Guest Blog: 10 Myths About Breastfeeding
Ayelet Kaznelson, an International Board Certified Lactation Consultant at the Seleni Institute in New York City, covers the most common breastfeeding myths so you know what’s normal, what’s not, and when to get help. (Be sure to check out her last post on pumping!)
1. Breastfeeding should come naturally. Though biologically natural, breastfeeding is actually a learned behavior. Like any other new skill, it may take time, practice, patience, and persistence to master. It can be quite frustrating at times. And during the already emotionally fragile period after having a baby, it’s even more difficult to cope with frustration and difficulties. But breastfeeding will become easier with time and professional help, if necessary.
2. Nipple shape matters. For most women, nipple size or shape has no impact on breastfeeding. If you have flat or inverted nipples, they may self-correct by the time the baby arrives or shortly thereafter. Even if the shape doesn’t change, it may not impact breastfeeding much. Babies breastfeed, not nipple feed. However, in some cases nipple shape can make breastfeeding a little more challenging. If that happens, a knowledgeable lactation consultant can offer some strategies, such as wearing breast shells or nipple shields, pumping, and using manual manipulation, to help overcome those challenges.
3. Small breasts won’t make enough milk. The capacity for a woman’s breasts to make milk is determined by the breast tissue (milk-producing cells), not by the size of her breasts. Breast size is determined by fat, which has no bearing on milk production.
4. If breastfeeding starts out difficult, it will just get worse. Most breastfeeding issues are manageable and can be overcome in a relatively short amount of time. Some challenges, such as nipple pain, are fairly simple and can be taken care of rather easily by adjusting the latch, for instance. Other problems, such as low milk production or a baby who is unable to latch, can be more complex. But with the right support – such as the help of an internationally board certified lactation consultant – you can overcome almost any breastfeeding problem.
5. Nipple pain is normal. Nipple pain is common but not “normal.” Nature designed breastfeeding to feel good. When breastfeeding works, it floods our system with hormones that contribute to relaxation and mother-infant bonding. Pain does the opposite; it fills our bodies with stress hormones. Tugging and pulling is normal and painless. Sometimes a woman may experience slight discomfort for the first few days. If you find yourself dreading feeding, curling your toes to get through the pain, or tensing up as your child begins to nurse, something is not working. A board certified lactation consultant can help you improve your position and help you work on a painless latch.
6. Babies should only nurse from one breast at each feeding. Most babies need to feed from both breasts. Some take the same amount of milk from each, and some take most of the milk from one and “dessert” from the other. A few don’t need the second breast at all. In the beginning, try to feed your baby from both breasts at each feeding. If you notice at any point that your baby is not interested in feeding from both breasts, seems satisfied after feeding from just one breast, and is gaining the appropriate amount of weight, that arrangement may be just fine. You may need to pump a little milk from the second breast to avoid getting overly full (engorged) as your body adjusts.
7. Newborns need schedules. The American Academy of Pediatrics recommends that babies be fed every 2 to 3 hours (or about 8 to 12 times in a 24-hour period) during the first couple weeks of life. But once your baby is back to birth weight (by two weeks at the latest), you can start following her cues. Feed her when she shows signs of hunger, such as restlessness, smacking and licking lips, sucking on hands, or opening and closing her mouth. Most babies start to have a more predictable eating pattern within a few weeks.
8. Skipping feedings won’t affect my production. If you give your baby a bottle of pumped milk or formula, you need to help prevent your breasts from becoming engorged and your milk production from diminishing. When a hungry baby is breastfed, the breast and brain get the message to produce milk. If your child is fed from a bottle instead of directly from your breasts, extra milk could build up in your breasts. This can lead to painful overfullness, or engorgement. That, in turn, tells the brain to slow down milk production. To avoid both of these problems, the best solution is to pump whenever your baby is fed with a bottle.
9. You will probably need to wean when you go back to work. Going back to work doesn’t have to mean the end of breastfeeding. If you can pump once every three hours when you are away from your baby, you should be able to maintain adequate milk production. If it’s not possible to pump that much during work (or you don’t want to), you can pump at other times and breastfeed when you are home with your baby.
Some women decide to pump immediately after breastfeeding at home, especially on weekends, to keep milk production up and to get more milk stored up for the workweek. Many moms find they’re able to breastfeed in the morning before leaving for work, in the evening after they get home, and on weekends and holidays. You can supplement the rest of the feedings with pumped breast milk or infant milk substitutes (formula). If you wean from pumping at work, your milk production may decrease just a little or it may decrease significantly. Your baby might be okay with continuing this pattern for a while, or she may wean shortly after you stop pumping at work. You won’t know until you try, but the bottom line is that going back to work doesn’t have to mean weaning. You may need to be creative, but it is possible to work and continue to breastfeed.
10. You can’t take medications when you’re breastfeeding. Many medications are compatible with breastfeeding. If you’re taking one that isn’t, you may be able to find a safer substitute. Ask your doctor or lactation consultant to look up the most recent data on any medications you need. If you have to take medication that is not safe for breastfeeding, pump and discard your milk while taking the medicine and then resume breastfeeding after it’s no longer in your system.
Ayelet Kaznelson is an International Board Certified Lactation Consultant and a Certified Lactation Counselor in private practice in Manhattan. She believes that there are many ways for women to breastfeed successfully. Her goal is to offer evidence-based information, advice, and support that fit each mother’s particular needs and goals. She provides home lactation consultation, teaches prenatal breastfeeding and newborn care classes, and runs postpartum breastfeeding clinics at the Seleni Institute. She lives in Manhattan with her two children, Zoë and Liam, and her husband Todd.
This article was originally created for the Seleni Institute, a New York City-based nonprofit center focused on the reproductive and maternal mental health of women.