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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 I131. 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 I123 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:
- An increase in the needs
of the baby, the so-called growth spurt.
If this is the reason for the seemingly
insufficient milk, a few days of more
frequent nursing will bring things back
to normal. Try compressing the breast
with your hand to help the baby get milk
(Handout #15, Breast
Compression).
- A change in the baby's
behaviour. At about five to six weeks
of age, more or less, babies who would
fall asleep at the breast when the flow
of milk slowed down, tend to start pulling
at the breast or crying when the milk
flow slows. The milk has not dried up,
but the baby has changed. Try using breast
compression to help the baby get more
milk. See the videos
on how to latch a baby on, how to know
the baby is getting milk, how to use compression.
- The mother's breasts
do not seem full or are soft. It is normal
after a few weeks for the mother no longer
to have engorgement, or even fullness
of the breasts. As long as the baby is
drinking at the breast, do not be concerned
(see handout 4 Is
My Baby Getting Enough Milk?).
- The baby breastfeeds
less well. This is often due to the baby
being given bottles or pacifiers and thus
learning an inappropriate way of breastfeeding.
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 #2Colic
in the Breastfed Baby and #15 Breast
Compression). Also see videos.
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? (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
#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
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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