Episode 60      Three Common Myths About Breastfeeding

There is so much information about breastfeeding. Some of it is great and accurate and exactly what we want moms to know.
Other information runs the gammet from poor to downright negligent. While there are frequently what I call “nuggets” of truth in what a lot of people share with
breastfeeding moms, it may not be right for their individual breastfeeding relationship. Confused? Well, come along with me for the ride and
I hope to be able to explain myself.

Poor information can be responsible for some mothers not continuing to breastfeed.
Poor information can be responsible for moms not making enough milk.
Poor information can be responsible for babies not gaining well.

So, here I am to the rescue…. Lori Jill Isenstadt, IBCLC, helping save mothers and babies and breastfeeding. I know that sound dramatic. I do mean for it to be as this is serious. I also thought it would be fun to add a bit of humor to this HOT topic, as well as to amuse my husband Alan, who edits all my shows. I can just hear him groaning in the other room.

What are some of the common things that mothers are told about breastfeeding that can screw up the breastfeeding relationship?
Here goes:

1. Only breastfeed from one side each feeding – This gets a Big Fat What?? from me –

While it may turn out that a mom is making enough milk for several other babies on the block & her baby might only need one side to get full and gain well, UNTIL we know this for sure, this is very poor advice. When mothers are advised this in the very beginning of breastfeeding, this puts her in jeopardy of not building a full supply to meet her babies needs. This puts her baby in jeopardy of not gaining well or losing too much weight.

The question I have for people who give this advice – How do you know how much milk this mom makes? How do you know how effective her baby is at removing the milk?

The first 6 weeks of breastfeeding are very important to building a good supply that meets your babies needs. We want to give your body the best chance to do this. By limiting the baby to one side per feed, you may limit your ability to make enough for your baby. The general rule of thumb is to always offer both sides for each feeding. If your baby is feeding well and has received enough milk from one side, he will more than likely turn you down. My suggestion is for the first few weeks, always offer the second side and let your baby be the one to turn you down. Once you get past the initial common weight loss that happens over the first 4 days and once you get to the 2 weeks old stage and your baby has gained back his birth weight, you may have a better idea on how to go about this.

If your baby’s breastfeeding behavior as far as frequency of feeds, milk transfer, output, is normal and breastfeeding is normal for you – no pain with breastfeeding, and you get to your two week visit and your baby is gaining well, you will be in a better position to evaluate one breast per feeding.

What exactly do I mean by this?

If your baby has been breastfeeding from both sides and has gained a normal amount of weight, this tells us that he needs to have volume from both sides in order to gain well. If this has been working well for you, keep doing the same thing. Please don’t listen to anyone who tells you that your baby only needs one side. I have seen this happen in that babies go for a weight check and when asked about feeding habits and moms talks about 45 minute feedings, they are told that their babies can get enough from one side, so reduce feeds to one side. Aggggh! Common sense tells us to not mess with something that has been working quite well.

If you have been offering both sides, but your baby rarely takes both sides per feeding, and yet has been gaining well, then it is likely at this point that your baby will be fine with just one breast per feeding. Be careful though to always be checking in with your baby. Pay attention to their hunger cues. As your baby gets older and your milk supply naturally regulates, your baby may want and need to nurse from both sides at each feeding. Some mothers get so use to feeding from one side per feeding that they miss the signs that baby wants the other side.

On a regular basis, I meet with moms whose baby was gaining well for the first couple of months and only nursing from one side. Everyone has been happy. But then they notice their baby is not sleeping as well, or fussy after some feedings, hard to settle down after some feedings, perhaps less output. Perhaps their baby is acting fairly normally and nothing stands out. They go in for a weight check and find out that their babies have been gaining much less than they should. They start doubting their supply, start taking herbs and pills and drinking excessive amount of water to increase their supply. Upon meeting with one mom this past week, I determine that there is no major cause for her baby losing weight, other than she was offering only one side per feeding. If her baby was hungry after he came off the breast the first time, she kept putting him back on until he seemed to fall asleep or feel full. Using the scale that I bring to consults, I was able to show her that when she put baby onto the right breast the first tie, he took 45 m. which was literally half a feeding..She put the baby back on breast twice more and baby took a total of 8 ml and 2 ml, for a total of 55 ml. the whole feeding. Typically, this would signal the end of the feeding session because as mom says: this is all she always takes. I ask her to experiment a bit and put the baby on the other side. Wallah! In 10 minutes, her baby transferred an additional 50 ml, for a total of 105 ml this feeding. The proof was in the pudding… or the scale we could say. Mom now realized that her baby does no need both sides. I spoke to this mom 3 days later and while she had not taken the baby in for a weight check yet, she noticed a significant difference in her babies behavior. She described wet diapers that she could really feel the weight, she also said that her baby who had been crying and fussy, was now cooing again and totally fine with being put down on the floor for a short time and be content to just watch others in the household , rather than cry as she had been doing the last few weeks.

So, my advice to new mothers, when your baby is born, always offer both sides per feeding. A well fed baby will let you know if he needs one side or both.
Continue to test the waters and be sure your baby is only wanting one side per feeding and you are not avoiding the other side because someone gave you poor advice.

2. Only feed your baby for a specific time on each side. Whether you are told 10 minutes, or 15 minutes, or 20 minutes on each side. you are told to only put your baby on the breast for a certain amount of time because he/she can get all they need in that time… Run, don’t walk… away from that poor advice.

In response to this advice I ask the person giving the advice:
Ohhh, so how much milk is the baby supposed to take per feeding? And does that always stay the same?
How much milk does the mom make? How effective is her baby at transferring the milk? How do you know how long it takes for her baby to take that volume?
The mom doesn’t know! The baby doesn’t know! How do you know?

The deal here is that babies are quicker and more efficient at some feedings than others. Babies want more at some feedings than others.

First, let’s think about our eating and drinking habits as adults. And by the way, as independent adults who can get up and get a glass of water if they are thirsty.

We drink water or coffee or tea or juice when we are thirsty. We have a snack when we are hungry. We eat our meals how much we want and when we want.
No one is forcing you to eat a certain amount of food at a certain time. No one is only letting you drink 4 oz of water when you are really parched and want 8 oz.
You would be pretty darn miserable if you were not able to pay attending to your hunger and hydration cues. You would be frustrated and perhaps even angry. This would begin to affect your mood and your sleep habits. We eat more foods and some meals and less than others. We don’t always finish our food in the same amount of time.

If your baby is breastfeeding well, in a good nursing rhythm, why on earth would you take away his meal just because the clock tells you he has been there for 10 minutes. If your baby is on a roll, please let him finish. He will be a much happier baby. After all, he can’t tell time. He just knows when he is hungry and when he is full.

One of my many breastfeeding mantras is: Watch the baby, not the clock!

3. A breastfed baby needs additional water from a bottle! Now that we are coming upon the summer weather, this is always a good one to talk about. The answer is – Absolutely not! Your breastmilk has a high water content and your baby definitely does not need additional fluids. He may be thirsty and so he needs to breastfeed. To get the hydration, along with all the other calories he needs.

This can actually be quite dangerous. For newborns, additional water can lead to a higher bilirubin level and excessive weight loss. Too much water can lead to a very dangerous medical condition called water intoxication. Adding water causes babies to fill up without adding calories and can result in severe weight loss. Babies who are supplemented with water, they will get empty calories, nurse less and may not gain well.

So, do not even think about offering your baby, at least until they are 6 months old or over and even then just very small amounts.

These are just 3 of the most common myths. There are a LOT of myths about breastfeeding so I will be back again with the same topic, but different myths.

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