Breast Feeding Common Myths and Pitfalls

Most women intend to breast feed their first newborn yet many unable to meet their own expectations. There are so many varied opinions and sources of information and misinformation available that here is every reason for this situation to be difficult and vexing. There are some common misconceptions and errors that could be avoided and some simple advice that could result in more women succeeding to breast feed their babies as they intended. Fortunately babies are not born hungry.

Many are not immediately eager to do more than sniff and snuggle up to the breast. Most problems arise right here with well meaning friends and hospital staff telling the parents that the baby isn't "getting enough" as though there is a problem with the mother's supply. Newborns are not meant to "eat" much for a few days after birth, probably to allow the passage of the intestinal debris, known as meconium, before actually having to digest milk protein. For this reason newborns are expected to lose up to 10% of their birth weight in the first week of life and regain their birth weight by the end of the second week. This correlates precisely with the plan of mother nature and should be understood and respected and not interfered with by the addition of formula. In some cultures, babies are given water-sugar combinations a little at a time during the first 2-4 days in order to keep them hydrated and interested in sucking so that when the mother's milk arrives the baby is able to take it. Modern versions of this is the glucose water that hospital staff may offer new babies and that is so often shunned by parents who have been told not to let the hospital feed their baby "pop" in place of good nutrition. Sugar water is usually unnecessary but it is not dangerous if given and may even be necessary in some situations such as hypoglycemia of the newborn. A well hydrated baby will be good and hungry and strong enough to learn to suckle when the mother's milk has come in. A tired and "dry" baby may be too weak to participate or too irritable to be dealt with by an anxious and frightened parent who may imagine she is starving her child and might as well give up and give formula. Obviously nature knows what it is doing - we just have to heed the signs.

Myth - Babies need to be left on the breast for as long as they want to suck or they will miss the important and superior hind milk.

Truth - Babies who suck on mother's breast for very long periods in the early days may even fail to thrive. Poor positioning on the breast may be the reason for lengthy feedings as the baby is left unsatisfied yet the outcome may be painful sore and cracked nipples.

Newborns also need non-nutritive sucking that can be gotten from an occasional pacifier or a parent's finger or from their own hand if they are assisted. If left on the breast endlessly, many infants will tire themselves out with little milk benefit in the first few days as the supply has not yet been built up. The exhaustion may lead to under feeding since after spending a long time on one breast the baby may be too tired to continue on the second which is full of milk and mother is left uncomfortable and frustrated. She may then try to express milk from the second breast and noting that not much comes out (see next myth) she may give up or stop trying to pump which may lead to blocked milk ducts and inflammation or even mastitis. Now the mother has one sore and bleeding nipple and one sore and swollen breast. Not a scenario likely to lead to success. A better solution would be to advise mothers to nurse briefly on both sides until the second week when the nipples are hardier and the breast milk production is more steady. Then gradually allow the baby to spend longer time on the second side since they will not yet have exhausted themselves after getting most of the milk from the first and then the wonderful hind milk of the second breast can be available to them. Another useful approach in the early weeks is to use only one breast per feeding and pump the second side if there is great discomfort. There are plenty of "goodies" to be had from all levels of mother's milk and there are immune globulins that are in fact mostly present in the fore milk.

Myth - If you cannot pump at least 4 ounces per breast you are not making sufficient milk to feed your baby.

Truth - In fact, most women's bodies are relatively "turned off" by mechanical pumping. Some women who can quite adequately sustain their babies (proof being on the scale as their infants steadily gain weight), are unable to produce any significant quantity with a breast pump. It is estimated that the usual pumped production is about one half to one third the amount that a baby can get by direct nursing. This should reassure most mothers instead of their being discouraged by what they see after the pumping attempt "fails". It is not even necessary for mothers to pump except to relieve breast over production (and this can be managed by hand expressing a little in order to relieve the discomfort) or to develop a supply to give daddy the opportunity to feed the baby or for times when mom will be unavailable. It is not easy to create a long term supply that will be completely sustaining for most women but at least if moms have some reasonable idea of what their babies actually consume they can adjust their schedules or use alternative supplementation if they so choose and not feel that they are unable to provide enough milk because their bodies can't meet the challenge.

Myth - Babies who nurse will not gain weight as well as formula fed babies and will not sleep through the night as soon.

Truth - Babies are intended to drink mother's milk and so the standard for weight gain and growth should be based on breast fed infants and not on formula fed babies.

Most growth charts in common use today are designed in the 1950's and are based on formula fed babies pace of growth. This leads many mothers to feel their baby is failing to thrive when they ask the pediatrician for the "percentiles" at the monthly check ups. It is best to refrain from comparing breast fed infant growth with formula fed patterns and most pediatricians are not eager to share percentile statements unless pressed for this very reason. New growth charts should be made taking this into account. Although it is true that nursing babies feed more frequently than formula fed infants, nursing babies are just as capable of sleeping through the night when they are developmentally ready. There is a huge wealth of current research based information available about breast feeding and Pediatricians are not always knowledgeable about this topic. Often the aid of a Board Certified Lactation Consultant can make all the difference in the breast feeding experience. New moms need all the support and accurate information they can get and are often able to continue nursing even with a few obstacles that may come up along the way.