baby to optimise milk
production. If your milk supply should be impaired, you can supplement
your baby at the breast with a Lactation Aid. Remember also that
there is much more to breastfeeding than milk!
• My nipples are flat/inverted. Will I be able to
breastfeed?
[top]
Absolutely! The baby feeds at the breast, not
on the nipple. In many women who seem to have flat/inverted nipples,
the situation seems to correct itself during the last trimester
of pregnancy or when breastfeeding is initiated. Truly inverted
nipples are rare. There are many types and shapes of nipples and
breasts, all perfectly « normal ». A perceived "anomaly"
and the expectation of a problem are what seem to create an obstacle
to breastfeeding. However, for mothers with flatter nipples, it
is possible that early feedings may require closer attention,
but this is by no means a contra-indication. In this situation,
it is even more important to avoid artificial nipples, since the
difference in stimulation from the artificial nipple compared
to that of the mother's is even more marked. That being
said, don't forget that no woman's nipple resembles
an artificial nipple!
• Is it true that it is easier for a baby to bottle
feed than to breastfeed?
[top]
No. Although a breastfeeding baby has a certain
degree of « work » to do to extract milk from the
breast, breastfeeding is easier because the baby controls the
flow of milk, whereas at the bottle, the baby has little or nothing
to do to obtain milk, and no real control. A baby at the breast
is more stable (oxygen saturation, breathing, temperature) than
at the bottle. It is easier (especially for a preemie) to learn
to coordinate sucking, breathing and swallowing at the breast.
• Aren't modern artificial baby milks a faithful
reproduction of breastmilk?
[top]
Absolutely not, although that's what the
formula companies would like you to believe. Breastmilk is specifically
designed for human babies, and is a living substance that changes
with the baby's age, the climate, the time of day, within
a feeding, the environment, etc. It contains more than 200 identified
components and each plays a role not only in the baby's
nutrition, but also in general development and growth as well
as the development of the immune and nervous systems. It is 99%
assimilated by the baby. Formula, on the other hand, is an inert
product that never changes or adapts, that has a poor shelf life
and is very vulnerable to contamination. Moreover, many components
essential to your baby's growth and development aren't
even present in artificial baby milks. A relatively low percentage
of formula is assimilated by the baby. The artificial baby milk
industry is not regulated in any way: it has been called the largest
"in vivo" experimentation in the history of humanity.
Formula is often recalled because of contamination, spoilage,
etc.
• If I breastfeed, won’t I be « stuck
» with my baby 24 hours a day?
[top]
It is only natural for a mother and her baby
not to be separated during the first months of life. At birth,
human beings are among the most vulnerable of mammals. Breastfeeding
is the natural progression of pregnancy and childbirth. The first
9 to 12 months are a period of "external gestation"
crucial to the baby's development. Breastfeeding allows
the mother to travel with her baby without having to worry about
sterile bottles, milk spoilage, etc. Once breastfeeding is well
established, around 4 to 6 weeks, if the mother wants to go away
for a few hours without her baby, she can express her milk and
provide it in a cup, spoon, dropper, etc., economically and without
jeopardising the breastfeeding relationship.
• Aren't breastfeeding mothers more tired
than non-breastfeeding mothers?
[top]
No! Having a baby is demanding and can be tiring,
no matter how the baby is fed. It is easy to blame fatigue on
breastfeeding when our expectations about life with a new baby
aren't met. Breastfeeding mothers who keep their baby close
by at night sleep more and have better sleep quality than those
who are separated from their baby and/or don't breastfeed.
Many mothers don't even wake up as they breastfeed at night!
Night breastfeeding is less disruptive to one's sleep than
getting up and preparing a bottle while your baby is crying. Mothers
whose spouse gets up at night to feed the baby often say that
they wake up anyway…
•
I have to go back to work, and the thought of
weaning my baby makes me very sad. Is it possible to juggle working
and breastfeeding? [top]
Yes. A Woman can easily and economically continue
breastfeeding after returning to work. Breastfeeding protects
your baby against illnesses that could require that you miss work.
Employers and co-workers are easily sensitised to the importance
of breastfeeding for working mothers. They can and must accommodate
you with the necessary time and space to express your milk. Transition
and separation are easier to adjust to for both mother and baby
when the breastfeeding relationship is maintained. When the mother
is home, she can breastfeed, whereas the mother who chooses to
wean no longer has this option. There are several ways other than
bottles to give breastmilk to the baby in the mother's absence.
See also Working
and breastfeeding and Dr. Jack Newman's
article What
to feed the baby when the mother is working
outside the home
•
My spouse is afraid he will feel excluded and
be unable to bond with our baby if I breastfeed. [top]
Babies
have many needs other than feeding. Fathers
bond with their babies through other activities,
such as massage, bathing, and rocking, where
they can interact with their child much
more than by bottle feeding. This fear is
the result of artificial baby milk marketing
that glorifies the act of giving a baby
a bottle, as if the acts of breastfeeding
and giving bottle were equivalent. Breastfeeding
is a dynamic process between a mother and
her baby, and this cannot be duplicated
with a bottle. This is why some advantages
of breastfeeding have nothing to do with
breastmilk itself. Breastfeeding is an essentially
maternal role. Mothers and fathers are not
substitutes for each other, but rather complement
each other perfectly!
•
Can
epidurals and other pain medications during labour affect my baby's
ability to breastfeed? [top]
Yes.
After an unmedicated labour and delivery,
healthy, term babies left on their mother's
abdomen have the innate ability to crawl
up and latch onto the breast, unassisted.
This reflex can be disrupted and even inhibited
when the mother is medicated or when mother
and baby have been separated. Most pain
medications used during labour have an effect
on the baby (sleepiness, irritability, etc.)
and possibly on early breastfeeding and
mother-baby attachment, and this varies
according to dosage and time lapsed between
administration and delivery. Certain effects
may last long after birth. Breastfeeding
difficulties that may stem from these effects
can, in certain cases, be difficult of impossible
to surmount, if they are poorly managed.
Expectant mothers must be well informed
about these possible consequences as well
as available alternatives so that they can
make informed choices when it comes to pain
management.
•
Is
it normal to have sore nipples/breasts during the first days/weeks
of breastfeeding? [top]
No. Pain is not part of the normal evolution
of breastfeeding. During the first few days, many women feel discomfort
when the baby initially latches on and stretches the nipple in
his mouth. However, any discomfort that worsens, especially if
the nipples are damaged/cracked, is not normal and should be a
red flag that there is an underlying problem requiring assistance
by a skilled helper. Some of the most common causes of nipple
pain/damage are incorrect latch and bacterial/fungal infections.
See also Sore
nipples and Dr. Jack Newman's article
Sore
nipples
• Is colostrum sufficient for my baby during the
first days of life?
[top]
Yes. At birth, your baby's stomach can
only contain 5-7 ml of colostrum at one time (the size of a marble),
and this matches quite closely the quantity produced by the mother
(about 30 to 100 ml per 24 hours). Therefore, it would not be
physiologically normal nor desirable to give larger quantities
of milk to your baby, as is often done when we give them a bottle.
Breastmilk is very easily and rapidly digested by your baby. Breastfeeding
in the early days is characterised by very frequent feedings (every
1 to 2 hours). As days go by and milk production increases, your
baby's stomach capacity also increases, so that on day 6,
and until 6 months, it can contain 50-60 ml of milk at one time
(the size of a golf ball). At this stage, your production will
correspond, accordingly, to about 500-750 ml per 24 hours.
• Can mixed feeding or occasional supplements interfere
with breastfeeding?
[top]
Supplements can delay the « coming in
» of milk and interfere with milk production, thus initiating
a vicious cycle difficult to break. There are very few medical
indications for supplementing a baby. First, we must always deal
with the cause of the problem before supplementing. If there is
a medical reason for supplementation, formula is the last choice:
mother's own milk is the first choice, then donated human
milk, and last, formula. Moreover, the bottle is also the last
choice of methods for giving supplements to a breastfed baby.
Milk can be given by Lactation Aid or spoon, among other options.
See
Dr. Jack Newman's articles
Using a Lactation Aid and Finger
feeding
• How can I tell that my baby is getting enough
milk?
[top]
By observing your baby (and not with absolute
measurements), you can know without a doubt that your baby is
getting enough milk:
-baby suckles well and swallows in a rhythmic fashion (no pain
for mother)
-as of day 4, baby stools at least 2-3 times per 24 hours (liquid,
yellowish stools)
-baby's urine is clear and with no strong odour
-baby has regained birth weight by 2 weeks (3 weeks maximum) and
is gaining an average of about 15-30 gr (½-1 on.) per day
until the age of 4 months.
See Dr. Jack Newman's article
Is my baby getting enough?
• How long should my baby feed on each breast?
[top]
Whoever gives you an absolute number is misleading
you and is giving you a false reference point. Each baby, and
each feeding, is unique. The duration of feedings varies with
the baby's age, time of day, quality of latch, and state
of baby (sleepy/alert). The baby can be at the breast without
actually feeding, so it's important to learn to tell the
difference. You are certainly not ahead of the game if your baby
spends hours at the breast without really suckling and feeding!
A baby who feeds well on one breast can very well turn down the
other. This is perfectly normal. It is actually preferable for
the baby to stay on one side until he is full than to switch sides
after "X" minutes. The latter could mean that the
baby is not getting the fatty hindmilk, and may be unsatisfied
and/or "colicky", or even have slow or poor weight
gain. The baby will tell you when the feeding ahs ended, either
by falling asleep or letting go of the breast.
• Does my breastfed baby need water on hot days?
[top]
No. Breastmilk is 85-90% water and it fully
satisfies your baby's fluid requirements. Formula, on the
other hand, can cause thirst because they have a high solute load.
Beware! Water has no nutritional value, but can fill up your baby's
stomach, thus he will drink less milk and get less nutrition,
and if the baby drinks less, the mother will produce less…
On hot days, we all tend to drink more, because our fluid requirements
increase. It is perfectly normal for your baby to do the same
and feed more frequently.
• Does my breastfed baby need Vitamin D?
[top]
Breastmilk
of healthy mothers contains adequate amounts
of Vitamin D. Babies are born with stores
of Vitamin D that last about 2 months. Thereafter,
one to two hours per week (only a few minutes
at a time) of exposure to sunlight enables
the baby to synthesize all the Vitamin D
he needs. Certain risk factors, such as
dark skin pigmentation, Vitamin D deficiency
in the mother or a baby that is not regularly
exposed to sunlight, may justify administrating
a Vitamin D supplement, but not all breastfed
babies require supplementation.
• Does formula pose a risk even if I give it to
my baby only occasionally?
[top]
Only one bottle of formula alters your baby's
gut flora for 2 weeks, which can make him more vulnerable to certain
pathogens, such as E-coli. Formula reduces some of the anti-infectious
properties of breastmilk. The earlier the baby is exposed to formula,
the higher the risk of developing certain diseases (such as Diabetes).
See also Risks and costs of
formula feeding
• Is there really such a thing as « nipple
preference »?
[top]
Nipple preference is a real problem, even though
it may not affect all babies. It results from a process called
"imprinting" and from the fact that suction mechanisms
at the breast and at the bottle are completely different. When
you compare the average woman's nipple to an artificial
nipple, it is plain to see why artificial nipples cause a super-stimulus
that can be quite confusing for the baby, and why so many women,
without reason, believe that their nipples are "flat"…
• If I breastfeed, do I need to have a perfect diet?
[top]
You should eat a balanced diet, like any other
healthy person. Except in extreme cases, your diet does not affect
the quality of your milk. However, if you eat poorly, you may
find yourself lacking certain nutrients, which can lead to fatigue
or weak immune system.
• Do I need to avoid certain foods/drinks?
[top]
There are no forbidden foods during breastfeeding.
"Colic", which is often blamed on something the mother
ate, is caused by the baby's immature digestive system and
is not related to the mother's diet. Certain babies may
react to high doses of caffeine ingested by the mother (don't
forget chocolate also contains caffeine!). Every culture has its
forbidden foods and its miracle foods, and some cultures forbid
other cultures' miracle foods!
• If I have a beer (or any other alcoholic beverage)
before breastfeeding, will my baby sleep longer?
[top]
No. Alcohol in moderation is not contraindicated
during breastfeeding, but it will not help the baby sleep. On
the contrary, common reactions to alcohol ingested by the mother
(depending on the quantity and time lapsed between ingestion and
breastfeeding) include inhibited letdown reflex, agitation and
reduced suckling efficiency, which can actually cause the baby
to sleep less than normal.
• Will introducing
solid foods help my baby sleep through the night?
[top]
No. Sleep has nothing to do with diet. A baby's
sleep cycle is a matter of neurological development, not nutrition.
Most babies continue to wake at night during the better part of
the first year of life. Studies have shown that the introduction
of solid foods has no impact on babies' sleep habits.
• I am a smoker. Can I still breastfeed my baby?
[top]
Absolutely!
Although it would be ideal to quit smoking (or at least cut down),
it is less risky to breastfeed in spite of your habit than to
formula feed. Breastfeeding reduces some of the effects of cigarette
on your baby.
No
matter what, NO ONE should ever smoke in the presence of your
baby.
• If I space out feedings, I'll have more milk,
right?
[top]
Wrong!
Although you may feel that your breasts are "fuller"
when the interval between feedings is longer, you are really not
producing more milk. In fact, the exact opposite could occur,
because milk that accumulates and "stays" in the breasts
sends a signal to your breasts to STOP producing milk. The quantity
of milk that can be "stored" before this signal is sent
varies from one woman to the other. This is why some women can
feed at longer intervals without experiencing a drop in milk supply.
Also, don't forget that the "fuller" your breasts, the
lower the fat concentration in the milk.
• My baby feeds more often
than every 4 hours. Is there a problem with my milk supply?
[top]
No. The average breastfed baby feeds every 1½
to 3 hours. Remember that your baby has to double his birth weight
by the age of 5-6 months. Considering that until this age his
stomach can only hold about 50-60 ml of milk at one time (the
size of a golf ball), and that breastmilk is digested very rapidly,
it is easy to understand why your baby needs to feed more frequently
than every 4 hours. Infrequent feedings can lead to insufficient
milk supply.
• Is breastfeeding really a reliable method of family
planning?
[top]
Yes,
it is the Lactation Amenorrhea Method (LAM).
It is 98-99% effective if you meet each
of the following criteria: your baby is
less than 6 months old; you have not had
the return of your menses; you are breastfeeding
exclusively (that is, your baby does not
receive any food or drink other than breastmilk);
AND feedings are frequent (no more than
6 hours apart). LAM is as effective as oral
contraceptives, but without the possible
negative side effects on milk production.
It is completely natural and free. It is
one more incentive to practice exclusive
breastfeeding and delay introduction of
solid foods, as is recommended by the World
Health Organisation.
• Does my baby still need breastfeeding after 6
(7, 8, 9…) months?
[top]
Yes! Breastmilk contains everything your baby
needs, and more. It changes constantly, in response to his changing
needs. Introduction of solid foods can start after 6 months, but
should only be done when your baby is showing signs of readiness,
not just because he has reached a certain age. Breastmilk still
remains an essential food, even for a baby who is discovering
other foods. The WHO recommends breastfeeding until at least 2
years, and for a long as mother and child wish to do so thereafter.
According to anthropological studies, natural weaning age in human
beings is between 4 and 7 years. The world average breastfeeding
duration is 4-5 years.
• I am pregnant. If I continue to breastfeed my
child, am I jeopardising my unborn baby?
[top]
No. This is a popular belief that has been shown
to be unfounded by recent studies. In a normal pregnancy, breastfeeding
poses no more risk than sexual relations. Breastfeeding during
pregnancy, and subsequent tandem nursing, is quite common in many
cultures, and has many benefits for mother, child and baby.
•
If my breasts aren't engorged between feedings
and/or don't leak, does this mean I have a low milk supply? [top]
No. The feeling of fullness associated with
the milk « coming in » isn't merely a surplus
of milk, but rather a combination of edema, lymphatic fluid and
milk. Around 4 to 6 weeks (sometimes earlier), and often quite
suddenly, the feeling of fullness that some women notice throughout
the early weeks tapers off. Although the mother may feel like
her breasts are « empty », she is still actually still
producing all the milk her baby needs. Persistent engorgement
(distension of breast tissue caused by insufficient/inefficient
drainage of milk), is not a normal part of breastfeeding, and
actually signals the breasts to stop producing milk. The degree
of fullness a woman feels is not an indication of the quantity
of milk produced, nor is the fact that breasts leak or not. Some
women's breasts never leak, while others leak during the
entire nursing period.
• Is it safe to loose weight while breastfeeding?
[top]
Yes. In fact, breastfeeding women naturally
and effortlessly regain their pre-pregnancy weight more quickly
than women who do not breastfeed. There is no contraindication
to slow, gradual weight-loss (1-2 lbs per week) that can be achieved
with a healthy, balanced diet and physical exercise. On the other
hand, restrictive (« crash ») diets are not safe (nor
are they effective in the long-term) and should NEVER be attempted
(breastfeeding or not). During breastfeeding, these drastic diets
can mobilise into milk the toxins that concentrate in fat tissue,
and extremely hypo caloric intake (less than 1500 calories per
day) can impact the quantity of milk produced.
• Does breastfeeding during the night or in bed
cause tooth decay?
[top]
No. The phenomenon of « bottle carries
» is associated with formula and use of bottles, and has
never been linked to breastfeeding or breastmilk.
See
Dr. Jack Newman's articles Some
breastfeeding myths, More
breastfeeding myths, Still
more breastfeeding myths, More
and more breastfeeding myths
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