Why the WHO code isn’t working

September 15, 2011 by 5 Comments

The World Health Organization (WHO) International Code of Marketing of Breastmilk Substitutes is intended to protect and promote breastfeeding by preventing the inappropriate marketing of breastmilk substitutes, bottles and nipples.

There seems to be a lot of confusion however about what this actually means, and why it is important. The WHO code does not prohibit the sale or use of formula, bottles or nipples. It is not a statement that moms who use formula or bottles are bad moms, and it is certainly not a statement that formula is evil. The WHO code simply deals with the way the products covered under the code are marketed. This is important, because whether we want to admit it or not, we are all influenced by the marketing that happens all around us every day. There are those who feel that they are smart enough not to fall prey to marketing, but formula companies spend millions of dollars on marketing every year, and they would not be doing so if it didn’t work. I have blogged before about the subtleties of formula marketing, and ALL of us are vulnerable. Marketing of formula, bottles and nipples, has a negative impact on breastfeeding initiation and duration, and there are 30 years of research to back that up. The WHO code is an important document that is sound in theory, but seems to have little impact in practice. Why is that?

The answer is simple. Following the WHO Code is voluntary, and following it means limiting marketing and potential sales, so why would any company want to?  The way things stand right now, it is not in a company’s best interest to be compliant with the WHO code. Since compliance is voluntary, and most companies have no interest in complying, those companies who do try to comply are put at a disadvantage.

Evenflo decided to try being WHO code compliant, and subsequently became the first bottle manufacturer to gain compliance with the code.  This was a wonderful accomplishment, and it shows that it is possible. Recently however, they backtracked on that commitment and they are no longer compliant with the WHO code. Although I do not like the recent changes at Evenflo, I do understand why they happened. Evenflo (and other companies like them) are for profit companies. They exist to make money, and they answer to their shareholders. Following a code that limits the marketing of their products results in lost sales, and if their competition is not following that same code, it’s inevitable that eventually market share is going to become more important than upholding the WHO code.

The WHO code is great in theory but with no legislation behind it to force compliance, it is never going to be effective. Until the government gets serious about supporting breastfeeding and makes it a requirement for all companies, doctor’s offices, etc to be compliant with the code, there will never be any real change. I feel that when we see companies who are not complying with the code we should provide feedback to the company, but at the same time we need to be directing more of our energy towards putting pressure on our government.  There will not be lasting change until governments decide to get behind the WHO code and make it mandatory to comply with it.

 

Filed Under: Breastfeeding

Can Social Media Help You Breastfeed?

July 22, 2011 by 17 Comments

World Breastfeeding Week happens each year during the first week of August (in Canada it is celebrated during the first week of October). This year, the theme is “Talk to me: Breastfeeding – a 3D experience”. The focus this year is on communication, with an emphasis on the role that digital media can play in protecting, promoting and supporting breastfeeding.

Recent statistics show that:

  • 79% of all adults are online
  • 95% of millennials (ages 18-33) are online
  • 86% of generation x (ages 34-45) are online
  • Searching for health information is the 3rd most popular online activity for all Internet users ages 18 and older (after e-mail and search engine use)

These same statistics show us the percentage of people using social networking sites by age group:

  • 83% of millennials (ages 18-33)
  • 62% of generation x (ages 34-45)
  • 50% of younger boomers (ages 46-55),
  • 43% of older boomers (ages 56-64)

From these statistics, it’s easy to see that if we are not reaching out to moms and moms-to-be via social media, we are missing out on a wonderful way to connect with them and provide accurate information and support. For millennials, social networking sites are the fourth most popular online activity. It’s obvious that if we want to reach moms-to-be, and moms with young children who are breastfeeding, social media is the way to go.

I remember as a new mom spending a lot of time online. I was able to find information, get support from others going through the same things as me, and sometimes help others who were looking for support with their own issues. Peer-to-peer support is so important when it comes to breastfeeding. Humans are social creatures by nature, and we are not meant to breastfeed or parent in isolation. In today’s world, social media is one of the ways that many moms are seeking out the support they need.

Along with peer-to-peer support, parents also need accurate, evidenced based information from experts, to help them make informed decisions. This is where we see a gap with social media use. There just are not as many of the older generations (the ones who often have the knowledge and expertise that moms are looking for) using social media. A common reason for this that I have heard among those that I have talked to, is not seeing the value of social media. “How can you help someone in 140 characters?” was something I heard once when talking about Twitter, and I know many people feel the same about other forms of social media.

So, in light of this year’s World Breastfeeding Week theme, I wanted to collect stories from those people who have been impacted by social media (for better or worse) during their breastfeeding journey. Has social media been a source of information or support for you? How did/does it impact your breastfeeding? Have you found help through social media with problems that you were having? Where did you find that support? Are there any drawbacks you’ve found to using social media as a source of information/support? Please tell me your story by posting in the comments, e-mail me at fleur@nurturedchild.ca or let me know your thoughts on Twitter or Facebook.

I look forward to hearing from you!

 

 

 

Filed Under: Breastfeeding

Why Formula Companies Love “Breast is Best”

June 7, 2011 by 71 Comments

My husband and I often talk to our children about marketing. We want them to be aware of how companies try to get people to buy their product(s), so that they can make more informed choices and don’t fall prey to clever marketing tactics (“Do you think those shoes can really make you fly?”).

I think this is something that we need to be aware of when talking about infant feeding as well. When I get into a conversation about formula companies, I often hear “Well formula companies can’t be all bad because it says right on their website and on the cans that “breast is best!”. This is very true. If you go to any formula company website, or if you look at a can of formula, you will see messages about “breast is best”. Does this mean that formula companies truly believe that and want all moms to breastfeed? The answer to that is a resounding No!  What it does mean is that their marketing division with their millions of dollars has determined that putting that message on their product won’t hurt sales. The formula industry is worth billions, and it is not against throwing it’s weight around to make changes to anything that it feels might jeopardize it’s profits. In 2004, they did just that when they opposed the new breastfeeding ads that the US government was planning to unveil. The ads were eventually replaced with a watered down version due to pressure from the formula companies. So if formula companies believed that putting the phrase “breast is best” on their websites and products would hurt sales, you can be sure that they would be making a fuss about it.

So why do formula companies love “breast is best”? Well, as outlined in Diane Wiessingers very insightful article “Watch Your Language“, “breast is best” frames formula feeding as the norm and breastfeeding as a nice extra if you’re able to do it. The message that parents receive has become “breast is best, but formula is OK too”. “Breast is best” allows formula companies to say “We fully support breastfeeding. See – it says so on our website and products”. It allows the companies to give the appearance of caring about breastfeeding while they go about undermining it. Breastfeeding is after all their main competition! I wonder what the reaction would be from the formula companies if they were required to put messages such as “Formula feeding increases your baby’s risk of obesity” on their websites and products?
Formula companies spend millions on marketing, and everything on their websites is designed to subtly turn mothers off of breastfeeding. The website for the new BabyNes machine from Nestle is a perfect example of their marketing tactics at work.

When you first open the page, you are greeted with a beautiful mother and her (formula fed) baby who are quite literally glowing thanks to the special effects on the page. Underneath, we see a woman breastfeeding her baby. Great that they’re showing breastfeeding right? Well, if we look closer at it, the breastfeeding mom is sitting on the floor, is barefoot, is half undressed and her dark roots are showing through her blond hair colouring (compare that to the beautifully highlighted hair of the formula feeding mom).  All of this is subtle, but it creates an emotional reaction (which is exactly what it was designed to do). The reaction may not even be a conscious one for many people, but it plays on the stereotype of women who breastfeed being barefoot “hippies” who just “whip it out”. It also plays into the fear of having a baby who ties you down and nurses so often that you can’t even get your hair coloured. Even the graph behind the mom with the downward slope to it produces a negative feeling about breastfeeding.

On the right is a picture of this same breastfeeding mom and baby with a doctor standing beside them.  The text surrounding this picture is talking about the service that Nestle offers where you can talk to their “experts” to get customized advice about feeding your baby. In using the image of the breastfeeding mother however, the implication is that breastfeeding is complicated and likely requires the help of a health professional.

Smack dab in the middle of these two pictures of the poor breastfeeding mother, is Nestle’s new “comprehensive nutrition system” to save you from having to expose yourself to the world, miss out on “you” time and spend lots of time at the doctors office due to those cracked and bleeding nipples you’re bound to have if you’re breastfeeding. A wonderful example of marketing tactics at work. Formula companies also use pictures of breastfeeding moms to convey the message that their formula is the next best thing to breastmilk. The breastfeeding mother in the pictures on the Nestle site is wearing white (which implies purity), and so is the formula feeding mom. The emotional message? Our product is just as good (pure) as breastmilk.

Along with the “breast is best” messages, formula websites often contain information about breastfeeding. This information is not placed there due to a desire to help breastfeeding moms however. The information is again designed to undermine breastfeeding. There is often talk of cracked and bleeding nipples, embarrassing leaks, the need to maintain a special diet etc. etc. When I gave birth to my son, I remember there was a “breastfeeding” booklet by the side of my bed (produced by a formula company). One thing I really remember was in the section on pumping where it started out with the  line “First, fully expose your breasts”. Who wants to pump if it means “fully exposing” yourself? Much easier to just go to formula right? It was a classic example of how the language the formula companies use is designed to make moms feel uncomfortable about breastfeeding, feel like it’s too much work or too restricting etc.

Formula companies spend a lot of money on getting their marketing right. To me, that means if the formula companies are happy to use the phrase “Breast is Best” on their cans of formula, then it’s definitely a phrase that we should not be using to try to encourage more moms to breastfeed. Breast is not best, it is normal.

 

Filed Under: Breastfeeding, Formula, Marketing, Parenting

My 8 year old’s tongue tie

May 19, 2011 by 95 Comments

This afternoon my 8 year old had his tongue tie released. I’ve known for a couple of years now that he was tongue tied,  but it was missed when he was a baby. When he was born I was not yet a lactation consultant, and although I was a registered nurse working on the mother baby unit of our local hospital, I had no idea my son was tongue tied, and no one else picked up on it either. I discovered it years later as I was studying to become an IBCLC. For those who don’t know, tongue tie (or ankyloglossia) is when the frenulum (thin membrane) that attaches the tongue to the floor of the mouth is unusually short/inelastic or attaches to the tongue in a manner that restricts normal movement of the tongue. Since tongue mobility is important for achieving and maintaining a good latch and effective milk transfer, a tongue tie can have a negative impact on breastfeeding. A tongue tie that prevents a baby from effectively breastfeeding can have other implications as well such as difficulties with speech, jaw development and placement of teeth.

Looking back we did have issues nursing, but I didn’t realize it at the time. My son used to nurse for an hour at a time, every hour and a half. At the time I figured it was normal newborn nursing and just went with it. At five months however, he starting biting me when he was nursing, and biting badly. I was in tears every time we nursed, and I started to dread nursing him. Not knowing then what I know now, and having not yet discovered the right kinds of support, I weaned my son to formula. Looking back, the severe biting will have been caused by my son’s inability to keep his tongue over his teeth due to the tongue tie, and the long frequent feedings were likely due to him not transferring milk very effectively. Thankfully, because I went with the flow with his frequent nursing we were able to compensate and his weight gain was never an issue.

We decided to have his tongue tie released because he has needed some speech therapy for articulation difficulties, and we have already been told that he will need braces due to the crowding of his teeth. In a baby with no restriction of movement in their tongue, sucking is what shapes their palate and jaw because muscle moves bone (and the tongue is a muscle!). Normal tongue movements and sucking at the breast help to spread out the palate and widen the jaw, allowing for adequate room for teeth. When there is restriction of movement due to a tongue tie, this spreading of the palate doesn’t happen the way it should and it can lead to a lot of problems with a child’s teeth. You can see in the pictures that my son’s bottom teeth are very crowded and his two front teeth on the bottom are turning inward into almost a v shape, which is typical with a tongue tie.  (For anyone who’s wondering about the black marks on his bottom front teeth, we went to the appointment straight from school, and I assume he was chewing on something black during the day – probably a pencil or something. Amazing what kids will put in their mouths!).

Our family has been talking for a while about whether or not we were going to have his tongue tie released, and the appointment to talk to the dentist was made after our son said he wanted it done because it hurt to stick his tongue out too far. After talking through the procedure with the dentist, our son decided that he wanted to go ahead. The dentist started by putting some numbing gel under his tongue, and then due to his age, put in some local anesthetic (this was the worst part because of course it stings a bit. For babies, no local anesthetic is needed). Once the anesthetic was in, he felt nothing, and the actual procedure (called frenotomy or frenectomy depending on the procedure) literally took seconds. The dentist we saw used an electrocautery tool, but it can also be done with special scissors, or by laser. There was a little bleeding afterwards that was easily controlled with some pressure on it (for babies, there is usually only a drop or two of blood, and nursing immediately after the procedure is a great way to stop any bleeding). Below are some before and after pictures:

 

My son sticking his tongue out before the release. You can clearly see the dimpling in the middle of his tongue (typical with tongue tie).

 

Under my son’s tongue before the tongue tie was released. You can see the frenulum, and you can also see how crowded his teeth are.

 

Not as clear, but another shot of under my son’s tongue before the release. Notice the difference between this picture and the one above. In order for him to elevate his tongue more (above) he has to close his mouth somewhat. In the after pictures below, you’ll see that he can now elevate his tongue with his mouth wide open.

 

Under his tongue about an hour after the release was done. Already he has better elevation of his tongue.

 

Under his tongue the next morning

 

Sticking his tongue out the morning after the procedure.

 

Healing on day two. It looks good, and with frequent exercises no adhesions are forming.

 

The morning after the procedure he was a little tender under his tongue, but the discomfort was easily managed with some ibuprofen. It has been really interesting to be able to hear from my son about the experience. The morning after he said that he felt like he couldn’t stick his tongue out. This tells me that already some adhesions were starting to form (the area was basically starting to heal back together). This can happen with babies too, and it is why it is so important to do exercises after the release to prevent reattachment and the need to do the procedure again. With an 8 year old it’s easy, because he can follow directions and he thinks it’s fun to stick his tongue out at mom and dad. There are exercises that can be done with babies as well, and your IBCLC/doctor/dentist whoever you are working with should provide you with information on this. By the time he went to school the morning after, we had done some exercises and the area had stretched out again. In the picture of him sticking his tongue out the morning after, you can see that there is still dimpling of his tongue when he sticks it out. I am finding that his ability to extend his tongue (stick it out) is slowly improving with the exercises we are doing. It will take time because he’s had 8 years of adapting to the restricted movement of his tongue, and now we have to work on overcoming those adaptations. Along with the exercises, I will be taking him for some craniosacral therapy (very effective at helping to overcome the adaptations to the restricted movement). When he does stick his tongue out now, I can see that one thing that has really improved is his ability to spread his tongue (rather than it bunching up when he sticks it out).

Overall the experience has been a positive one for our son. He was so excited to go to school the next morning and tell his friends all about it! Have you had a child who was/is tongue tied? I’d love to hear about it in the comments.

Update:

Two weeks after the procedure, my ds can stick his tongue out much further (without it hurting!) and the dimpling in the tip of his tongue is almost gone.

 

For more information about tongue and lip-tie, please see the links below:

Breastfeeding Challenges: Tongue-tie and Lip-tie

What to Expect After Tongue-tie and Lip-tie Release

 

 

 

Filed Under: Breastfeeding, Challenges, Tongue tie (ankyloglossia)

Sometimes Breastfeeding Sucks

April 4, 2011 by 8 Comments

The breastfeeding messages that women get these days are that “breast is best”, breastfeeding is the natural way to feed your baby, breastfeeding is an amazing way to bond with your baby, breastfeeding is free, it’s easy etc. etc. In other words, the consistent message is that breastfeeding is all sunshine and roses.

While it is true that breastfeeding is the natural way for us to feed our babies, it helps with bonding etc., the reality is that sometimes, breastfeeding just sucks. Sometimes, you end up with a baby who won’t latch, your nipples are sore, you’re engorged, you end up having to give formula because your baby is losing weight, you’re exhausted, an emotional wreck and feeling like a failure because something so “natural” isn’t working.

Why the difference between the messages that women get and the reality that many women experience? Well unfortunately, we do not live in a society that supports normal breastfeeding. Most mothers start their breastfeeding relationship after giving birth in hospital where interventions like inductions, epidurals, C-sections, forceps, vacuum, separation from baby, inaccurate information etc. are all too common. All of these interventions can have a negative impact on breastfeeding. Combine that with the fact that most of us no longer go home to a large family waiting to “mother the mother” as she eases into her role (as it used to be), and breastfeeding can be down right hard. Many of us grow up never having seen a baby being breastfed. Some women have never held a baby before their own. Breastfeeding is natural, but it is also a learned skill, and how are we supposed to learn if we have never seen it before becoming a mother?

So if breastfeeding does suck, what can you do? Well, first of all, remember that breastfeeding is parenting and parenting is hard work. If it’s not the breastfeeding, there’s bound to be some other aspect of parenting that you’re finding difficult. Second, remember it will get better with the right support. We are not meant to breastfeed or parent in isolation, so when it does suck, find help. Many moms struggle on their own, feeling (like I did) that they should be able to figure it out themselves. It’s breastfeeding, not rocket science right?! True, but natural or not, we’re not meant to do it alone.

Contact your local La Leche League group, find a local breastfeeding cafe (or start one yourself!), or find support on-line. Connecting with other nursing moms will help you to realize that you’re not alone, and that it is possible to overcome early difficulties and go on to a happy breastfeeding relationship. If your struggles are more complex, or you haven’t been able to find the right kind of support, then contact an International Board Certified Lactation Consultant (IBCLC) for help. You can search for one in your area at the ILCA website. If you’ve already seen an IBCLC and are still struggling, keep trying. As with any other professional help, sometimes it is a case of finding the person that is right for you (There are of course rare situations where exclusive breastfeeding may not be possible, but an IBCLC can help you maximize your milk production and come up with solutions that work for you). Breastfeeding is the natural way to feed our babies, and yes, once it is working well, it truly is a wonderful experience.

 

Filed Under: Breastfeeding

Foremilk and Hindmilk

March 29, 2011 by 31 Comments

In almost every conversation I have with a mom about breastfeeding, the subject of foremilk and hindmilk comes up. Most moms have heard about it, and many moms are worried about making sure their baby “gets the hindmilk”. Is there really a need to be concerned? The short answer is no.

Photo credit: Azoreg/Wikimedia Commons

The term “foremilk” is commonly used to refer to the initial milk that a baby supposedly receives at the beginning of a feeding that is more watery and lower in fat content, while “hindmilk” refers to the milk towards the end of a feed that is supposedly higher in fat content. This description does not give the whole picture however, and can lead to a lot of unnecessary worry.

The fat content of breastmilk varies throughout  a feeding, and throughout the day. What is important when thinking about fat intake is not how much fat your baby gets per feeding, but how much they get in 24 hours. The “emptier” your breasts are (for lack of a better term, because your breasts are never truly empty) the higher the fat content of your milk. Because of this, fat content tends to be lower early in the morning when most moms tend to feel the fullest, and is usually higher in the evening when most moms feel less full. Over the course of 24 hours, if you are nursing your baby on cue, he gets everything he needs.

Your breasts don’t contain two distinct types of milk (foremilk and hindmilk), it is all breastmilk, and it is all beneficial for your baby. The fat content of your breastmilk gradually changes during a feed, similar to water gradually getting hotter when you first turn on the hot water tap. If you are following your babies cues, and your baby is nursing frequently, the milk at the start of the next feed is still high in fat content (hindmilk), similar to the water from the hot water tap still being warm if it hasn’t been very long since you last turned it on.

True formilk-hindmilk imbalance is rare, and I have only seen it in cases of severe oversupply of milk, or strict timing of feeds. If you are nursing your baby on cue, then there is no need to worry about whether or not your baby is getting enough “hindmilk”. If your baby is gaining weight, content after feeding, meeting milestones etc, then everything is good.

Filed Under: Breastfeeding

Breastfeeding: It’s What Mammals Do

March 3, 2011 by 2 Comments

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Filed Under: Breastfeeding

Managing Oversupply

February 23, 2011 by 6 Comments

As a lactation consultant I sometimes get calls from moms who are struggling with an overabundance of milk. For some moms (especially those struggling with low milk production), having too much milk may sound like nothing to complain about, however an oversupply of milk can be troublesome. It often leads to a mom who is uncomfortable and at an increased risk of blocked ducts and mastitis, and a fussy baby who is being overwhelmed with milk.

When I do get calls about possible oversupply of milk, the first thing I do is figure out if that really is the problem. Sometimes babies will come off the breast choking and mom will be spraying milk everywhere due to having a forceful letdown. Moms with oversupply usually have a forceful letdown due to the sheer volume of milk, but the reverse is not always true. If you have a forceful letdown, it doesn’t automatically mean that you have an oversupply of milk. Moms with an oversupply are frequently engorged and uncomfortable, may have frequent blocked ducts or repeated episodes of mastitis, and their babies may be fussy, and experiencing poop that is green and frothy looking. It’s important to make sure oversupply really is an issue before making any changes to lower milk production.

Many women who are having issues with oversupply use block feeding (keeping baby on the same side for several feedings in a row) which is the most common method of dealing with the issue. I prefer to start with a method of switch nursing that I learned about from Joan Fisher. Joan is an IBCLC in Ottawa Ontario who has been working with breastfeeding moms and babies for over twenty years.

With block feeding, mom is going for long periods of time with no stimulation to one breast. I’ve heard of some women going 8-12 hours on one side! The breast that is not being used gets full and uncomfortable (putting mom at risk for blocked ducts and mastitis)  and when baby does eventually feed on that side, they are overwhelmed with milk as the breast is so full. Because the breast is so full, this milk is also low in fat (the emptier the breast the higher the fat content of the milk). Block feeding in women with oversupply can eventually lead to low milk production because the breasts aren’t getting enough stimulation.

With Joan’s method, mom switches sides frequently during one feeding. An easy way to approach it is to switch sides halfway through the feeding (although you can switch sides more frequently if that works better for you and your baby). So if baby normally feeds on one side for 10 minutes, mom would switch to the other breast at 5 minutes (this is the only time that I would recommend that moms watch the clock!). If baby normally feeds for 5 minutes on one breast, then switch breasts at 2.5 minutes (if baby wants to keep nursing past the usual number of minutes mom can keep baby on that side or switch again). By using this method of switch nursing, both breasts are still getting stimulation, but they are also getting the message to slow milk production down a bit because there is milk left over in the breasts. Mom stays comfortable, and the reduction in milk production is gradual and even. Using this method you may have a day or two of a fussy baby (and continued green poop if that was a problem initially) as your body adjusts, but the method does work, and it eliminates the risk of eventual low supply.

Although this is the method I recommend first, that’s not to say that it is the one and only method for all moms. For some moms, simply keeping baby on one side per feed or block feeding for short periods of time will work without any problem. This method is another “tool in the toolbox” that I have found to be very effective and usually more comfortable for both mom and baby. If you are concerned that you may have an oversupply of milk, please talk to an International Board Certified Lactation Consultant (IBCLC) to determine the best plan of care for you and your baby.

Filed Under: Breastfeeding, Challenges

The Truth Behind Common Breastfeeding Myths

January 30, 2011 by 90 Comments

There are many common misconceptions about breastfeeding, and they often cause damage to the breastfeeding relationship. Here are some of the ones that are frequently held by parents and health care providers alike, and the truth behind them.

Myth: It’s normal for breastfeeding to hurt. Truth: If breastfeeding  hurts something is wrong. Nursing may be a little uncomfortable during the early days as your body adjusts to a new sensation, but it should never be painful. Poor latch is the most common cause of pain in the early weeks, but there are other possibilities including sucking issues with baby from birth interventions or physical characteristics such as tongue-tie. If nursing hurts, get help as soon as possible. The earlier breastfeeding problems are addressed, the easier they are to fix. If you go to someone for help and the problem isn’t solved, keep trying until you find someone with the knowledge and experience to help.

Myth: Moms with small breasts can’t make enough milk. Truth: Breast size doesn’t matter.  Milk production has nothing to do with breast size.  It’s even possible for women with smaller breasts to have an oversupply of milk! Following your baby’s lead and nursing whenever your baby cues to feed will help to ensure adequate production of milk.

Myth: Many moms can’t produce enough milk. Truth: The vast majority of mothers can make more than enough milk for their baby (or babies!). It is estimated that only 2-5% (some believe this number is lower, closer to 1-2%) of women are truly unable to produce enough milk for their baby. Our species never would have survived if we weren’t able to provide for our young. Low milk production is usually the result of not enough stimulation of the breast from nursing or pumping.

Myth: There is no milk in the first few days. Truth: Colostrum *is* breastmilk! The small amounts are perfect for a new baby’s tiny stomach. Newborn stomach capacity: Day one 9-10ml (1/3 oz), day three 22-27ml (3/4-1 oz), day 10 60-81ml (2-2.5 oz).

Myth: Babies usually nurse every 3-4 hours. Truth: Babies often need to eat every 2 hrs or less. Babies have small stomachs and breastmilk is digested quickly. This is not a flaw in nature’s design, babies need to be held and interacted with frequently to aid in the development of  their brains. Frequent feedings help to ensure this!

Myth: Night feedings aren’t important. Truth: Prolactin levels (the hormone responsible for milk production) are highest at night, so those night feedings (or pumping sessions)  are important for milk production.

Myth: Breastfeeding mothers get less sleep. Truth: Recent research has shown that breastfeeding mothers get more sleep, and enjoy better quality sleep, than formula feeding mothers do. Another recent study found no difference in the amount of sleep that breastfeeding and formula feeding mothers get.  Giving formula at night to try to get more rest doesn’t work (and may make things worse if your baby doesn’t react well to the formula), and missing night time nursing sessions can have a negative impact on your milk production.

Myth: Breasts need time to fill up between feedings. Truth: Your breasts are continually making milk as your baby drinks. You don’t need to wait a certain amount of time before putting your baby back to breast.

Myth: There is no way to tell how much baby is getting. Truth: To know whether or not your baby is getting enough breastmilk, look at your baby! If your baby is gaining weight, having plenty of wet and dirty diapers, is content after feedings, meeting developmental milestones, outgrowing clothes and diapers etc, then he’s getting everything he needs.

Myth: If your breasts feel soft you don’t have enough milk. Truth: Many women worry that they don’t have enough milk if their breasts are soft, or they can’t feel their milk “let-down”.  After the early weeks, your body adjusts to your baby’s needs, and the full feeling that you may have experienced early on disappears. This does not mean that you don’t have enough milk, it simply means that your milk production is in sync with your baby’s needs. Being able to feel your milk let down is also not an indicator of milk production. Many women never feel their milk let down.

Myth: If your baby is nursing frequently, he’s just using you as a pacifier. Truth: Breasts are the original pacifier! Babies don’t nurse just for food. This often comes as a surprise to parents, but babies go to the breast for many reasons. They’re hungry, thirsty, tired, hurt, overstimulated, bored, lonely, in the mood for cuddles, etc. All are equally valid reasons to nurse. Believing that babies only nurse because they are hungry can lead to problems if parents try to hold off feedings because “he can’t be hungry he just ate!”. I’m sure most of us have heard someone say “Don’t let your baby use you as a pacifier. My response to this is “I’m not pacifying, I’m mothering!“ Pacifiers were invented to allow babies to satisfy their sucking needs when mom is not available, not the other way around. Mothers are not meant to nurse their babies only when a pacifier isn’t available.

Myth: Frequent nursing and holding will spoil your baby, make him too dependent etc. Truth: Research tells us that babies who are held and nursed frequently, actually go on to be very outgoing and adventurous children. Babies’ first relationships set the tone for all future relationships in life. By responding to our babies’ needs quickly, consistently and with love, we teach our children that the world is a safe and wonderful place. This gives them the courage to go out and explore because they know that they have a safe and loving place to return to.

Myth: If you let your baby fall asleep at the breast, he’ll never learn to go to sleep on his own. Truth: All children eventually learn to settle themselves to sleep. Babies fall asleep at the breast because nature designed it that way. Nursing is a peaceful and easy way to help our babies and young children settle to sleep during a time when they do not yet have the ability to self soothe.

Myth: pumping shows how much milk you have. Truth: The amount you are able to pump is not a good indicator of milk production. Many moms don’t respond well to pump, and a baby who is able to nurse effectively is far more efficient than any pump.

Myth: You have to drink milk to make milk. Truth: Cow’s milk is not a necessary component of anyone’s diet. We are the only mammals who drink milk past the time of natural weaning and yet every other mammal manages to produce milk for their young.

Myth: Eating gassy foods will make your baby gassy/breastfeeding moms have to be careful about what they eat/drink. Truth: Breastmilk is made from what’s in your bloodstream not your stomach. Most babies have no trouble with “gassy” or “spicy” foods, caffeine etc. Everything in moderation unless your baby’s behaviour is telling you otherwise. There is no need to unnecessarily limit your diet.

Myth: You can’t breastfeed if you’re taking medication. Truth: Most medications can be safely taken while breastfeeding. If you have questions about medications and breastfeeding, make sure you have accurate information by calling an IBCLC or the Infant Risk Centre.

Myth: you have to pump & dump after having x-rays, a CT scan or an MRI. Truth: Most scans (even those that use contrast dye) are safe while breastfeeding. Scans using radioactive isotopes are usually the only ones that require a temporary cessation of breastfeeding. If you have questions, check with an IBCLC or call the Infant Risk Centre for more information.

Myth: If you don’t have enough milk with your first baby, it will be the same with your next baby so there’s no sense in trying. Truth: Breasts usually develop more glandular tissue with each pregnancy, so if you didn’t have enough milk with a previous baby, that may not be the case with your next one. Also, most cases of low supply are due to not enough stimulation of your breasts through either nursing or pumping in the early weeks, so arm yourself with good information and support as you prepare for your next baby.

Myth: foremilk-hindmilk imbalance is a common problem. Truth: True foremilk-hindmilk imbalance is rare, and usually only happens in cases of oversupply of milk or timed feedings. Many parents are concerned about their baby getting the fatty “hindmilk”, but all breastmilk has some fat in it. When looking at fat intake, one feeding is not important. What is important is the fat intake over 24 hours. Fat content of breastmilk naturally varies throughout a feeding, and throughout a day. The emptier your breast is, the higher the fat content. So early in the day when milk volume tends to be higher, fat content will naturally be lower. Later in the day when milk volume is naturally lower, the fat content will higher. If you follow your baby’s cues and nurse your baby whenever he is looking for the breast, your baby will get what he needs.

Myth: Once your child gets teeth, can talk etc it’s time to stop nursing. Truth: According to anthropological research, the natural age of weaning for humans is between 2.5-7 years of age. Breastfeeding can and should continue for as long as is mutually desired.

Myth: Breastmilk is a dairy product. Truth: You’re not a cow! Breastmilk is considered a clear fluid.

Myth: Formula is just as good as breastmilk. Truth: Breastmilk is the biological norm for our species. It is a complex and living substance that scientists are still trying to unravel. Breastmilk has over 300 ingredients including white cells, antibacterial and antiviral agents etc. Formula has only 40 (non-living) ingredients.

Myth: After x number of months, breastmilk has no nutritional value. Truth: Breastmilk does not suddenly turn to water just because your baby has reached a certain age. Breastmilk continues to have fat, protein, carbohydrates, vitamin and minerals, antibodies etc, for as long as your child is nursing.

Myth: Doctors and nurses know a lot about breastfeeding. Truth: Most doctors and nurses (including pediatricians) have little to no education about breastfeeding (unless they pursue it on their own) as it is not part of their curriculum in school. If you need information about breastfeeding, call someone knowledgeable such as an IBCLC, La Leche League Leader or breastfeeding peer counsellor.

Myth: many mothers give up on breastfeeding too easily. Truth: Most moms want to breastfeed. Breastfeeding initiation rates are high, but the numbers of women exclusively breastfeeding drop off dramatically in the first month. Most moms run into problems and eventually switch to formula feeding due to  lack of accurate info and a lack of support.

Myth: breastfeeding is easy. Truth: Breastfeeding is natural, but in today’s culture it is often not easy. Mothers don’t fail at breastfeeding, society does. In a society where doctors and nurses have little to no training in breastfeeding and are frequently handing out harmful advice, where birth interventions that interfere with breastfeeding are the norm, formula marketing is rampant and mothers are made to feel ashamed to nurse their babies in public, it’s amazing that any woman manages to meet her breastfeeding goals. You can even the odds by educating yourself and establishing a support network. We are not meant to breastfeed or parent in isolation, so don’t be afraid to ask to for help!

Filed Under: Breastfeeding, Expectations, Mothering, Parenting

The Problem with Breastfeeding Research & Rules

January 21, 2011 by 5 Comments


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?



Filed Under: Breastfeeding, Expectations, Mothering, Research
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