by Amy Spangler
August 07, 2012
“Breastfeeding is natural.” Sound familiar? If you assume that breastfeeding is natural, it doesn’t take a leap of faith to accept that breastfeeding must be easy. Why, then, do so many mothers describe breastfeeding as hard? In reality, making milk is natural, but breastfeeding is a skill that babies (and moms) must learn. Some babies enter this world knowing just what to do, but most need a bit of practice. Knowing that myths masquerading as facts can undermine the success of even the most ardent mom, we aim to separate fact from fiction regarding the 10 most common myths.
1. “Engorgement is normal.”
It’s easy to confuse breast fullness—which is normal—with breast engorgement, which can hint at a problem that will only worsen if ignored.
After your baby is born, your blood carries the fluid and nutrients needed for milk production to your breasts, causing your breasts to swell. Frequent breastfeeding or milk expression (by hand or with a pump) relieves the swelling and softens the breasts. If feedings are infrequent, delayed, or missed, your breasts can overfill and engorgement can occur. Classic signs of engorgement include swollen, hot, painful breasts and a low-grade fever (less than 100°F or 37.7°C).
You can prevent engorgement by breastfeeding as soon as possible after birth; breastfeeding “on request,” in response to your baby’s first signs of hunger (sucking on fingers or fists) rather than on a strict schedule; breastfeeding at least 8–12 times in each 24 hours; and hand expressing or pumping to relieve fullness.
2. “Pain is normal.”
Many new mothers describe breastfeeding as “painful” or “uncomfortable,” but the feeling should occur only at the start of a feeding and last only a few seconds. Once a mother gets accustomed (after several days or weeks) to the stretching sensation that occurs when her baby latches on, breastfeeding will cease to hurt.
If the pain persists throughout the feeding, it can signal a poor latch. Trying to breastfeed “through the pain” will only result in a still-hungry baby and a damaged nipple. Break the suction by sliding your finger into the corner of your baby’s mouth, remove your baby from the breast, and try again. Mothers who are unable to achieve a pain-free latch are urged to get help from someone trained to help moms and babies breastfeed, such as an international board certified lactation consultant (IBCLC).
3. “Babies cry when they need to be fed.”
While it’s true that your baby’s cry can signal hunger, crying is a late sign of hunger. Watch, instead, for early signs of hunger, such as sucking on fingers or fists, smacking lips, squirming, and fussing, and feed your baby before she starts to cry. If you baby is calm, she is more likely to latch on well and breastfeed. Babies who reach the point of crying before they are fed often fall asleep at the breast after a short time and miss out on the nutrients and calories they need to grow.
4. “Latch is more important than position.”
Position and latch go hand-in-hand. It’s hard to achieve a good latch when your baby is positioned poorly. The best breastfeeding positions are the ones that work for you and your baby. Regardless of which position you choose for a feeding, make sure your baby is well-supported and facing your breast. Consider how you position yourself to eat—facing your meal—and place your baby the same way. This will allow your baby to get a good and deep latch, the necessary mouth full of breast, and a belly full of milk.
5. “Many moms just don’t make enough milk.”
“Not enough milk” is one of new moms’ top fears (see the whole list here).
It is also the number one reason moms say they stop breastfeeding sooner rather than later. While it’s hard to measure (and easy to worry about) what you can’t see, there are other ways to know that your baby is getting enough to eat.
From day 1 you can watch your baby’s poopy diapers. Remember, nothing comes out the bottom unless something goes in the top! You can be sure your baby is getting enough to eat if your baby has at least one stool a day on days 1 and 2 and three or more stools a day by day 3. A stool is a stain at least the size of your baby’s fist or at least 1 teaspoon of solid material. The color of your baby’s stool is just as telling as the number of stools. Your baby’s stool should be black on days 1 and 2, green on days 3 and 4, and yellow by day 5.
6. “Inadequate weight gain is common.”
Knowing how much weight babies typically lose and gain during their first weeks of life can help you know if your baby is gaining too little, too much, or just the right amount of weight.
Newborns lose, on average, 5 percent of their birth weight during the first five days after birth. Some babies lose as little as 0–2 percent and some lose as much as 7–10 percent. Weight loss greater than 10 percent or continued weight loss after day 5 can be cause for concern and should be reported to your baby’s health care provider.
Most babies are back to their birth weight by 10 days of age and gain between 4–8 ounces a week during the remainder of the first three months. It is important to remember that every baby is different and some will gain more slowly than others. Unless there are other signs of illness, slow weight gain alone is usually not a cause for concern. If you are worried about your baby’s weight, talk with your baby’s health care provider.
7. “A lot of breastfed babies will need formula supplements.”
Although 9-in-10 mothers initiate breastfeeding, less than 2-in-10 breastfeed exclusively for six months (as recommended by health care organizations worldwide). Despite compelling evidence of the benefits of exclusive breastfeeding, work/school demands, illness of mom/baby, pain, and low milk supply are among the many reasons mothers cite for giving formula supplements. The fact is, most mothers are able to breastfeed their babies exclusively. Although formula supplements are widely used, their use is seldom medically indicated. If a mother or baby is unable to breastfeed, a mother’s own milk (MOM) in a bottle is the next best option, followed by donor milk.
If these options are not viable, artificial infant formula can be used. However, mothers are urged to talk with their baby’s health care provider before offering formula supplements, so that, together, you can develop a feeding plan that best meets your needs and the needs of your baby.
8. “How much milk you pump is how much milk you make.”
It’s easy for a hungry baby to trigger a let-down; it’s a different story, when the “trigger” has to be plugged in and turned on. How much milk a mother expresses from her breasts (by hand or with a pump) is seldom a reflection of how much milk she makes—or her baby takes—at a feeding. When it comes to milk removal, nothing beats a baby! It’s not unusual for a baby to consume 4 or more ounces at a feeding, even when her mom can express only 1–2 at a session.
Like breastfeeding, milk expression is a skill that requires patience, practice, and persistence. In the beginning, you may get only enough milk to cover the bottom of the collection container. Don’t worry. It can take days or weeks before you see an increase in the amount obtained. Whether you are pumping one breast at a time or both breasts at once, you will want to pump for 3–5 minutes (or longer if milk is still flowing), then rest for 3–5 minutes. This will allow more milk to accumulate before you trigger another let-down. Repeat this process two or three times, until both breasts are soft. “Hands-on pumping” can also increase the amount you pump.
9. “You need to wait at least 2 hours after you pump to breastfeed.”
The same rule that applies to breastfeeding applies to pumping: Watch your baby, not the clock, and feed your baby at the first sign of hunger. Your breasts are constantly producing milk, so there is no need to wait for even one minute after pumping before feeding your child. In fact, the more milk you remove from your breasts by breastfeeding or pumping, the more milk you will make. Ongoing production ensures that there is milk available 24 hours a day 7 days a week—whenever your baby is hungry or thirsty.
Moms often mistake “soft” breasts for “empty” breasts, but breasts are never truly empty, they’re simply more or less full.
Moms, especially those returning to work or school and wanting to stockpile milk for later use, are urged to breastfeed first and pump afterwards. You can also pump in between feedings or whenever your breasts feel full. This will ensure that your baby gets the nutrients and calories she needs to grow, while you fill your freezer with milk!
10. “‘No leaking’ means ‘no milk.’”
Milk dripping (leaking) from your breasts is a sure sign that your body is making milk—hooray! Now you simply need to get the milk out of your breasts and into your baby. Once your baby acquires a feeding routine (about 6–12 weeks of age), leaking usually stops. Don’t panic! You’re not losing your milk. Your breasts have simply learned how much milk to make and when to make it.
Parents today have access to unlimited amounts of information—good, bad, and everything in between. Learn to separate fact from fiction and you will gain the knowledge and confidence you need to meet your breastfeeding goals.
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