Breastfeeding Myths: Experts Set the Record Straight
When it comes to breastfeeding, everyone from your mother's second cousin to your hairstylist will ply you with advice and opinions. Some of the "wisdom" imparted may be helpful, but chances are much of it won't be. "There are so many myths surrounding breastfeeding that it can be hard for women to know what's true and what's not," says Wendy Haldeman, R.N., M.N., a certified lactation consultant and co-owner of The Pump Station, a breastfeeding-support center in Santa Monica, Calif. To help you sort through it all, here are the truths behind some of the most common myths.
Myth: You need to toughen nipples for breastfeeding.
During pregnancy your breasts naturally undergo changes that get them ready for breastfeeding, says Christina Smillie, M.D., a pediatrician, lactation expert, and founder of Breastfeeding Resources, in Stratford, Connecticut. Even before your baby is born, the area around your nipples will thicken and the glands in your areolas will produce oils for lubrication and protection.
Once your baby arrives and you begin breastfeeding, a surge in the hormone oxytocin makes your nipples more pliable and stretchy for your baby's mouth. If you have flat or inverted nipples, a lactation consultant can teach you techniques that will help you nurse.
Myth: It's normal for nursing to hurt.
Although it's common to feel discomfort at first, pain is a sign that your baby isn't latching onto your breast properly. Instead of focusing only on your nipple, she should be opening wide and pulling your nipple and breast deep into her mouth, using her jaw and tongue to massage milk out of your breast, explains Parents advisor Jane Morton, M.D., clinical professor of pediatrics at Stanford University and a breastfeeding expert in Menlo Park, California. Keep changing positions until your baby feels safe and secure. With a little time and patience, you'll both get it right.
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Myth: Breastfeeding will cause your breasts to sag.
In reality, droopy breasts are a result of pregnancy, because hormonal changes cause the ligaments underneath them to loosen and stretch. As you gain weight and your breasts become larger and heavier, they may begin to sag, explains Matthew R. Schulman, M.D., assistant professor of plastic surgery at the Mount Sinai School of Medicine, in New York City. When you first begin to nurse, your breasts may become swollen with milk (a temporary process called engorgement) and grow larger; however, they'll diminish in size once you've established a solid breastfeeding routine. After you wean your baby, your breasts will become softer and you can expect them to return to their pre-pregnancy size, unless you've gained or lost a significant amount of weight.
Myth: If you have small breasts, you won't produce enough milk to feed your baby.
Size doesn't matter! "The breast tissue you need to nurse a baby grows in response to pregnancy regardless of your breast size," says Judith Lauwers, I.B.C.L.C., a spokeswoman for the International Lactation Consultant Association. It is in this so-called functional tissue—rather than in the fatty tissue that is responsible for breast size—that the milk ducts are located. So rest assured that whether you're an A or D cup, your breasts are capable of providing your baby with the milk she needs.
Myth: You won't be able to breastfeed if you've had breast-augmentation or breast-reduction surgery.
"These days, implants are usually inserted near the armpit or under the breast tissue or chest muscle, which shouldn't interfere with breastfeeding," says Carol Huotari, I.B.C.L.C., manager of the Center for Breastfeeding Information at La Leche League International. On the other hand, if you had surgery in which the nipple was removed in order to insert the implant and then reattached, breastfeeding may be hampered, as this procedure disrupts so many nerves that milk letdown is impaired. In this case, you will likely need to supplement with formula.
Whether you will be able to breastfeed after breast-reduction surgery also depends on how the procedure was performed. "If the nipple is left partially attached during the procedure and then reattached once the unwanted breast tissue has been removed, it's more likely that you'll be able to breastfeed," Huotari says.
If you have had either type of breast surgery, be sure to let your pediatrician know so she can keep a close watch on your baby's weight gain.
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Myth: You need to nurse every two hours around the clock—no more, no less—to make sure that your baby gets enough to eat.
Babies' eating patterns are as individual as those of their parents.That said, many newborns do naturally fall into an every-two-hours routine. "'Watch the baby and not the clock' is what we always emphasize," Haldeman says.
If you're worried that your baby isn't getting enough to eat, count the number of dirty diapers she has—she should have at least six wet diapers plus two or three "seedy" stools daily. You can also schedule a weight check with your pediatrician if you're worried that your baby isn't getting enough to eat.
Myth: You must eat only bland foods while breastfeeding.
By the time the foods you eat have been digested and used to make breast milk, the potentially upsetting elements have been broken down and shouldn't affect your baby at all. In other words, if you eat cabbage or broccoli, it's unlikely that it will make your baby gassy. And if you indulge in some spicy salsa, your baby probably won't refuse to nurse. As Haldeman of The Pump Station says: "Women in India eat really hot curry and their babies still breastfeed. And there is research that shows babies actually prefer garlicky milk." Still, there are a few foods that do cross into breast milk and upset some babies' stomachs, she says. Among them are dairy products, soy, peanuts, fish and shellfish.
Many breastfeeding moms swear by the wait-and-see approach: Don't alter your diet at all and see if your baby has a problem. If she does seem fussy after you eat certain foods, experiment with your diet. "If necessary, keep a food diary, and if your baby is fussy two to 12 hours after you've eaten a certain food, cut it out of your diet for a while," Huotari says.
Myth: Moms who take antidepressants shouldn't breastfeed.
Untreated postpartum depression can make nursing more difficult and stressful, so it's important to get help if you've been feeling blue for two or more weeks, says Stephanie Ho, M.D., a reproductive psychiatrist in New York City. If you need medication, a mental-health specialist with experience in treating postpartum depression will know which antidepressants are safe to prescribe to breastfeeding moms. If you took antidepressants while you were pregnant, stick to the same medication to keep your baby's exposure to a minimum.
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Myth: Breastfeeding will make your baby clingy and dependent.
"Studies have shown that babies who benefit from the attachment of breastfeeding tend to be more independent later in life," says Bettina Forbes, a certified lactation counselor and cofounder of the Best for Babes Foundation, an organization dedicated to changing cultural taboos that surround nursing.
Myth: If you give your baby bottles of pumped milk, she will refuse the breast.
Most babies switch between breast and bottle with no problem. "As long as you wait until your baby has mastered breastfeeding (usually at about six weeks) before you offer her a bottle, she should be willing to switch back and forth," Haldeman says. She notes, however, that women who limit their babies to one bottle per day tend to have less of a struggle.
Myth: Exercise will turn your milk sour.
Common wisdom used to be that workouts produce high levels of lactic acid in breast milk, giving it an unpalatable taste. But recent studies show that babies don't notice any difference. One thing that could make them turn up their squidgy little noses? Saltiness left on your skin by sweat—so shower right after your session, Berens suggests. (And whatever you do, don't pull up your exercise bra to nurse; the tight band can lead to clogged ducts.)
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Myth: You have to "pump and dump" after you drink alcohol.
Rather than throw away your precious breast milk, time your glass of wine or beer wisely. After you've had a drink, it will leave your milk at the same rate that it leaves your bloodstream, explains Dr. Ho. To make sure that your milk is alcohol-free, wait at least two and a half hours before nursing again. You can also dip test strips from the drugstore into a sample of your breast milk to ensure it's untainted. Consider pumping milk ahead of time in case your baby becomes hungry while the alcohol is still in your system.
Myth: You can't get pregnant while nursing.
If you are having sex, you can get pregnant, regardless of whether you're breastfeeding. However, you're less likely to conceive if you are within the first six months of breastfeeding, your period has not returned, and your baby is nursing every two to three hours, even at night. Unless you're ready for another child, talk to your doctor about your best birth-control options.
Myth: You shouldn't nurse if you're sick
Continuing to breastfeed while you have a cold or the flu actually helps protect your baby from illness. The germ-fighting antibodies that your body is busy making are transferred to your baby every time she nurses. As a result, she probably won't get sick at all, or if she does, it will be a milder version of whatever is ailing you, says Dr. Smillie. Keeping up your bonding sessions, in spite of feeling rotten, can help improve your mood too.
Myth: You shouldn't nurse if you have a blocked duct or breast infection.
Exactly the opposite is true. The best way to treat a blocked duct is to nurse as often as you can. And the best way to prevent an infection is to clear a blocked duct. But how do ducts become blocked in the first place? "It usually happens when the baby's nursing patterns change and the breast becomes overfull," Lauwers says. "For instance, when a baby starts taking longer naps, eating solid foods, and sleeping through the night, she may nurse less frequently, which can lead to blocked ducts."
Besides frequent nursing, applying heat—in the form of a heating pad or wet washcloth—before nursing can help clear a duct. Also be sure your bra isn't too constricting; and avoid underwire bras, as they can compress ducts.
If you do develop a breast infection—symptoms include redness and soreness in the breast, a fever and flulike symptoms—see your doctor right away, as you'll need to take antibiotics. "But you can still nurse with a breast infection," Lauwers says. "It's not going to hurt your baby."
Myth: Once you go back to work, you'll have to wean.
"If you commit to pumping, you can give your baby breast milk for as long as you wish," Haldeman says. This involves pumping three times a day when you're at work—preferably at the same times she would normally nurse—until your baby is 6 months old. After that, when she's eating some solids, you can drop down to twice a day. (If you continue to nurse in the morning and at night, in addition to pumping twice, you should be able to maintain an adequate milk supply.)
Since pumping will probably consume most of your break and lunch times, keep a supply of nutritious snacks at your desk so you have the fuel you need to make milk. Haldeman recommends fruit, protein bars, nuts and the nutritional drink Ensure. Also be sure to drink plenty of water—at least eight glasses a day.
Myth: If you don't nurse, you're a bad mom.
Although breastfeeding provides significant health benefits for your baby and you, deciding not to breastfeed – or being unable to breastfeed for whatever reason – doesn't make you an unfit mother. Feed your baby a formula that you feel good about, and move on. With your love and care, your child will thrive whether he dines on breast milk, formula, or some combination of the two.