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".
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
Still More Breastfeeding Myths
Written by Jack Newman, MD, FRCPC
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