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). 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 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
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, mothers who have had breast
reduction surgery sometimes manage very well to 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 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.
(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 6 months after
birth. But it is reliable only when breastfeeding is exclusive,
when feedings are fairly frequent (at least 6-8 times in 24
hours), there are no long periods during which the baby does
not feed, and 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.
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 mini-pill, find that their
milk supply decreases. Ostrogen in the pill 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 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 ostrogen).
14.
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.
Handout
#12 More Breastfeeding Myths. Revised January 1998
Jack
Newman, MD, FRCPC is a pediatrician, a graduate of the University
of Toronto medical school. He started the first hospital-based
breastfeeding clinic in Canada in 1984. He has been a consultant
with UNICEF for the Baby Friendly Hospital Initiative in Africa.
Dr. Newman has practiced as a physician in Canada, New Zealand,
and South Africa.
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