by Jack Newman, MD, FRCPC
1. Women with flat or inverted nipples cannot breastfeed.
Not true! Babies do not breastfeed on nipples, they breastfeed on the breast. Though it may be easier for a baby to latch on to a breast with a prominent nipple, it is not necessary for nipples to stick out. A proper start will usually prevent problems and mothers with any shaped nipples can breastfeed perfectly adequately. In the past, a nipple shield was frequently suggested to get the baby to take the breast. This gadget should not be used, especially in the first few days! Though it may seem a solution, its use often result in poor feeding and severe weight loss, and makes it even more difficult to get the baby to take the breast. If the baby does not take the breast at first, with proper help, he will often take the breast later. Breasts also change in the first few weeks, and as long as the mother maintains a good milk supply, the baby will usually latch on, sooner or later.
2. A woman who becomes pregnant must stop breastfeeding.
Not true! If the mother and child desire, breastfeeding can continue. There are women who continue nursing the older child even after delivery of the new baby. Many women do decide to stop nursing when they become pregnant because their nipples are sore, or for other reasons, but there is no rush nor medical necessity to do so. In fact, there are often good reasons to continue. The milk supply may decrease during pregnancy, but if the baby is taking other foods, this is not a problem.
3. A baby with diarrhea should not breastfeed.
Not true! The best treatment for a gut infection (gastroenteritis) is breastfeeding. Furthermore, it is very unusual for the baby to require fluids other than breastmilk. If lactose intolerance is a problem, the baby can receive lactase drops, available without prescription, just before or after the feeding, but this is rarely necessary in breastfeeding babies. Get information on its use from the clinic. In any case, lactose intolerance due to gastroenteritis will disappear with time. Lactose free formula is not better than breastfeeding. Breastfeeding is better than any formula.
4. Babies will stay on the breast for 2 hours because they like to suck.
Not true! Babies need and like to suck, but how much do they need? Most babies who stay at the breast for such a long time are probably hungry, even though they may be gaining well. Being at the breast is not the same as drinking at the breast. Latching the baby better onto the breast allows the baby to nurse more effectively, and thus spend more time actually drinking. You can also help the baby to drink more by expressing milk into his mouth when he is no longer swallows on his own. Babies younger than 5-6 weeks often fall asleep at the breast because the flow of milk is slow, not necessarily because they have had enough to eat.
5. Babies need to know how to take a bottle. Therefore a bottle should always be introduced before the baby refuses to take one.
Not true! Though many mothers decide to introduce a bottle for various reasons, there is no reason a baby must learn how to use one. Indeed, there is no great advantage in a baby's taking a bottle. Since Canadian women are supposed to receive 26 weeks maternity leave, the baby can be started eating solids before the mother goes back to her outside work. The baby can even take fluids or solids that are quite liquidy off a spoon. At about 6 months of age, the baby can start learning how to drink from a cup, and though it may take several weeks for him to learn to use it efficiently, he will learn. If the mother is going to introduce a bottle, it is better she wait until the baby has been nursing well for 4-6 weeks, and then give it only occasionally. Sometimes, however, babies who take the bottle well at 6 weeks, refuse it at 3 or 4 months even if they have been getting bottles regularly (smart babies). Do not worry, and proceed as above with solids and spoon. Giving a bottle when breastfeeding is going badly is not a good idea and usually makes the breastfeeding even more difficult. For your sake and the baby's do not try to starve the baby into submission. Get help.