26 Myths About Breastfeeding

Myths about breastfeeding are rampant in our culture. Sadly, a lot of women don't even try to nurse their babies, or give up almost immediately due to feelings of incompetence, lack of education and/or in many cases poor or misinformed advice from their doctors. Unbelievably, medical schools barely touch on the subject of breastfeeding, so many doctors know very little about it and in fact, some end up perpetuating many of the myths that keep women from breastfeeding their babies. Here is a list containing 26 of the most common myths.

1. Many women do not produce enough milk. - Not true! The vast majority of women produce more than enough milk. Indeed, an overabundance of milk is common. Most babies that gain too slowly, or lose weight, do so not because the mother does not have enough milk, but because the baby does not get the milk that the mother has. The usual reason that the baby does not get the milk that is available is that he is poorly latched onto the breast. This is why it is so important that the mother be shown, on the first day, how to latch a baby on properly, by someone who knows what they are doing.
2.  It is normal for breastfeeding to hurt. - Not true! Though some tenderness during the first few days is relatively common, this should be a temporary situation which lasts only a few days and should never be so bad that the mother dreads nursing. Any pain that is more than mild is abnormal and is almost always due to the baby latching on poorly. Any nipple pain that is not getting better by day 3 or 4 or lasts beyond 5 or 6 days should not be ignored. A new onset of pain when things have been going well for a while may be due to a yeast infection of the nipples. Limiting feeding time does not prevent soreness.
3. There is no (not enough) milk during the first 3 or 4 days after birth. - Not true! It often seems like that because the baby is not latched on properly and therefore is unable to get the milk. Once the mother's milk is abundant, a baby can latch on poorly and still may get plenty of milk. However, during the first few days, the baby who is latched on poorly cannot get milk. This accounts for "but he's been on the breast for 2 hours and is still hungry when I take him off". By not latching on well, the baby is unable to get the mother's first milk, called colostrum. Anyone who suggests you pump your milk to know how much colostrum there is, does not understand breastfeeding, and should be politely ignored.
4.  A baby should be on the breast 20 (10, 15, 7.6) minutes on each side. - Not true! However, a distinction needs to be made between "being on the breast" and "breastfeeding". If a baby is actually drinking for most of 15-20 minutes on the first side, he may not want to take the second side at all. If he drinks only a minute on the first side, and then nibbles or sleeps, and does the same on the other, no amount of time will be enough. The baby will breastfeed better and longer if he is latched on properly. He can also be helped to breastfeed longer if the mother compresses the breast to keep the flow of milk going, once he no longer swallows on his own. Thus it is obvious that the rule of thumb that "the baby gets 90% of the milk in the breast in the first 10 minutes" is equally hopelessly wrong.
5. A breastfeeding baby needs extra water in hot weather. - Not true! Breastmilk contains all the water a baby needs.
6. Breastfeeding babies need extra vitamin D. - Not true! Except in extraordinary circumstances (for example, if the mother herself was vitamin D deficient during the pregnancy). The baby stores vitamin D during the pregnancy, and a little outside exposure, on a regular basis, gives the baby all the vitamin D he needs.
7.  A mother should wash her nipples each times before feeding the baby. - Not true! Formula feeding requires careful attention to cleanliness because formula not only does not protect the baby against infection, but also is actually a good breeding ground for bacteria and can also be easily contaminated. On the other hand, breastmilk protects the baby against infection. Washing nipples before each feeding makes breastfeeding unnecessarily complicated and washes away protective oils from the nipple.
8. Pumping is a good way of knowing how much milk the mother has. - Not true! How much milk can be pumped depends on many factors, including the mother's stress level. The baby who nurses well can get much more milk than his mother can pump. Pumping only tells you have much you can pump.
9. Breastmilk does not contain enough iron for the baby's needs. - Not true! Breastmilk contains just enough iron for the baby's needs. If the baby is full term he will get enough iron from breastmilk to last him at least the first 6 months. Formulas contain too much iron, but this quantity may be necessary to ensure the baby absorbs enough to prevent iron deficiency. The iron in formula is poorly absorbed, and most of it, the baby poops out. Generally, there is no need to add other foods to breastmilk before about 6 months of age.
10. It is easier to bottle feed than to breastfeed. - Not true! Or, this should not be true. However, breastfeeding is made difficult because women often do not receive the help they should to get started properly. A poor start can indeed make breastfeeding difficult. But a poor start can also be overcome. Breastfeeding is often more difficult at first, due to a poor start, but usually becomes easier later.
11. Breastfeeding ties the mother down. - Not true! But it depends how you look at it. A baby can be nursed anywhere, anytime, and thus breastfeeding is liberating for the mother. No need to drag around bottles or formula. No need to worry about where to warm up the milk. No need to worry about sterility. No need to worry about how your baby is, because he is with you.
12. There is no way to know how much breastmilk the baby is getting. - Not true! There is no easy way to measure how much the baby is getting, but this does not mean that you cannot know if the baby is getting enough. The best way to know is that the baby actually drinks at the breast for several minutes at each feeding (open—pause—close type of suck). Other ways also help show that the baby is getting plenty.
13. Modern formulas are almost the same as breastmilk. - Not true! The same claim was made in 1900 and before. Modern formulas are only superficially similar to breastmilk. Every correction of a deficiency in formulas is advertised as an advance. Fundamentally they are inexact copies based on outdated and incomplete knowledge of what breastmilk is. Formulas contain no antibodies, no living cells, no enzymes, no hormones. They contain much more aluminum, manganese, cadmium and iron than breastmilk. They contain significantly more protein than breastmilk. The proteins and fats are fundamentally different from those in breastmilk. Formulas do not vary from the beginning of the feed to the end of the feed, or from day 1 to day 7 to day 30, or from woman to woman, or from baby to baby... Your breastmilk is made as required to suit your baby. Formulas are made to suit every baby, and thus no baby. Formulas succeed only at making babies grow well, usually, but there is more to breastfeeding than getting the baby to grow quickly.
14. If the mother has an infection she should stop breastfeeding. - Not true! With very, very few exceptions, the baby will be protected by the mother's continuing to breastfeed. By the time the mother has fever (or cough, vomiting, diarrhea, rash, etc) she has already given the baby the infection, since she has been infectious for several days before she even knew she was sick. The baby's best protection against getting the infection is for the mother to continue breastfeeding. If the baby does get sick, he will be less sick if the mother continues breastfeeding. Besides, maybe it was the baby who gave the infection to the mother, but the baby did not show signs of illness because he was breastfeeding. Also, breast infections, including breast abscess, though painful, are not reasons to stop breastfeeding. Indeed, the infection is likely to settle more quickly if the mother continues breastfeeding on the affected side.
15. If the baby has diarrhea or vomiting, the mother should stop breastfeeding. - Not true! The best medicine for a baby's gut infection is breastfeeding. Stop other foods for a short time, but continue breastfeeding. Breastmilk is the only fluid your baby requires when he has diarrhea and/or vomiting, except under exceptional circumstances. The push to use "oral rehydrating solutions" is mainly a push by the formula (and oral rehydrating solutions) manufacturers to make even more money. The baby is comforted by the breastfeeding, and the mother is comforted by the baby's breastfeeding.
16. If the mother is taking medicine she should not breastfeed. - Not true! There are very very few medicines that a mother cannot take safely while breastfeeding. A very small amount of most medicines appears in the milk, but usually in such small quantities that there is no concern. If a medicine is truly of concern, there are usually equally effective, alternative medicines which are safe. The loss of benefit of breastfeeding for both the mother and the baby must be taken into account when weighing if breastfeeding should be continued.
17. A breastfeeding mother has to be obsessive about what she eats. - Not true! A breastfeeding mother should try to eat a balanced diet, but neither needs to eat any special foods nor avoid certain foods. A breastfeeding mother does not need to drink milk in order to make milk. A breastfeeding mother does not need to avoid spicy foods, garlic, cabbage or alcohol. A breastfeeding mother should eat a normal healthful diet. Although there are situations when something the mother eats may affect the baby, this is unusual. Most commonly, "colic", "gassiness" and crying can be improved by changing breastfeeding techniques, rather than changing the mother's diet.
18. A breastfeeding mother has to eat more in order to make enough milk. - Not true! Women on even very low calorie diets usually make enough milk, at least until the mother's calorie intake becomes critically low for a prolonged period of time. Generally, the baby will get what he needs. Some women worry that if they eat poorly for a few days this also will affect their milk. There is no need for concern. Such variations will not affect milk supply or quality. It is commonly said that women need to eat 500 extra calories a day in order to breastfeed. This is not true. Some women do eat more when they breastfeed, but others do not, and some even eat less, without any harm done to the mother or baby or the milk supply. The mother should eat a balanced diet dictated by her appetite. Rules about eating just make breastfeeding unnecessarily complicated.
19. A mother who smokes is better not to breastfeed. - Not true! A mother who cannot stop smoking should breastfeed. Breastfeeding has been shown to decrease the negative effects of cigarette smoke on the baby's lungs, for example. Breastfeeding confers great health benefits on both mother and baby. It would be better if the mother not smoke, but if she cannot stop or cut down, then it is better she smoke and breastfeed than smoke and formula feed.
20.  A mother should not drink alcohol while breastfeeding. - Not true! Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers.
21.  A woman who has had breast augmentation surgery cannot breastfeed. - Not true! Most do very well. There is no evidence that breastfeeding with silicone implants is harmful to the baby. Occasionally this operation is done through the areola. These women do have problems with milk supply, as does any woman who has an incision around the areola line.
22.  A woman who has had breast reduction surgery cannot breastfeed. - Not true! Breast reduction surgery does decrease the mother's capacity to produce milk, but since many mothers produce more than enough milk, mothers who have had breast reduction surgery sometimes manage very well to breastfeed exclusively. In such a situation, the establishment of breastfeeding should be done with special care to the principles mentioned in the topic #2 Breastfeeding: Starting Out Right. However, if the mother seems not to produce enough, she can still breastfeed, supplementing with a lactation aid (so that artificial nipples do not interfere with breastfeeding).
23. 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 with cleft palate 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. (topic #2 Breastfeeding: Starting Out Right). 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.
24. Women with small breasts produce less milk than those with large breasts. - Absolute Nonsense! 
25. 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. It almost as good as the pill if the baby is under 6 months of age, if breastfeeding is exclusive, and if 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.
26. Breastfeeding women cannot take birth control pills. - 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 may 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, or at least wait 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).

Written by Jack Newman, MD, FRCPC - Revised January 1998.

Jack Newman graduated from the University of Toronto medical school as a pediatrician in 1970. He started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's Hospital for Sick Children and, more recently, established similar clinics at Toronto's Doctors Hospital and St. Michael's Hospital. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa, and has published articles on the subject of breastfeeding in Scientific American and several medical journals. Dr Newman has practiced as a physician in Canada, New Zealand, South Africa and in Central and South America.