Common Breastfeeding Myths

By Lisa Marasco
Assistant Area Professional Liaison
LLL of Southern California/Nevada USA
From: LEAVEN, Vol. 34 No. 2, April-May 1998, pp. 21-24

Myth 1: Frequent nursing leads to poor milk production, a weak let-down response and ultimately unsuccessful nursing.

Fact: Milk supply is optimized when a healthy baby is allowed to nurse as often as he indicates the need. The milk-ejection reflex operates most strongly in the presence of a good supply of milk, which normally occurs when feeding on baby's cue.

Myth 2: A mother only needs to nurse four to six times a day to maintain good milk supply.

Fact: Research shows that when a mother breastfeeds early and often, an average of 9.9 times a day in the first two weeks, her milk production is greater, her infant gains more weight and she continues breastfeeding for a longer period. Milk production has been shown to be related to feeding frequency, and milk supply declines when feedings are infrequent or restricted.

Myth 3: Babies get all the milk they need in the first five to ten minutes of nursing.

Fact: While many older babies can take in the majority of their milk in the first five to ten minutes, this cannot be generalized to all babies. Newborns, who are learning to nurse and are not always efficient at sucking, often need much longer to feed. The ability to take in milk is also subject to the mother's let-down response. While many mothers may let down immediately, some may not. Some may eject their milk in small batches several times during a nursing session. Rather than guess, it is best to allow baby to suck until he shows signs of satiety such as self-detachment and relaxed hands and arms.

Myth 4: A breastfeeding mother should space her feedings so that her breasts will have time to refill.

Fact: Every baby/mother dyad is unique. A lactating mother's body is always making milk. Her breasts function in part as "storage tank," some holding more than others. The emptier the breast, the faster the body makes milk to replace it; the fuller the breast, the more production of milk slows down. If a mother consistently waits until her breasts "fill up" before she nurses, her body may get the message that it is making too much and may reduce total production.

Myth 5: Babies need only six to eight feedings a day by eight weeks of age, five to six feedings a day by three months, no more than four or five feedings a day by six months of age.

Fact: A breastfed baby's frequency of feeding will vary according to the mother's milk supply and storage capacity, as well as baby's developmental needs. Growth spurts and illnesses can temporarily change a baby's feeding patterns. Studies show that breastfeeding babies fed on cue will settle into a pattern that suits their own unique situation. In addition, the caloric intake of a breastfed baby increases toward the end of the feeding, so putting arbitrary limits on the frequency or duration of feedings may lead to inadequate caloric intake.

Myth 6: It is the amount of milk that a baby takes in (quantitative), not whether it is human milk or formula (qualitative), that determines how long a baby can go between feedings.

Fact:Breastfed babies have faster gastric emptying times than fomula-fed babies--approximately 1.5 hours versus up to 4 hours--due to the smaller size of the protein molecules in human milk. While intake quantity is one factor in determining feeding frequency, the type of milk is equally important. Anthropologic studies of mammalian milk confirm that human babies were intended to feed frequently and have done so throughout most of history.

Myth 7: Never wake a sleeping baby.

Fact: While most babies will indicate when they need to eat, babies in the newborn period may not wake often enough on their own and should be awakened if necessary to eat at least eight times a day. Infrequent waking to feed can be caused by labor drugs, maternal medications, jaundice, trauma, pacifiers and/or shutdown behavior after delayed response to feeding cues.

In addition, mothers who wish to take advantage of the natural infertility of lactational amenorrhea find that the return of menses is delayed longer when baby continues to suckle at night.

Myth 8: The metabolism of a baby is disorganized at birth and it requires the implementation of a routine or schedule to help stabilize this disorganization.

Fact: Babies are uniquely wired from birth to feed, sleep and have periods of wakefulness. This is not disorganized behavior but reflects the unique needs of newborn infants. Over time, babies naturally adapt to the rhythm of life in their new environment and do not require prompting or training.

Myth 9: Breastfeeding mothers must always use both breasts at each feeding.

Fact: It is more important to let baby finish the first breast first, even if that means that he doesn't take the second breast at the same feeding. Hindmilk is accessed gradually as the breast is drained. Some babies, if switched prematurely to the second breast, may fill up on the lower-calorie foremilk from both breasts rather than obtaining the normal balance of foremilk and hindmilk, resulting in infant dissatisfaction and poor weight gain. In the early weeks, many mothers offer both breasts at each feeding to help establish the milk supply.

Myth 10: If a baby isn't gaining well, it may be due to the low quality of the mother's milk.

Fact: Studies have shown that even malnourished women are able to produce milk of sufficient quality and quantity to support a growing infant. Most cases low weight gain are related to insufficient milk intake or an underlying health problem in the baby.

Myth 11: Poor milk supply is usually caused by stress, fatigue and/or inadequate fluids and food intake.

Fact: The most common causes of milk supply problems are infrequent feedings and/or poor latch-on and positioning; both are usually due to inadequate information provided to the breastfeeding mother. Suckling problems on the infant's part can also impact milk supply negatively. Stress, fatigue or malnutrition are rarely causes of milk supply failure because the body has highly developed survival mechanisms to protect the nursling during times of scarce food supply.

Myth 12: A mother must drink milk to make milk.

Fact: A healthy diet of vegetables, fruits, grains and proteins is all that a mother needs to provide the proper nutrients to produce milk. Calcium can he obtained from a variety of nondairy foods such as dark green vegetables, seeds, nuts and bony fish. No other mammal drinks milk to make milk.

Myth 13: Non-nutritive sucking has no scientific basis.

Fact: Experienced breastfeeding mothers learn that the sucking patterns and needs of babies vary. While some infants' sucking needs are met primarily during feedings, other babies may need additional sucking at the breast soon after a feeding even though they are not really hungry. Babies may also nurse when they are lonely, frightened or in pain.

Myth 14: The mother should not be a pacifier for the baby.

Fact: Comforting and meeting sucking needs at the breast is nature's original design. Pacifiers (dummies, soothers) are literally a substitute for the mother when she can't be available. Other reasons to pacify a baby primarily at the breast include superior oral-facial development, prolonged lactational amenorrhea, avoidance of nipple confusion and stimulation of an adequate milk supply to ensure higher rates of breastfeeding success.

Myth 15: There is no such thing as nipple confusion.

Fact: Breast and bottle feeding require different oral-motor skills, and rubber nipples provide a type of "super stimulus" that babies may imprint upon instead of the softer breast. As a result, some babies develop suck confusion and apply inappropriate suckling techniques to the breast when they switch between breast and bottle.

Myth 16: Frequent nursing can lead to postpartum depression.

Fact: Postpartum depression is believed to be caused by fluctuating hormones after birth and may be exacerbated by fatigue and lack of social support, though it mostly occurs in women who have a history of problems prior to pregnancy.

Myth 17: Feeding on baby's cue does not enhance maternal bonding behavior.

Fact: The responsive parenting of cue feeding brings mother and baby into synchronization, leading to enhanced bonding.

Myth 18: Mothers who hold their babies too much will spoil them.

Fact: Babies who are held often cry fewer hours a day and exhibit more security as they mature.

Myth 19: It is important that other family members get to feed baby so that they can bond, too.

Fact: Feeding is not the only method by which other family members can bond with the baby; holding, cuddling, bathing and playing with the infant are all important to his growth, development and attachment to others.

Myth 20: Child-directed feeding (nursing on demand) has a negative impact on the husband/wife relationship.

Fact: Mature parents realize that a newborn's needs are very intense but also diminish over time. In fact, the teamwork of nurturing a newborn can actually bring a couple closer as they develop parenting skills together.

Myth 21: Some babies are allergic to their mother's milk.

Fact: Human milk is the most natural and physiologic substance that baby can ingest. If a baby shows sensitivities related to feeding, it is usually a foreign protein that has piggybacked into mother's milk, and not the milk itself. This is easily handled by removing the offending food from mother's diet for a time.

Myth 22: Frequent nursing causes a child to be obese later in life.

Fact: Studies show that breastfed babies who control their own feeding patterns and intake tend to take just the right amount of milk for them. Formula feeding and early introduction of solids, not breastfeeding on demand, have been implicated in risk of obesity later in life.

Myth 23: The lying-down nursing position causes ear infections.

Fact: Because human milk is alive and teeming with antibodies and immunoglobulins, the baby is less likely to develop ear infections overall, no matter what position is used.

Myth 24: Nursing a baby after 12 months is of little value because the quality of breast milk begins to decline after six months.

Fact: The composition of human milk changes to meet the changing needs of baby as he matures. Even when baby is able to take solids, human milk is the primary source of nutrition during the first year. It becomes a supplement to solids during the second year. In addition, it takes between two and six years for a child's immune system to fully mature. Human milk continues to complement and boost the immune system for as long as it is offered.