9. Premature babies need to learn to take bottles before they can start breastfeeding.
Not true! Premature babies are less stressed by breastfeeding than by bottle feeding. A baby as small as 1200 grams and even smaller can start at the breast as soon as he is stable, though he may not latch on for several weeks. Still, he is learning and he is being held which is important for his wellbeing and his mother's. Actually, weight or gestational age do not matter as much as the baby's readiness to suck, as determined by his making sucking movements. There is no more reason to give bottles to premature babies than to full term babies. When supplementation is truly required there are ways to supplement without using artificial nipples.
10. Babies with cleft lip and/or palate cannot breastfeed.
Not true! Some do very well. Babies with a cleft lip only usually manage fine. But many babies do indeed find it impossible to latch on. There is no doubt, however, that if breastfeeding is not tried, it will not work. The baby's ability to breastfeed does not always seem to depend on the severity of the cleft. Breastfeeding should be started, as much as possible, using the principles of proper establishment of breastfeeding. If bottles are given, they will undermine the baby's ability to breastfeed. If the baby needs to be fed, but is not latching on, a cup can and should be used in preference to a bottle. Finger feeding occasionally is successful in babies with cleft lip/palate, but not usually.
11. Women with small breasts produce less milk than those with large breasts.
Nonsense!
12. Breastfeeding does not provide any protection against becoming pregnant.
Not true! It is not a foolproof method, but no method is. In fact breastfeeding is not a bad method of child spacing, and gives reliable protection especially during the first 6 months after birth. But it is reliable only when breastfeeding is exclusive, when feedings are fairly frequent (at least 6-8 times in 24 hours), there are no long periods during which the baby does not feed, and the mother has not yet had a normal menstrual period after giving birth. After the first six months, the protection is less, but still present, and on average women breastfeeding into the second year of life will have a baby every 2 to 3 years even without any artificial method of contraception.
13. Breastfeeding women cannot take the birth control pill.
Not true! The question is not exposure to female hormones, to which the baby is exposed anyway through breastfeeding. The baby gets only a tiny bit more from the pill. However, some women who take the pill, even the mini-pill, find that their milk supply decreases. Estrogen in the pill decrease the milk supply. Because so many women produce more than enough, this often does not matter, but sometimes it does and the baby becomes fussy and is not satisfied by nursing. Babies respond to rate of flow of milk, not what's “in the breast”, so that even a very good milk supply may seem to cause the baby who is used to faster flow to be fussy. Stopping the pill often brings things back to normal. If possible, women who are breastfeeding should avoid the pill until the baby is taking other foods (usually 4-6 months of age). Even if the baby is older, the milk supply may decrease significantly. If the pill must be used, it is preferable to use the progestin only pill (without estrogen).
14. Breastfeeding babies need other types of milk after 6 months.
Not true! Breastmilk gives the baby everything there is in other milks and more. Babies older than 6 months should be started on solids mainly so that they learn how to eat and so that they begin to get another source of iron, which by 7-9 months, is not supplied in sufficient quantities from breastmilk alone. Thus cow's milk or formula will not be necessary as long as the baby is breastfeeding. However, if the mother wishes to give milk after 6 months, there is no reason that the baby cannot get cow's milk, as long as the baby is still breastfeeding a few times a day, and is also getting a wide variety of solid foods in more than minimal amounts. Most babies older than 6 months who have never had formula will not accept it, because of the taste.
by Jack Newman, MD, FRCPC
