The Problem with Breastfeeding Research & Rules

Parents are often confronted these days by news headlines that question the benefits of breastfeeding, or present new information about the “right” way to approach breastfeeding. The often sensational headlines are great for selling more papers, but they do little for parents who are often left feeling confused and wondering whose advice they should follow.

Why is there so much conflicting research? Well, breastfeeding research is hard to do. With all that is known about the risks of not breastfeeding, it would be unethical to randomly assign mothers to either exclusively breastfeed, or exclusively formula feed. This means that researchers are looking at women who have already made the decision about whether or not to breastfeed, and it is impossible to account for those confounding factors that may have played into the mom’s decision. It is also rare for breastfeeding studies to have adequate control groups. Because exclusive breastfeeding is the biological norm, that is what anything else should be compared to. Many studies do not include what their definition of “exclusive” breastfeeding is, or they allow a certain amount of formula to be given while still saying that the baby is being “exclusively” breastfed.  Any amount of formula in the control group is going to alter the results of the study. It is also important to look at who is doing the research. If breastfeeding research is being funded by formula companies for example, how biased are the results?

Breastfeeding research is fascinating to read, but I really can’t help wondering what ever happened to common sense and listening to our babies and instincts? How on earth did our ancestors survive without knowing about all the breastfeeding “rules” that we have these days. Nurse 10 minutes each side, feed every 2-3 hours, introduce solids at 6 months etc. etc. Breastfeeding is an art, not a science. There is nothing black and white about it. What applies to one baby isn’t necessarily going to apply to every other baby. Breastfeeding “rules” aren’t really rules at all. They are guidelines, and it’s important to remember that babies don’t read the books or watch the clock or calender. Some babies will be ready for solids around six months, some will be ready sooner, and some later. Most babies will need to eat every 2-3 hours, but some may be content for longer between feeds, and some may need to feed more frequently. There is a wide range of normal when it comes to breastfeeding and babies.

It’s important for parents and health care providers alike to understand that breastfeeding is not black and white, because rigid “rules” create problems. Parents who have been told by their nurse or doctor in hospital that their baby should be feeding every 3-4 hours, worry that they don’t have enough milk when their baby wants to feed every 2 hours (which is very normal). Babies are often pushed to eat solids before they are ready, or made to wait even though they are showing clear signs of readiness due to the “rule” of starting solids at 6 months. Parents worry about their baby’s weight gain, worry because their baby isn’t sleeping through the night yet, is feeding too often or not enough, isn’t getting enough hindmilk, wants to nurse to sleep, etc. etc.

So with all the conflicting information out there, what is a mother to do? The answer is simple. Arm yourself with credible information (La Leche League International, Dr. Jack Newman and Kellymom are good places to start), and then follow your baby’s lead! If you are having trouble with breastfeeding, or have questions about the latest headlines, talk to an IBCLC or LLL Leader in your area.

What breastfeeding rules have you struggled with?


  1. Rules that didn’t work for me (when I had a 4-month old baby who had been slowly gaining and then started to lose weight): “Never wake a sleeping baby” “You obviously don’t have enough milk for your baby because she nurses so often; babies of that age don’t need to feed this much.” This was 29 years ago but you still hear this incorrect advice given today.

  2. This post was fabulous! Thank you!
    I’ve trained for years as a scientist and put a fair bit of stock into research and data, but when it comes to breastfeeding, I throw it all out the window. Breastfeeding really is an art and no two breastfeeding dyads are alike.

    You asked what breastfeeding rules readers have struggled with?
    Well, a big one for us was the ubiquitous suggestion of using cross-cradle for a deeper latch.
    My DD had a thick labial frenulum (aka: lip-tie), which resulted a poor latch. We were told over and over to use a cross-cradle hold to help her get a better latch. Obviously, this wasn’t terribly effective, since she physically couldn’t relax her top lip to take a deep latch… But the bigger problem was that I had a very active letdown at first and the additional pressure of holding my breast would cause a firehose of milk to make her gag and sputter, spit my breast out, and sob with terror in her eyes.
    I had to “prove” this to several people who insisted that cross-cradle could solve all of our latch difficulties and simply couldn’t comprehend that it wouldn’t… And that’s why I’m do lactation education and support now!

  3. Stephanie says:

    I think it’s important that when it comes to feeding baby there shouldn’t be any rules at all! My son was on formula as well as breast milk in the early days as I was developing my supply (he wouldn’t latch and I had had breast reduction so it was a bit of an uphill battle, anyhow…) he was a grazer, whether he was receiving my milk or the formula he would only eat a little at a time, sometimes only 1/4 of an ounce and others 2 but rarely more than 3! I would often feed him up to 18 times in one day!! If we tried to get him to eat more it usually ended up all over us as he would end up vomiting!! It took about 8 weeks before my supply was 100% so even with the more “filling” formula he still wanted to eat small meals more frequently! I can’t imagine what would have happened if I had tried to follow the clock to feed him!!


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