Breastfeeding myths.

I. Many women do not produce enough milk.

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 or she 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 she or he is doing.

2. It is normal for breastfeeding to hurt.

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 three or four or lasts beyond five or six 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.

3. A breastfeeding baby needs extra water in hot weather.

Not true! Breastmilk contains all the water a baby needs.

4. Breastfeeding babies need extra vitamin D.

Not true! Except in extraordinary circumstances (for example, if the mother herself was vitamin D deficient during the pregnancy). The baby stores vitamin D during the pregnancy, and a little exposure to sunshine, on a regular basis, gives the baby all the vitamin D she or he needs.

5. 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 a good breeding ground for bacteria and can 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 nipple.

6. 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 how much you can pump.

7. 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 she will get enough iron from breastmilk to last him at least the first six 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 the baby poops out most of it. Generally, there is no need to add other foods to breastmilk before about six months of age.

8. Breastfeeding ties the mother down.

Not true! 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.

9. 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--pause--close type of suck).

10. 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 they 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, 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 one to day seven 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.

11. If the mother has an infection she should stop breastfeeding.

Not true! With very, very few exceptions, the baby will be protected by the mother's continuing to breastfeed. By the time the mother has fever (or cough, vomiting, diarrhea, rash, and so on) 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, she 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 she was breastfeeding. Also, breast infections, including breast abscesses, 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.

12. 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 (and oral rehydrating solutions) manufacturers to make even more money. The baby is comforted by the breastfeeding, and the mother is comforted by the baby's breastfeeding.

13. 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.

--Reprinted from Jack Newman, MD, FRCPC.

May be copied and distributed without further permission. Dr. Newman has been a consultant with UNICEF for the Baby Friendly Initiative in Africa, and has published articles about breastfeeding in Scientific American and several medical journals. He can be reached at newman@ globalserve.net.