1. Exclusive breastfeeding is not enough for proper
weight gain in infants
Medical research
tells us that exclusive breastfeeding allows babies to thrive for the first 6
months. In the words of the World Health Organization,
“Breastfeeding
is an unequalled way of providing ideal food for the healthy growth and
development of infants… A recent review of evidence has shown that, on a
population basis, exclusive breastfeeding for 6 months is the optimal way of
feeding infants.”
2. The best way to increase an underweight baby's
weight is by supplementing with formula
Breastmilk has
more calories than formula and nutrients are more bio-available in breast milk as
compared to formula milk.
3. Babies with 'breastmilk jaundice' should not be
breastfed
Early, frequent,
unrestricted breastfeeding helps to eliminate bilirubin from baby’s body.
Bilirubin exits the body in the infant’s stools, and because breastmilk has a
laxative effect, frequent breastfeeders tend to have lots of soiled diapers and
thus, lower bilirubin levels.
4. Breasts need around 2-3 hours to refill in between
feeds
Every baby/mother dyad is unique. A lactating mother's
body is always making milk. Her breasts function in part as "storage
tank," some holding more than others. The emptier the breast, the faster the
body makes milk to replace it; the fuller the breast, the more production of
milk slows down. If a mother consistently waits until her breasts "fill
up" before she nurses, her body may get the message that it is making too
much and may reduce total production.
5. Exclusive nursing will make the mother weak
A nutritious
diet is very important after you have a baby for many reasons. Your body needs vitamins and minerals to heal
properly after delivery. Although it is
important to eat well postpartum, your breast milk always maintains a certain
nutritional quality even if your diet is less than adequate. No special diet or foods are necessary, but
mothers should try to eat a balanced, varied diet to remain healthy and
energetic.
While
breastfeeding a baby, you will need to consume approximately 300 to 500 extra
calories a day. For most breastfeeding
women that means you will need to consume 2000 to 2500 calories per day but
this varies depending on your height and weight.
6. If the baby nurses too frequently, it means the
mother doesn't have enough milk
Research shows that when a mother breastfeeds early
and often, an average of 9.9 times a day in the first two weeks, her milk
production is greater, her infant gains more weight and she continues
breastfeeding for a longer period. Milk production has been shown to be related
to feeding frequency and milk supply, which declines when feedings are
infrequent or restricted.
7. You should have a minimum gap of 1.5 hours between
feeds
Every baby/mother dyad is unique. A lactating mother's
body is always making milk. Her breasts function in part as "storage
tank," some holding more than others. The emptier the breast, the faster
the body makes milk to replace it; the fuller the breast, the more production
of milk slows down. If a mother consistently waits until her breasts "fill
up" before she nurses, her body may get the message that it is making too
much and may reduce total production.
8. If babies cry in spite of frequent nursing, it
means they are hungry and should be supplemented with formula
9. Longer feeds will cause a newborn to lose weight
While many older babies can take in the majority of
their milk in the first five to ten minutes, this cannot be generalized to all babies.
Newborns, who are learning to nurse and are not always efficient at sucking,
often need much longer to feed. The ability to take in milk is also subject to
the mother's let-down response. While many mothers may let down immediately,
some may not. Some may eject their milk in small batches several times during a
nursing session. Rather than guess, it is best to allow baby to suck until he
shows signs of satiety such as self-detachment and relaxed hands and arms.
10. You should not allow the baby to 'snack' at the
breast
Some babies
simply love to nurse. They’re gaining
fine, but they need lots and lots of time at breast. They’re nursing for food, for security, for
love, for entertainment, and they won’t do it forever
11. A baby that falls asleep before 15 minutes of
nursing should be smacked awake to complete the feed
If you have a
sleepy baby, remember that the most important thing is making sure that he gets
enough to eat. Monitor his urine and stool output and his weight gain closely,
especially during the first couple of weeks. If he is not gaining weight
adequately, consult a lactation professional for advice on how to increase his
weight gain.
12. Bigger babies will need to be supplemented with
formula
Medical research
tells us that exclusive breastfeeding allows babies to thrive for the first 6
months. In the words of the World Health Organization,
“Breastfeeding
is an unequalled way of providing ideal food for the healthy growth and
development of infants… A recent review of evidence has shown that, on a
population basis, exclusive breastfeeding for 6 months is the optimal way of
feeding infants.”
13. You cannot exclusively breastfeed twins
“Virtually all
mothers can breastfeed one or more infants, provided that they have correct
information and the support of their family, the health care system, and
society at large.”
- Bennington,
Linda K. “Breastfeeding Multiples: It Can Be Done.” Newborn and Infant Nursing
Reviews 11.4 (2011): 194-197.
14. Exclusively breastfed infants need iron
supplementation
No supplements
(water, glucose water, formula, and so forth) should be given to breastfeeding
newborns unless a medical indication exists… Exclusive breastfeeding is ideal
nutrition and sufficient to support optimal growth and development for
approximately the first 6 months after birth.
15. Exclusive nursing will slow down recovery from a
C-section
16. Babies shouldn't be nursed for more than 15-20
minutes on each breast
The length of
each breastfeeding session can vary, depending on baby’s age, hunger level, and
individual nursing style. Generally speaking, newborns will feed anywhere from
5–40 minutes (occasionally even longer), while older babies tend to finish in a
shorter time.
17. If weight gain is not adequate, it's better to
introduce solids by 4 months
Studies have
shown that for babies under six months, solids tend to replace breastmilk in a
baby’s diet – they do not add to baby’s total intake (WHO 2003, Cohen 1994,
Dewey 1999). The more solids that baby eats, the less milk he takes from mom,
and less milk taken from mom means less milk production. Babies who eat lots of
solids or who start solids early tend to wean prematurely.
18. After 6 months, breastmilk should only supplement
solids
According to Ted
Greiner, PhD, and noted breastfeeding researcher, any foods other than breast
milk or formula given during the first 6 months have a displacement rather than
additive effect because they displace the fat and calories the baby needs from
milk.
From 6 – 12
months, babies need an “educational” diet, where other foods gradually begin to
provide for nutritional needs that milk alone can’t provide. Breastmilk or
formula should be the main source (75%) of calories until the end of the first
year.
From 12 – 24
months, the “complementary” diet goes up until at 18 months, milk provides 50%
of the baby’s calories,
From 2 -3 years, up to 80% – 90% of the baby’s
caloric intake is provided by foods other than milk.
19. Comfort nursing has no value and is best avoided
Lactation
consultant Fleur Bickford of Ottawa says that a 2009 study published in the
journal Pediatrics showed that breastfeeding was more effective than any other
intervention (being held, sucking on a pacifier, oral glucose solution or
formula feeding) in reducing a baby’s pain after a heel prick, as measured by
several factors including the amount of crying and the baby’s heart rate.
“Babies go to the breast for many reasons — they’re hungry or thirsty, they’re
tired, they’re scared or hurt, they’re feeling overwhelmed. All of these are
equally valid reasons for a baby to nurse,” says Bickford.
20. There is not much nutrition in breastmilk after one
year
In the second year (12-23 months), 448 mL of breastmilk provides:
§ 29% of energy requirements
§ 43% of protein requirements
§ 36% of calcium requirements
§ 75% of vitamin A requirements
§ 76% of folate requirements
§ 94% of vitamin B12 requirements
§ 60% of vitamin C requirements
–
Dewey 2001
21. Many medications and medical conditions/procedures
contraindicate breastfeeding
Almost all prescription
and over-the-counter medications taken by the mother are safe during
breastfeeding. Several resources are available to help estimate the degree of
drug exposure an infant will receive through breastmilk.23-25 The National
Library of Medicine provides an easy-to-use online source for information on
the use of drugs in lactation; it is available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT(toxnet.nlm.nih.gov).
Physicians must weigh the risks of
replacing breastfeeding with artificial feeding against the risk of medication
exposure through breast milk.
22. One or two feeds of formula a day will have no
impact on breastfeeding
Breastfed and
formula-fed infants have different gut flora.
* Breastfed
babies have a lower gut pH (acidic environment) of approximately 5.1-5.4
throughout the first six weeks that is dominated by bifidobacteria with reduced
pathogenic (disease-causing) microbes such as E coli, bacteroides, clostridia,
and streptococci o babies fed formula have a high gut pH of approximately
5.9-7.3 with a variety of putrefactive bacterial species.
* In infants fed
breast milk and formula supplements the mean pH is approximately 5.7-6.0 during
the first four weeks, falling to 5.45 by the sixth week.
* When formula
supplements are given to breastfed babies during the first seven days of life,
the production of a strongly acidic environment is delayed and its full
potential may never be reached.
* Breastfed
infants who receive supplements develop gut flora and behavior like formula-fed
infants.
23. If breastfeeding is painful for new mothers,
nipple shields are a good solution
Often, nipple
shields are recommended within the first few days of birth. Frequently in these
cases, the shields are not needed and are handed out without proper
instructions for using and weaning from them – a shield should generally not be
used during the first week after birth unless there is an obvious problem such
as prematurity or difficulty latching which is attributable to some physical
characteristic of the baby.
24. Many women do not produce enough milk
Marianne Neifert
estimates that “as many as 5% of women may have primary insufficient lactation
because of anatomic breast variations or medical illness that make them unable
to produce a full milk supply despite heroic efforts.”
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.
25. There is no (not enough) milk during the first
three or four days after birth
A 1 day old
baby's stomach capacity is about 5-7 ml, or about the size of a marble.
Interestingly, researchers have found that the day-old newborn's stomach does
not stretch to hold more. Since the walls of the newborn's stomach stays firm,
extra milk is most often expelled (spit up). Your colostrum is just the right
amount for your baby's first feedings!
By day 3, the
newborn's stomach capacity has grown to about 0.75-1 oz, or about the size of a
"shooter" marble. Small, frequent feedings assure that your baby
takes in all the milk he needs.
Around day 7,
the newborn's stomach capacity is now about 1.5-2 oz, or about the size of a
ping-pong ball. Continued frequent feeding will assure that your baby takes in
all the milk he needs, and your milk production meets his demands.
26. A breastfeeding baby needs extra fluids in hot
weather
Exclusively
breastfed babies do not need additional water – breastmilk is 88% water and
supplies all the fluids that your baby needs. Even in the first few days after
birth, before mom’s milk has “come in”, colostrum is all that is needed to keep
baby well hydrated (assuming baby is nursing effectively).
Exclusively
breastfed babies do not require additional water even when it is very hot
outside, as long as baby is allowed to nurse as needed. Even in extremely hot,
dry weather your baby can get all the liquids needed via breastmilk. A number
of research studies investigating the need for water in exclusively breastfed
babies were done in various locations (both humid and dry) at temperatures
ranging from 22-41°C (71.6-105.8°F) and 9-96% relative humidity; these studies
concluded that exclusive breastfeeding provides all the fluids needed.
27. Pumping is a good way of knowing how much milk the
mother has
28. A woman who becomes pregnant must stop
breastfeeding
With increasing
first-hand experience among health professionals, many well-respected sources
are asserting that breastfeeding is safe in healthy pregnancies, including Ina
May Gaskin, LM,4 the American Academy of Family Physicians,11 and Ruth
Lawrence, MD, in Breastfeeding: A Guide for the Medical Profession.12
29. Formula helps babies sleep better at night
30. Frequent nursing beyond the first year will
interfere with intake of solids, and should be discouraged
Some toddlers
are eating very few solids, or even no solids, at 12 months. This is not
unusual and really depends on your child – there is quite a big variation. Some
babies will be taking more solids by 12 months, but others will still be
exclusively or almost-exclusively breastfed at this point. It is normal for baby
to keep breastmilk as the primary part of his diet up until 18 months or even
longer. An example of a nice gradual increase in solids would be 25% solids at
12 months, 50% solids at 18 months, and 80% solids at 24 months.
31. Night nursing will lead to cavities
Two dentists,
Dr. Brian Palmer and Dr. Harold Torney, have done extensive research on human
skulls (from 500-1000 years ago) in their study of tooth decay in children. Of
course these children were breastfed, probably for an extended length of time.
Their research has led them to conclude that breastfeeding does not cause tooth
decay.
32. There is no benefit in nursing beyond 2 years
The Academy of Breastfeeding Medicine Breastfeeding Medicine.
December 2011: 435-440
