Breast Feeding
Common Myths and Pitfalls

Myth - Women naturally make breast milk and can feed their babies right after birth.
Truth - Most women make only a small quantity of colostrum in the first few days after birth, particularly after the first birth, and are unable to produce any significant quantity of milk until the 3rd or 4th day.

Fortunately babies are not born hungry and generally are unwilling to do more than sniff at and snuggle up to the breast and so therefore it is not important that actual nursing take place form the start. Most problems arise right here with well meaning friends and hospital staff telling the parents that the baby isn't "getting enough" as though there is a problem with the mother's supply. Newborns are not meant to "eat" much for a few days after birth, probably to allow the passage of the intestinal debris, known as meconium, before actually being required to digest milk protein. For this reason newborns are expected to lose up to 10% of their birth weight in the first week of life and regain their birth weight by the end of the second week. This correlates precisely with the plan of mother nature and should be understood and respected and not interfered with by the addition of formula. In more simple societies, babies are given water-sugar combinations a little at a time during the first 2-4 days in order to keep them hydrated and interested in sucking so that when the mother's milk arrives the baby is able to take it. Modern versions of this is the glucose water that hospitals offer new babies and that is so often shunned by parents who have been told not to let the hospital feed their baby "pop" in place of good nutrition. Sugar water is good nutrition at this particular point in the baby's life and should not be over used but also not refused. A well hydrated baby will be good and hungry and strong enough to learn to suckle when the mother's milk has come in . A tired and "dry" baby may be too weak to participate or too irritable to be dealt with by a nervous and frightened parent who imagines she has starved her child and might as well give up and give formula. Obviously nature knows what it is doing - we just have to heed the signs.

Myth - Babies need to be left on the breast for as long as they want to suck or they will miss the important and superior hind milk .
Truth - Babies who suck on mother's breast for very long periods in the early days and weeks are often failing to thrive and their mother's nipples are usually cracked and bleeding.

There is a lot of non-nutritive sucking that a newborn desires and can get from time on a pacifier or a finger or on their own hand if they are assisted. If left on the breast for an hour or longer they will tire themselves out with little milk benefit since the new mother doesn't yet make the supply that the demand is asking for. The exhaustion leads to under feeding since after spending a long time on one breast the baby is usually too tired to continue on the second which is full of milk and so the mother is left uncomfortable and frustrated. She may then try to express milk from the second breast and noting that not much comes out (see next myth) she may give up or stop trying to pump which then leads to milk backup and inflamation of the milk ducts and mastitis. Now the mother has one sore and bleeding nipple and one sore and swollen breast. Not a scenario likely to lead to success. A better solution would be to advise mothers to nurse briefly on both sides until the 2nd or 3rd week when the nipples are hardier and the breast milk production is more steady. Then gradually allow the baby to spend longer time on the SECOND side since they will not yet have exhausted themselves after getting most of the milk form the first and then the wonderful hind milk of the second breast can be available to them. There is plenty of "Goodies" to be had form all levels of mother's milk and there are immune globulins that are in fact mostly present in the fore milk. Let's not focus so much on the immediate benefits of the various components of breast milk and lets get the long-term outcome to be a breast feeding baby.

Myth - If you cannot pump at least 4 ounces per breast you are not making sufficient milk to feed your baby.
Truth - In fact, most women's bodies are relatively "turned off" by the mechanical pumping action of most devices.

Many women who can quite adequately sustain their babies (proof being on the scale), are unable to produce any quantity with a breast pump. It is estimated that the usual pumped production is about « to 1/3 the amount that a baby can get from direct nursing. This should reassure most mothers instead of their being discouraged by what they see after the pumping attempt "fails". It is not even necessary for mothers to pump except to relieve breast over production (and this can be managed by hand expressing a little in order to relieve the discomfort) or to develop a supply to give daddy the opportunity to feed the baby or for times when mom will be unavailable. It is not easy to create a long term supply that will be completely sustaining for most women but at least if moms have some reasonable idea of what their babies actually consume they can adjust their schedules or use alternative supplementation if they so choose and not feel that they are unable to provide enough milk because their bodies can't meet the challenge. Of course there are exceptions but most women think everyone can pump but them.

Myth - Babies who nurse will not gain weight as well as formula fed babies and will not sleep through the night as soon.
Truth - Babies are intended to drink mother's milk and so the standard for weight gain and growth should be based on breast fed infants and not on formula fed babies.

Most growth charts in common use today are designed in the 1950's and are based on formula fed babies pace of growth. This leads many mothers to feel their baby is failing to thrive when the pediatrician is asked for the "percentile" at the monthly check ups. It is best to refrain form comparing breast fed infant growth with formula fed patterns and most pediatricians are not eager to share percentile statements unless pressed for this reason. Although it is true that nursing babies feed more frequently than formula fed infants their babies are just as capable of sleeping through the night when they are developmentally ready.