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1. A breastfeeding
mother has to be obsessive about what she
eats. Not
true! A breastfeeding mother should try
to eat a balanced diet, but neither needs
to eat any special foods nor avoid certain
foods. A breastfeeding mother does not need
to drink milk in order to make milk. A breastfeeding
mother does not need to avoid spicy foods,
garlic, cabbage or alcohol. A breastfeeding
mother should eat a normal healthful diet.
Although there are situations when something
the mother eats may affect the baby, this
is unusual. Most commonly, "colic",
"gassiness" and crying can be
improved by changing breastfeeding techniques,
rather than changing the mother's diet.
(Handout #2 Colic in
the Breastfed Baby).
2. A breastfeeding mother
has to eat more in order to make enough
milk. Not true! Women on even very low
calorie diets usually make enough milk,
at least until the mother's calorie intake
becomes critically low for a prolonged period
of time. Generally, the baby will get what
he needs. Some women worry that if they
eat poorly for a few days this also will
affect their milk. There is no need for
concern. Such variations will not affect
milk supply or quality. It is commonly said
that women need to eat 500 extra calories
a day in order to breastfeed. This is not
true. Some women do eat more when they breastfeed,
but others do not, and some even eat less,
without any harm done to the mother or baby
or the milk supply. The mother should eat
a balanced diet dictated by her appetite.
Rules about eating just make breastfeeding
unnecessarily complicated.
3. A breastfeeding mother
has to drink lots of fluids. Not true!
The mother should drink according to her
thirst. Some mothers feel they are thirsty
all the time, but many others do not drink
more than usual. The mother's body knows
if she needs more fluids, and tells her
by making her feel thirsty. Do not believe
that you have to drink at least a certain
number of glasses a day. Rules about drinking
just make breastfeeding unnecessarily complicated.
4. A mother who smokes
is better not to breastfeed. Not true!
A mother who cannot stop smoking should
breastfeed. Breastfeeding has been shown
to decrease the negative effects of cigarette
smoke on the baby's lungs, for example.
Breastfeeding confers great health benefits
on both mother and baby. It would be better
if the mother not smoke, but if she cannot
stop or cut down, then it is better she
smoke and breastfeed than smoke and formula
feed.
5. A mother should not
drink alcohol while breastfeeding. Not
true! Reasonable alcohol intake should not
be discouraged at all. As is the case with
most drugs, very little alcohol comes out
in the milk. The mother can take some alcohol
and continue breastfeeding as she normally
does. Prohibiting alcohol is another way
we make life unnecessarily restrictive for
nursing mothers.
6.
A mother who bleeds from her nipples should
not breastfeed. Not true! Though blood
makes the baby spit up more, and the blood
may even show up in his bowel movements,
this is not a reason to stop breastfeeding
the baby. Nipples that are painful and bleeding
are not worse than nipples that are painful
and not bleeding. It is the pain the mother
is having that is the problem. This nipple
pain can often be helped considerably. Get
help. (Handout #3 Sore
Nipples and #3b Treatments
for Sore Nipples and Sore Breasts).
Sometimes mothers have bleeding from the
nipples that is obviously coming from inside
the breast and is not usually associated
with pain. This often occurs in the first
few days after birth and settles within
a few days. The mother should not stop breastfeeding
for this. If bleeding does not stop soon,
the source of the problem needs to be investigated,
but the mother should keep breastfeeding.
7. A woman who has had
breast augmentation surgery cannot breastfeed.
Not true! Most do very well. There is no
evidence that breastfeeding with silicone
implants is harmful to the baby. Occasionally
this operation is done through the areola.
These women do often have problems with
milk supply, as does any woman who has an
incision around the areolar line.
8. A woman who
has had breast reduction surgery cannot
breastfeed. Not true! Breast reduction
surgery does decrease the mother's capacity
to produce milk, but since many mothers
produce more than enough milk, some mothers
who have had breast reduction surgery sometimes
can breastfeed exclusively. In such a situation,
the establishment of breastfeeding should
be done with special care to the principles
mentioned in the handout #1 Breastfeeding—Starting
Out Right. However, if the mother seems
not to produce enough, she can still breastfeed,
supplementing with a lactation aid (so that
artificial nipples do not interfere with
breastfeeding).
9. Premature babies
need to learn to take bottles before they
can start breastfeeding. Not true! Premature
babies are less stressed by breastfeeding
than by bottle feeding. A baby as small
as 1200 grams and even smaller can start
at the breast as soon as he is stable, though
he may not latch on for several weeks. Still,
he is learning and he is being held which
is important for his wellbeing and his mother's.
Actually, weight or gestational age do not
matter as much as the baby's readiness to
suck, as determined by his making sucking
movements. There is no more reason to give
bottles to premature babies than to full
term babies. When supplementation is truly
required there are ways to supplement without
using artificial nipples.
10. Babies with
cleft lip and/or palate cannot breastfeed.
Not true! Some do very well. Babies with
a cleft lip only usually manage fine. But
many babies with cleft palate do indeed
find it impossible to latch on. There is
no doubt, however, that if breastfeeding
is not even tried, for sure the baby won’t
breastfeed. The baby's ability to breastfeed
does not always seem to depend on the severity
of the cleft. Breastfeeding should be started,
as much as possible, using the principles
of proper establishment of breastfeeding.
(Handout #1 Breastfeeding—Starting
Out Right). If bottles are given, they
will undermine the baby's ability to breastfeed.
If the baby needs to be fed, but is not
latching on, a cup can and should be used
in preference to a bottle. Finger feeding
occasionally is successful in babies with
cleft lip/palate, but not usually.
11. Women with small
breasts produce less milk than those with
large breasts. Nonsense!
12. Breastfeeding does
not provide any protection against becoming
pregnant. Not true! It is not a foolproof
method, but no method is. In fact, breastfeeding
is not a bad method of child spacing, and
gives reliable protection especially during
the first six months after birth. It almost
as good as the pill if the baby is under
six months of age, if breastfeeding is exclusive,
and if the mother has not yet had a normal
menstrual period after giving birth. After
the first six months, the protection is
less, but still present, and on average,
women breastfeeding into the second year
of life will have a baby every two to three
years even without any artificial method
of contraception.
13. Breastfeeding women
cannot take the birth control pill.
Not true! The question is not exposure to
female hormones, to which the baby is exposed
anyway through breastfeeding. The baby gets
only a tiny bit more from the pill. However,
some women who take the pill, even the progestin
only pill, find that their milk supply decreases.
Estrogen containing pills are more likely
to decrease the milk supply. Because so
many women produce more than enough, this
often does not matter, but sometimes it
does even in the presence of an abundant
supply, and the baby becomes fussy and is
not satisfied by nursing. Babies respond
to rate of flow of milk, not what's "in
the breast", so that even a very good
milk supply may seem to cause the baby who
is used to faster flow to be fussy. Stopping
the pill often brings things back to normal.
If possible, women who are breastfeeding
should avoid the pill, or at least wait
until the baby is taking other foods (usually
around 6 months of age). Even if the baby
is older, the milk supply may decrease significantly.
If the pill must be used, it is preferable
to use the progestin only pill (without
estrogen).
14. Breastfeeding babies
need other types of milk after six months.
Not true! Breastmilk gives the baby everything
there is in other milks and more. Babies
older than six months should be started
on solids mainly so that they learn how
to eat and so that they begin to get another
source of iron, which by 7-9 months, is
not supplied in sufficient quantities from
breastmilk alone. Thus cow's milk or formula
will not be necessary as long as the baby
is breastfeeding. However, if the mother
wishes to give milk after 6 months, there
is no reason that the baby cannot get cow's
milk, as long as the baby is still breastfeeding
a few times a day, and is also getting a
wide variety of solid foods in more than
minimal amounts. Most babies older than
six months who have never had formula will
not accept it because of the taste.
Questions? (416) 813-5757
(option 3) or drjacknewman@sympatico.ca
or my book Dr. Jack Newman’s Guide
to Breastfeeding (called The Ultimate Breastfeeding
Book of Answers in the USA)
Handout #12 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
1. Breastfeeding:
Starting out right
a) The
importance of Skin-to-Skin contact
2. Colic in the Breastfed Baby
3. a) Sore Nipples
b) Treatments
for Sore Nipple and Sore Breasts
4. Is my baby getting enough?
5. Using a Lactation Aid
6. Using Gentian Violet
7. Breastfeeding and Jaundice
8. Finger Feeding
9. a) You should continue breastfeeding
(Medications and breastfeeding)
b) You
should continue breastfeeding (Illness in the mother or baby)
10. Breastfeeding and other foods
11. Some breastfeeding myths
12. More breastfeeding myths
13. Still more breastfeeding
myths
14. More and more breastfeeding
myths
15. Breast compression
16. Starting solid foods
17. What to feed the baby when
the mother is working outside the home
18. How to know a health professional
is not supportive of breastfeeding
19. a) Domperidone 1
b) Domperidone
2
20. Fluconazole
21. Breastfeed a toddler –
Why on earth?
22. Blocked ducts and
mastitis
23. Breastfeeding your adopted baby
24. Miscellaneous treatments for problems
25. Slow weight gain after
the first few months
26. When the Baby refuses to
latch on
27. Expressing Milk
28. Toxins and Infant Feeding
How breastmilk protects Newborns
Risks of formula feeding
Breastfeeding and guilt
Candida protocol
Protocol to increase the intake
of Breastmilk by the Baby ("Not enough milk")
When latching
Protocols for Induced Lactation
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