10 common misconceptions of breastfeeding

Today is the last day of the World Breastfeeding Week 2018. This is an annual celebration of breastfeeding in more than 120 countries.

Breastfeeding is a cause worthy to promote and celebrate, which I personally treasure closely. Breastfeeding has been a gift to me. As is recommended by the WHO and Unicef, we have reached the state of breastfeeding 2 years and beyond in our house.  Currently it is only one short moment before Beertje's bedtime anymore, but that moment still exists.  In the past I've listed the advantages of breastfeeding. If you didn't read it yet, I recommend reading it.

Unfortunately there exists a lot of misconceptions and wrong advice around on breastfeeding which cause a lot of mothers to stop. Remember one important mantra when breastfeeding:

Breastfeeding = feeding on demand = feeding very frequently (in small quantities) 

1. Breastfeeding is easy. When you are breastfeeding you float on a pink perfect cloud

It comes as a shock to some new mom's, but breastfeeding is not always so easy and idyllic as you see on the beautiful peaceful pictures. I was suprised at Kabouter's birth to feel it's tiring, it can be painfull (it shouldn't but neverthelesss), it can be a struggle, ... It seems endless and overwhelming. It seems a hassle to find right positions, et.

And yet it can become so beautiful if you persist and if you succeed.  At the start you must learn the proper positions, the baby needs to learn to suckle correctly in order to avoid horribly painful nipple cracks. You need to find a rhythm together.

It's good to surround  you with some good support, role models and well adviced care takers. People that help you when things are a little difficult, rather than advicing you to stop right away.

2. Not enough milk production

For a small % of women there is a medical reason that they are not producing enough milk. However I hear very often that women stopped breastfeeding because "they ran out of milk".  If it is so common to run out of milk or to lack milk production from the start, the evolution of the human race would have been quite dramatic. After all, there's only been formula milk since a bit more than 100 years.

So why do women run out of milk? Most often because we don't feed our babies frequently enough. When I had some prenatal info sessions at the hospital for Kabouter, the midwives all of a sudden mentioned that a breastfed child had to drink at least 10-12 times a day. I thought they were out of their mind.  Since they were a credible source,  I figured this insane high frequency was probably the case for 2-3 weeks after which things would "normalise".   What I conceived as "normal", is what a lot of people think is normal.  It's the frequency stated on the backside of formula packages: 4-5 times a day.  It is the frequency what those instagram supermoms picking up all their hobbies and activities right after giving birth seem to stick too.  Well in fact, it's only natural that a baby drinks 10-12 times a day for months. Not many mothers achieve this, as we all want to pick up our household, hobbies and "live" again asap. It takes dedication and time and lack of sleep to feed for weeks at such a high frequency around the clock.

People who believe a baby should only drink 4-8 times a day, probably also have the image of a 200-250ml filled bottle that you see everywhere. It's hard to find smaller baby bottles in the stores: only  pumping brands seem to offer small bottles. Well, if you'll try to pump milk as a breastfeeding mother chances are that you will never ever pump that amount of milk.  If you pump only 50 - 150ml of milk each time, don't stress about not having enough milk production. Your baby doesn't need such a quantity at once. Yet your baby needs to drink small quantities more frequently and that's also how your baby will regulate your production.

All the good intended advice (let's hope it's well intended) to give a mother some rest by letting the father give in between a bottle of formula milk, by giving the baby a bottle before bedtime if the mother is too exhausted, by training the baby quite quickly to have longer periods in between feeding to let the baby's stomach rest, by trying to feed a bigger quantity (of pumped milk or formula bottles) at once to increase the time in between feeding sessions, ...all this good intended advice is in fact advice to stop breastfeeding. Following such advice will certainly decrease the demand of breastmilk production. Hence the production will reduce below the babies needs, the baby will cry more, ...which is often responded to adding bottles without good guidance. You enter in a vicious circle which will make the milk production end.
(=> don't get me wrong, if your baby does not gain enough weight, you need proper help!! It might be necessary to combine breast feeding with bottle feeding but it needs to be done in a proper way with quantities and frequencies and extra pumping in order not to reduce your milk production. Do seek help if your baby doesn't gain enough weight! Lactation specialists are not anti-formula so they will advice you to feed extra bottles if it is necessary for your child, but in a way so that they try not to stop your milk production in the long run).

It's also little known that the first day(s) the baby needs very very little milk. The first day the mother might only produce some drips of yellow gold (the first milk = colustrum which is brightly yellow because full of antibodies) but that is sufficient. Yet some mothers pump milk and panic because of the small quantity.

Below are the natural baby stomach sizes...by breastfeeding you will never overfeed and stretch a stomach.  However you can stretch a stomach by feeding too big bottles which will result in less frequent feeding and production decrease. Once a baby is used to big quantities, it will ask for bigger feedings and will become restless at the breast.

Day 1: 5-7 ml is about the size of a large marble or a cherry
Day 3: 22-27 ml is about the size of a ping pong ball or a walnut
One week: 45-60 ml is the size of an apricot or plum
One month- 6 months: 80-150 ml is about the size of an large chicken egg
(source LLL Canada)

The baby benefits from such frequent feedings, 24h/24h by getting regular delicate sugar boost for its ongoing brain development. So it's good for a young baby not to sleep through the night too quickly and it's better for the breastfeeding mom to be feeding during the night because the prolactine hormone is higher at night which is very beneficial for the milk production.

Some babies demand cluster feedings, where they have a daily moment that they cling to the breast for a few hours. They also have some days that they adjust the production by constant drinking during 24-72 hours....That's not a sign that the mother lacks milk.  By fighting it, the adjustment does not happen and the baby will continue to fuss at the breast which will make a mother feel very insecure and failing.  By giving in and allowing the baby to feed unlimitedly, the production will match demand quicker. I personally was warned with Kabouter that these days would happen approx at week 3 and 6, yet they were very overwhelming. I doubted myself and I needed to call for help from my lactation midwive as well as La Leche League Vlaanderen. It's easy to think you lack production. With Beertje I had much more the up front mindset to let him drink drink drink. Feeding was my only to do in the first weeks and my adaptation days were much less and not so heavy.

If you want to help a breastfeeding mom that feels overwhelmed, tired, ...  do not advice less frequent feeding or bigger bottles!! Help by doing her household chores, help with older children, by giving her all the support that might give her difficulty to feed frequently. That's the help she needs.  Not advice that will cause her milk production to go down.

All that being said, I don't want to claim that all mothers who state they didn't have enough milk for their children are liars! Some sincerely have a lack of milk for medical reasons, others might lack milk due to their breastfeeding approach, due to stress and fatigue, ... I'm convinced that a lot of them were wrongly informed and supported. Even I have been told by a specialist in the UZLeuven (for goodness sake, a hospital with a lactation label) that I was feeding Beertje too frequently. She told me to feed him less frequently so he'd drink more per session  (que?!?) even though she agreed that he needed 900ml per day at the time and I was feeding him 9 times a day (and if pumped milk his bottle was about 100ml). So unfortunately as a mother, you need to be well informed to counter the misinformation that even medical staff dare to give you.  Only lactation specialists have a proper scientific schooling in lacation...gynocologists are only specialist in the female reproduction parts and other doctors got 2h (!) of training on breastfeeding in their minimum 7 years of medical schooling.  Even our federal government lists among the breastfeeding myths that "all health profesionals are well trained to guide you with breastfeeding." Sadly, they are not.
I'm also convinced that the mothers that stop breastfeeding because they are convinced they lack milk, do so because they want to give the best to their child, because they are good loving mothers that don't want to take any risk. They do so because they feel tired and overwhelmed and in doubt without any support to fix that. I can't blame them for a second. A big hug to them all. Every mother has the right to switch to formula bottles without pointing finger.  But it's a pity if they would have made another choice if they had had options and support to increase/keep their production.

3. Breastfeeding takes more time and is more tiring than feeding bottles.

I tend to agree on this one for the first couple of weeks given the fact that infants feed so frequently and that this takes time at the start.

But seriously what is a few weeks in the lifetime of your child? You don't realise yet when your baby is born how quickly time will fly. After a few weeks I started to pity the parents that had to get out of bed, find empty bottles, wash bottles, warm bottles, prepare "on the road" packages etc while breastfeeding is always right there available without packaging at the right temperature without any dishes to do.  In the long run it takes so much less time. Really, trust me. The easiness and lack of hassle in breastfeeding was one of my prime motivators to keep going.

And for the dads: there are many many other ways to help the mother! You can nap with your child, help your child burp, you can sooth cramps, you can massage your baby...don't worry that you can't bond with your baby.

4. Pump milk to see what your baby drinks
It's not such a common advice anymore but old school midwives used to advice mom's to pump milk in order to see and control what your baby was drinking.  Ha, sadly enough that is the perfect way to make a mother feel more insecure because the amount of milk that you can pump is always less than what a baby manages to drink himself directly from the breast.   The baby simply is more naturally compatible with the breast. A live baby will trigger more oxytocine hormone in you so you'll produce more than when you pump. On top of that you'll also stimulate your milk production less efficiently than allowing your baby to drink live. And you'll miss the bonding, you create a hassle of bottles and dishes that wasn't really needed etc... And you'll notice that a baby drinks sometimes more and sometimes less, which is natural, but which can be stressful if you feel insecure.  And stress...has a negative impact on the milk production.

So please, allow your baby to drink live with you as much as possible. You'll do yourself a favour.

And if you feel uncertain whether your baby drinks sufficiently: check the number of wet diapers on a day and the your baby's growth.  They will tell if you if all is allright.

5. You can't breastfeed if you have small size of breasts (or if you have flat nipples or ...)

Fortunately your breast size does not tell you anything about your capacity to breastfeed! Thank goodness. The size of your breasts is determined by fat, not by the presence and capacity of the milk glands. If you had a breast reduction, then it might be possible that you have less capacity if the glands were impacted and then you need good coaching to see whether additional feeding is necessary or not.

And your baby can/will learn to latch on to flat nipples.

6. Relactation

I was convinced that stopping with breastfeeding was irreversable.  But it isn't.  In fact, I've met now online several couples where the female partner of a mother managed to breastfeed as well.  But it takes a lot of perseverence to achieve this and possibly some hormone intake.  And pumping pumping pumping...But clearly if you are very very motivated and you get proper guidance, it is possible to lactate or relactate again.  Still it's easier not to stop feeding if you don't want to.

Carefull: if a child stops drinking for a period of time, they do unlearn the skill to latch on correctly and drink. That is irreversable!

7. After 6 months there is no more added value in breast milk. 

This image says it all, doesn't it?  Formula milk is a good healthy alternative if you can't breastfeed. But it's still inferior to breastmilk, even after 6 months.

Formula milk is regulated by the WHO and European Union until 6 months since 1981.  Production companies cannot sell any formula milk for infants younger than 6 months in the supermarkets, neither can they make any publicity of infant formula milk, bottles, teats etc.  In order to advertise their products, they had to "split" their offer in formula for infants and products for children older than 6 months.  The number 2 only contains more sugar.  Your child does not need that.  If you want to feed your baby formula, keep giving number 1 as it is the closest to breast milk.  Number 2 milk, growth milk... : it's just marketing nonsense.

8. Breastmilk is full of dioxines wherease formula milk is controled by the government

It's true that the mother's breasts contain fat storage that might have stocked up dioxine intake the mother has encountered in her life.  And it's true that traces can be found in the fatty breast milk. Breast milk has been often researched so when traces were found, that led to big frightening news headlines.

Fact is that most dioxines are already passed on from mother to child in the womb. And that all research has shown time after time that the health advantages from breastmilk are greater than this disadvantage.  And if you ever read this while in doubt to breastfeed a 2nd child after having breastfed the first one: most of the stored dioxines are now already gone after the first time ;).

9. There is an alternative to breastfeeding in our Western world so we don't need to breastfeed.

A dietist told me so! And I've heard it in conversations before: the importance of breastfeeding is only in those poor countries where there is lack of pure water. But why would we do it? Of course there is a recommendation of the WHO "but that organisation focusses on third world countries".  No it doesn't and the American association of pediatrics make the same recommendation of 6 months of exclusive breastfeeding...not quite a third world country.

I counter the remark: why do we need to switch to an alternative if the original is completely viable, more healthy, more ecological, cheaper, ...

Our federal health department confirms: also in Belgium breastfeeding should be the first choice. If that is impossible, then own pumped milk is the 2nd choice.   And they also clearly state that infant formula does not cover an infant's full immunity needs neither its full nutrients needs.  So we can only conclude that third choice would be donor milk and only in 4th place would be formula.  Yet let's rejoice the fact that we live in an era where formula milk exists for those who need it.

10. Breastfeeding will give me hanging tits

Sorry to break the news to you but your case is lost as soon as you got pregnant.  It's too late now, whether you breastfeed or not. Motherhood has changed you already before you made a feeding choice.


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