1. It is normal for breastfeeding
Not true! Though some tenderness during the first
few days is relatively common, this should be a temporary
situation that lasts only a few days and should never
be so bad that the mother dreads nursing. Any pain
that is more than mild is abnormal and is almost always
due to the baby latching on poorly. Any nipple pain
that is not getting better by day 3 or 4 or lasts
beyond 5 or 6 days should not be ignored. A new onset
of pain when things have been going well for a while
may be due to a yeast infection of the nipples. Limiting
feeding time does not prevent soreness.
2. There is no (not enough) milk
during the first 3 or 4 days after birth
Not true! It often seems like that because the baby
is not latched on properly and therefore is unable
to get the milk that is available. When there is not
a lot of milk (as there is not, normally, in the first
few days), the baby must be well latched on in order
to get the milk. This accounts for "but he's
been on the breast for 2 hours and is still hungry
when I take him off." By not latching on well,
the baby is unable to get the mother's first milk,
called colostrum. Anyone who suggests you pump your
milk to know how much colostrum there is, does not
understand breastfeeding, and should be politely ignored.
Once the mother's milk is abundant, a baby can latch
on poorly and still may get plenty of milk.
3. A baby should be on the breast
20 minutes on each side
Not true! However, a distinction needs to be made
between "being on the breast" and "breastfeeding."
If a baby is actually drinking for most of 15-20 minutes
on the first side, he may not want to take the second
side at all. If he drinks only a minute on the first
side, and then nibbles or sleeps, and does the same
on the other, no amount of time will be enough. The
baby will breastfeed better and longer if he is latched
on properly. He can also be helped to breastfeed longer
if the mother compresses the breast to keep the flow
of milk going, once he no longer swallows on his own.
Thus it is obvious that the rule of thumb that "the
baby gets 90% of the milk in the breast in the first
10 minutes" is equally hopelessly wrong.
4. A breastfeeding baby needs
extra water in hot weather
Not true! Breastmilk contains all the water a baby
5. Breastfeeding babies need
extra vitamin D.
Not true! All babies need vitamin D. Formula has
it added at the factory. But the baby is born with
a liver full of vitamin D, and outside exposure allows
the baby to get the vitamin D from ultraviolet light.
The baby does not need a lot of outside exposure and
does not need outside exposure every day. Vitamin
D is a fat soluble vitamin and is stored in the body.
In some circumstances (for example, if the mother
herself was vitamin D deficient during the pregnancy)
it may be prudent to supplement the baby with vitamin
6. A mother should wash her nipples
each time before feeding the baby
Not true! Formula feeding requires careful attention
to cleanliness because formula not only does not protect
the baby against infection, but also is actually a
good breeding ground for bacteria and can also be
easily contaminated. On the other hand, breastmilk
protects the baby against infection. Washing nipples
before each feeding makes breastfeeding unnecessarily
complicated and washes away protective oils from the
7. Pumping is a good way of knowing
how much milk the mother has
Not true! How much milk can be pumped depends on
many factors, including the mother's stress level.
The baby who nurses well can get much more milk than
his mother can pump. Pumping only tells you have much
you can pump.
8. Breastmilk does not contain
enough iron for the baby's needs
Not true! Breastmilk contains just enough iron for
the baby's needs. If the baby is full term he will
get enough iron from breastmilk to last him at least
the first 6 months. Formulas contain too much iron,
but this quantity may be necessary to ensure the baby
absorbs enough to prevent iron deficiency. The iron
in formula is poorly absorbed, and most of it, the
baby poops out. Generally, there is no need to add
other foods to breastmilk before about 6 months of
9. It is easier to bottle feed
than to breastfeed
Not true! Or, this should not be true. However,
breastfeeding is made difficult because women often
do not receive the help they should to get started
properly. A poor start can indeed make breastfeeding
difficult. But a poor start can also be overcome.
Breastfeeding is often more difficult at first, due
to a poor start, but usually becomes easier later.
10. Breastfeeding ties the mother
Not true! But it depends how you look at it. A baby
can be nursed anywhere, anytime, and thus breastfeeding
is liberating for the mother. No need to drag around
bottles or formula. No need to worry about where to
warm up the milk. No need to worry about sterility.
No need to worry about how your baby is, because he
is with you.
11. There is no way to know how
much breastmilk the baby is getting
Not true! There is no easy way to measure how much
the baby is getting, but this does not mean that you
cannot know if the baby is getting enough. The best
way to know is that the baby actually drinks at the
breast for several minutes at each feeding (open mouth
wide-pause-close mouth type of suck). Other ways also
help show that the baby is getting plenty.
12. Modern formulas are almost
the same as breastmilk
Not true! The same claim was made in 1900 and before.
Modern formulas are only superficially similar to
breastmilk. Every correction of a deficiency in formulas
is advertised as an advance. Fundamentally formulas
are inexact copies based on outdated and incomplete
knowledge of what breastmilk is. Formulas contain
no antibodies, no living cells, no enzymes, no hormones.
They contain much more aluminum, manganese, cadmium,
lead and iron than breastmilk. They contain significantly
more protein than breastmilk. The proteins and fats
are fundamentally different from those in breastmilk.
Formulas do not vary from the beginning of the feed
to the end of the feed, or from day 1 to day 7 to
day 30, or from woman to woman, or from baby to baby.
Your breastmilk is made as required to suit your baby.
Formulas are made to suit every baby, and thus no
baby. Formulas succeed only at making babies grow
well, usually, but there is more to breastfeeding
than getting the baby to grow quickly.
13. If the mother has an infection
she should stop breastfeeding.
Not true! With very, very few exceptions, the mother's
continuing to breastfeed will actually protect the
baby. By the time the mother has fever (or cough,
vomiting, diarrhea, rash, etc) she has already given
the baby the infection, since she has been infectious
for several days before she even knew she was sick.
The baby's best protection against getting the infection
is for the mother to continue breastfeeding. If the
baby does get sick, he will be less sick if the mother
continues breastfeeding. Besides, maybe it was the
baby who gave the infection to the mother, but the
baby did not show signs of illness because he was
breastfeeding. Also, breast infections, including
breast abscess, though painful, are not reasons to
stop breastfeeding. Indeed, the infection is likely
to settle more quickly if the mother continues breastfeeding
on the affected side.
14. If the baby has diarrhea
or vomiting, the mother should stop breastfeeding
Not true! The best medicine for a baby's gut infection
is breastfeeding. Stop other foods for a short time,
but continue breastfeeding. Breastmilk is the only
fluid your baby requires when he has diarrhea and/or
vomiting, except under exceptional circumstances.
The push to use "oral rehydrating solutions"
is mainly a push by the formula manufacturers (who
also make oral rehydrating solutions) to make even
more money. The baby is comforted by the breastfeeding,
and the mother is comforted by the baby's breastfeeding
15. If the mother is taking medicine
she should not breastfeed
Not true! There are very very few medicines that
a mother cannot take safely while breastfeeding. A
very small amount of most medicines appears in the
milk, but usually in such small quantities that there
is no concern. If a medicine is truly of concern,
there are usually equally effective, alternative medicines
that are safe. The loss of benefit of breastfeeding
for both the mother and the baby must be taken into
account when weighing if breastfeeding should be continued.
16. 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.
17. 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.
18. 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
19. 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.
20. 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
21. 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. 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 breastfeed! If
bleeding does not stop soon, the source of the problem
needs to be investigated, but the mother should keep
22. 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 have problems with milk
supply, as does any woman who has an incision around
the areolar line.
23. 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, mothers who
have had breast reduction surgery sometimes can breastfeed
exclusively. 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).
24. 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.
25. 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 tried, it will not work. 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. 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.
26. Women with small breasts
produce less milk than those with large breasts.
27. 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 6 months after birth. It almost as
good as the pill if the baby is under 6 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 2 to 3 years even without any artificial
method of contraception.
28. 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 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 4-6 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 œstrogen).
29. Breastfeeding babies need
other types of milk after 6 months.
Not true! Breastmilk gives the baby everything there
is in other milks and more. Babies older than 6 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 6 months who
have never had formula will not accept it, because
of the taste.
30. 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 results in poor
feeding and severe weight loss, and makes it even
more difficult to get the baby to take the breast.
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, by 8 weeks of age no matter
what, but get help and the baby may latch on before.
31. A woman who becomes pregnant
must stop breastfeeding.
Not true! If the mother and child desire, breastfeeding
can continue. Some 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 or 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 usually
a problem. However, some babies will stop breastfeeding
if the milk supply is low.
32. A baby with diarrhea should
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
33. 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. Babies younger than 5-6 weeks often fall
asleep at the breast becausethe flow of milk is slow,
not necessarily because they have had enough to eat.
34. 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.
35. 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. Some 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.
36. 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.
37. 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.
38. Breastfeeding in public is
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 hang-ups or
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.
39. Breastfeeding a child until
3 or 4 years of age is abnormal and bad for the child,
causing an overdependent relationship between mother
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
40. 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.
41. After exercise a mother should
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
42. A breastfeeding mother cannot
get a permanent or dye her hair.
43. Breastfeeding is blamed for
True! Family, health professionals, neighbors, 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.
44. 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
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 2 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 6 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.
45. 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
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 using breast compression 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.
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.
46. 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
47. Physicians know a lot about
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
* This is quite true in Singapore. Some doctors can
be quite discouraging when it comes to breastfeeding.
So be informed about breastfeeding so that you will
not be misguided.
48. 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.
* This is quite true in Singapore. Some doctors can
be quite discouraging when it comes to breastfeeding.
So be informed about breastfeeding so that you will
not be misguided.
49. 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?
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
50. 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.
51. 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.
52. Mothers who receive immunizations
(tetanus, rubella, hepatitis B, hepatitis A, etc.)
should stop breastfeeding for 24 hours (3 days, 2
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.
53. There is no such thing as
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 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
54.Many women do not produce
Not true! The vast majority of women produce more
than enough milk. Indeed, an overabundance of milk
is common. Most babies that gain too slowly, or lose
weight, do so not because the mother does not have
enough milk, but because the baby does not get the
milk that the mother has. The usual reason that the
baby does not get the milk that is available is that
he is poorly latched onto the breast. This is why
it is so important that the mother be shown, on the
first day, how to latch a baby on properly, by someone
who knows what they are doing.
by Jack Newman, MD, FRCPC, All text above, reproduced
with his permission.
Jack Newman, MD, FRCPC, graduated from the University
of Toronto medical school as a pediatrician in 1970.
He started the first hospital-based breastfeeding clinic
in Canada in 1984 at Toronto's Hospital for Sick Children.
He has been a consultant with UNICEF for the Baby Friendly
Hospital Initiative in Africa and has published articles
on the subject of breastfeeding in Scientific American
and several medical journals. Dr. Newman has practiced
as a physician in Canada, New Zealand, and South Africa.
Dr. Jack Newman is a leading authority on infant care
who has implemented breastfeeding clinics throughout
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