There’s lots of advice and information out there for new moms about breastfeeding, but not all of it is accurate or helpful.
Tidelands Health family medicine physician Dr. Eileen Conaway, a board-certified lactation consultant and a faculty member at the Tidelands Health MUSC Family Medicine Residency Program, says she’s put to rest many misconceptions about breastfeeding among new and expectant moms during her years of medical practice.
Here are the top 10 myths she’s encountered:
Fact: A baby’s stomach is the size of a cherry the first day and a walnut the second day, so it doesn’t take much volume to fill them up. Formula supplementation is not necessary.
“Colostrum, that thick substance that comes before milk, is the perfect newborn food,” says Dr. Conaway, who has extensive experience using neuromusculoskeletal medicine to care for pregnant and postpartum women and infants who are having difficulty breastfeeding.. “It’s nutrient dense and full of antibodies and other beneficial things for the baby.”
Fact: Most medications are safe to take while breastfeeding. Rather than simply pump and dump, discuss your medical history and medications with a physician or other qualified care provider.
“The prescribing physician should verify the safety for breastfeeding and use an alternative if not compatible,” says Dr. Conaway.
Fact: Babies cry. And some cry more than others, particularly from about two weeks to three to four months because of the intense development that takes place during that period for babies (it’s often called the fourth trimester).
“Babies want to be with their mom pretty much all the time, and that is completely normal,” says Dr. Conaway. “Many breastfeeding women are concerned that they’re not making enough milk. Your baby’s doctor will monitor their weight at well-baby checkups in the office.”
Moms can also monitor wet diapers at home. Babies should have one wet diaper for each day of life for the first week. After the first week, the baby will produce six to eight wet diapers a day going forward.
Fact: While the composition of milk changes as a baby grows, the volume does not. The average full milk supply is 24 to 32 ounces in a 24-hour period from one to nine months. That means the average woman can produce a total of 1 to 1 1/4 ounces of milk per hour from both breasts combined.
“Most women start to experience a slow decline around nine months as the infant becomes more interested in complimentary foods but still gets the majority of nutrients from breast milk,” Dr. Conaway explains. “The average feeding of a breastfed infant is usually around three to four ounces the entire time they breastfeed. It does not increase with age after one month.”
Fact: While nipple soreness is common in the first few weeks, persistent pain or nipple cracking/damage should be evaluated by a lactation professional.
Fact: You will only need enough milk for the first day back to work and a little extra for emergencies. Keep in mind the average intake is 1 to 1 1/4 ounces per hour, so if you’re away from the baby for nine hours, you need about 9 to 11 1/4 ounces, maybe less if you breastfeed immediately before dropping off baby to the caregiver and when you pick the baby up.
“Spend your maternity leave enjoying and bonding with your baby; not freezing gallons of milk,” Dr. Conaway says.
Fact: By adding a bottle at bedtime or introducing foods early, you may only gain a few extra minutes of sleep. As such, the benefits of exclusive breastfeeding through six months far outweigh any small increase in sleep.
“Our society is preoccupied with infant sleep,” says Dr. Conaway. “Night in the infant world is defined as 10 p.m. to 4 a.m. Most infants will wake to feed one to three times during this period, and the number of nighttime feedings does not typically change from one to 6 ½ months.”
Fact: Frequent breastfeeding is sufficient to establish and maintain supply. Most women need to feed eight to 12 times per day to maintain a full supply. Breast size is irrelevant since small breasts may hold a lot of milk or large breasts not very much.
“If the infant is feeding well and frequently and is not separated from mom due to a medical reason, there is no need for extra pumping,” says Dr. Conaway.
Fact: The only anesthesia that is not safe for breastfeeding after surgery is Demerol (meperidine). Talk to your anesthesiologist before surgery so another anesthetic can be used.
“There’s no need to pump and dump with other common anesthetics,” Dr. Conaway says. “This includes novocain at the dentist.”
Fact: While many women lose weight while breastfeeding, not all do. Some find their body holds on to an extra 10 pounds while breastfeeding.
“Every woman is different, and many factors come into play with weight loss during breastfeeding,” Dr. Conaway says. “Remember, it took nine months for your body to grow that baby. Give yourself some time and grace to lose the baby weight.”
Calorie-restrictive diets are not recommended during breastfeeding because doing so can compromise milk supply, Dr. Conaway says. Breastfeeding women need about 300-500 extra calories a day to support breastfeeding, roughly the same 300 extra calories needed during the second and third trimesters of pregnancy.