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. 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 continue breastfeeding. The exception is the thyroid
scan. 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. 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
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 5-6 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 compressing the breast with your
hand to help the baby get more milk.
- 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
- 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.
- If the baby truly seems not to be getting enough, get help,
but do not introduce a bottle which will only make things worse.
If absolutely necessary, the baby can be supplemented, using a
lactation aid which 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,
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
5. Formula company literature and free formula samples do not
influence whether or 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?
Is the cost of the samples and booklets taken on by formula companies
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. 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 higher
fat milk, by compressing the breast once the baby no longer actually
swallows at the breast. (Handouts #3 Colic in the breastfed baby
and #15 Breast Compression).
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 shouldn't 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!
A baby who is only bottle fed for the first two weeks of life, for
example, will usually refuse to take the breast, even if the mother
has an abundant supply. A baby who has had only the breast for 3
or 4 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.
Handout #14. More and More Breastfeeding Myths.
Revised January 1998
More and More Breastfeeding
Written by Jack Newman, MD, FRCPC
This page's content (NOT its design) may be copied and distributed
without further permission.