by Jack Newman, MD, FRCPC
1. Nursing mothers cannot breastfeed if they have had X-rays.
Not true! Regular X-rays such as a chest X-ray or dental X-rays do not affect the milk or the baby and the mother may nurse without concern. Mammograms are harder to read when the mother is lactating, but can be done and the mother should not stop breastfeeding just to get this done. There are other ways of investigating a breast lump. Newer imaging methods such as CT scan and MRI scans are of no concern, even if contrast is used. And special X-rays using contrast media? As long as no radioactive isotope is used there is no concern and the mother should not stop even for one feed. Herein are included studies such as intravenous pyelogram, lymphangiogram, venogram, arteriogram, myelogram etc. What about studies using radioactive nucleotides (bone scans, lung scans, etc.)? The baby will get a little radioactive nucleotide. However, as we often do these very same tests on children, even small babies, and the potential loss of benefits if the mother stops breastfeeding are considerable, the mother should continue breastfeeding. The exception is the thyroid scan. This test must be avoided in breastfeeding mothers. There are many ways of evaluating the thyroid, and only very occasionally does a thyroid scan truly have to be done. Check first before taking the radioactive iodine, the test can wait until you know for sure. In many cases where the scan must be done, it can be put off for several months.
2. Breastfeeding mothers' milk can “dry up” just like that.
Not true! Or if this can occur, it must be a rare occurrence. Aside from day to day and morning to evening variations, milk production does not change suddenly. There are changes which occur which may make it seem as if milk production is suddenly much less:
The baby breastfeeds less well. This is often due to the baby being given bottles or pacifiers and thus learning an inappropriate way of breastfeeding.
The birth control pill may decrease your milk supply. Think about stopping the pill or changing to a progesterone only pill. Or use other methods.
If the baby truly seems not to be getting enough, get help, but do not introduce a bottle which will only make things worse. If absolutely necessary, the baby can be supplemented, using a lactation aid which will not interfere with breastfeeding. However, lots can be done before giving supplements. Get help. Try compressing the breast with your hand to help the baby get milk.
3. Physicians know a lot about breastfeeding.
Not true! Obviously, there are exceptions. However, very few physicians trained in North America or Western Europe learned anything at all about breastfeeding in medical school. Even fewer learned about the practical aspects of helping mothers start breastfeeding and helping them maintain breastfeeding. After medical school, most of the information physicians get regarding infant feeding comes from formula company representatives or advertisements.
4. Pediatricians, at least, know a lot about breastfeeding.
Not true! Obviously, there are exceptions. However, in their post medical school training (residency), most pediatricians learned nothing formally about breastfeeding, and what they picked up in passing was often wrong. To many trainees in pediatrics, breastfeeding is seen as an “obstacle to the good medical care” of hospitalized babies.
