As a first time mum, I have at one time or another wondered or worried about my approach to breastfeeding. Either because I am inexperienced, or because I don’t have that many points of reference, or because there is so much conflicting and confusing information out there.
Sioned, Medela’s in-house Lactation Consultant is here to help debunk what I think are ten common breastfeeding myths:
1. Is it possible to overfeed a breastfeeding baby?
I think most parents at some point or another will worry about over or underfeeding their babies, especially breastfeeding parents. As a mum with a baby in the 75th percentile I’ve always been worried about overfeeding. Health visitors have always been quick to reassure me that I haven’t, but comments from family members about overfeeding in the past has at times put an element of doubt in my mind. So, is it possible to overfeed a breastfed baby?
Sioned’s Response: Not in the first six months when all your baby needs is breast milk. Growth charts are now international and are based upon breastfed babies, good growth is not just weight but also length and brain growth (head measurements). Mum and Dad’s genetics also play a part so birth weight falling on 75th means that your baby will generally follow the line. But these are averages plot lines. If your baby goes through a growth spurt you may find length and head change but not the weight etc. Once your baby becomes more active they will use up the fat stores. After six months you will be introducing solids and if baby’s growth is moving towards the 90th centile on weight you may have to tweak the breastfeeds and offer water at meal times.
2. Do you need to establish a regular feeding routine when breastfeeding?
If parents read books or listen to advice as I have done in the past (much to my downfall I might add), then they will have been told that they need to establish a routine for their baby. Usually the sooner the better. However, if you breastfeed then you usually breastfeed on demand which goes against the grain of establishing routines. So what is the best way to go about establishing some form of routine if you are breastfeeding?
Sioned’s Response: Remember this is your baby and family; there are no set rules for parenting. You must try and do what suits you all. In the first few months after birth you and your baby need to be close, feed in response to your baby’s hunger and to your breast fullness for comfort. Once you have settled into breastfeeding you may find that you have a flexible routine for going out and about or around bed and nap times. However these can go to pot if your little one hits a growth spurt and all she wants is to feed for days, or if she is unwell. Establishing a routine may help parents settle and a night routine of quiet time; bath and feed can lay the foundations for later on. However, remember routines have to be flexible as life is unpredictable.
3. Do you need to feed from both breasts during each feed?
I have read and been told so many mixed things around this. I’ve tried both feeding from each side during a feed and alternating between sides from one feed to another and I’ve never really noticed any difference. Is there a difference, should you breastfeed from both sides every feed?
Sioned’s Response: No, you don’t need to feed from both breasts at all times. Sometimes your baby may just be thirsty and others he may want a three course meal. What is important is that you listen to your baby and your body’s needs. Feeding from the first breast you need to listen and see if you can hear your baby swallowing milk regularly, on average it takes your baby about seven minutes to feed from a breast but at other times your baby will pause and will stimulate the breast with his hands to trigger another milk ejection reflex. The longer he’s on the first breast the better he will drain the fat rich milk that comes as your feed progresses. If he is still rooting then offer the other breast after you feel that the first breast is soft.
If you switch from side to side your baby will be receiving a lot of foremilk – which has protein, carbohydrates and water but not as much fat. As these fat globules are bigger and heavier they take a little longer to travel down the ductal network in the breast. This can affect your baby’s growth because it is important that they get the fat rich milk. When expressing you can pump from both breasts but just be aware it takes approx. 45mins to start replenishing your milk supply after you finish a feed or pumping session.
4. How do you know if your baby has emptied the breast during a feed?
I’ve often heard and read that babies should empty the breast during a feed, especially before you move them onto the next breast. But I’ve always wondered how you know if it is empty or not. Is there any easy way for mums to tell?
Sioned’s Response: In the early days (the first 4-6 weeks) your breasts are over-producing milk, this is what we call supply and demand. Many mums feel fuller as time passes between feeds and by touching the breast mums will be able feel a change from a full to a softer breast. After this early period you and your baby will have learnt how your breast and feeds feel. It is very much based around touching and feeling the breast and also listening to how your baby is sucking and swallowing milk – lots of swallowing means lots of milk transfer.
5. How do you know if your baby has got both the fore and hind milk during a feed?
I understand that breast milk contains both fore and hind milk, which a baby should get during each feed. But how can I tell if my baby is doing this and are there any ways to know if a baby is getting both types of milk?
Sioned’s Response: The majority of milk that baby swallows during a breastfeed is mid-flow milk. However, the research Medela supports from University of Western Australia identifies that breastmilk changes between the beginning (foremilk) and end of the feed (hind milk). The fore milk that comes through first following a milk ejection reflex has all the composition for nutrition carbs, proteins, minerals and vitamins, water and a small quantity of fat molecules that are in the ducts from the last feed. The longer the baby actively feeds from the breast the greater the hind milk he will get. As baby feeds the milk cell activates the release of the fat molecules and oxytocin helps to squeeze the molecule down the ductal system, this is the hind milk. Breast compression during the feed and massaging the breast also supports the trigger of additional milk ejection reflexes which also helps with transporting the fat molecules to the nipple.
There is no real way to tell what is fore milk and what is hind milk, the only way you could really find out is by having the milk analysed. However there are signs you can look for. If baby is having a good amount of hind milk he will have good growth and have periods of content between feeds and feed actively for 5-10 minutes. If it’s mainly fore milk – the baby will usually only be on the breast for a short time and is switching breasts then growth may be sub-optimal and the nappies may have greener frothy poos.
6. What is cluster feeding and why do babies do it?
In the early days my daughter used to feed for reasonably long durations (approx. 40 minutes), sometimes back to back, especially in the evenings. From what I’ve read and heard, this sounds like it was cluster feeding. However, she hasn’t fed like that again since she was around 3/4 months and she is now six months. Does this sound like it was cluster feeding and why did she cluster feed then but not now?
Sioned’s Response: Cluster feeding in the early days often falls in the evening when mums sit down and put their feet up. It’s an enjoyable time and it is nature’s way of promoting a lot of skin to skin contact which in turn boosts breastfeeding hormones. Clusters can also coincide with a growth spurt around three weeks and three months. Even though your supply is now finely tuned to your baby’s demands, you may still find that she has episodes of cluster feeding if she is unwell or needs reassurance. Remember every mum and baby relationship is different.
7. Do you need to change how often you breastfeed your baby as they grow?
I have noticed that you often hear formula feeding mums talk about extending the frequency and increasing the quantity of milk as their babies grows. Do breastfeeding mums need to take a similar approach with breastfeeding?
Sioned’s Response: No you don’t. A breastfed baby will feed to meet his hunger and growth needs. Initially your baby’s tummy is very small and designed especially for small volumes of colostrum. As baby grows, his stomach expands to cope with mature milk that comes in around 14 days later. How much he feeds at a time is down to him; however what has recently been found is that the first week is critical for giving the milk cells in the breast the recipe for making milk and storage capacity. As your baby grows, again feeding time may vary, sometimes he may only want a power snack and other times both breasts, if he is more active he may wake up more frequently and when going through growth spurts and want frequent feeds. Remember human milk is for human babies and is easily digestible; formula is cow’s milk and is made up to have different proteins etc. to human milk. Also breast milk is free, but be aware that there is a financial gain in the formula market even when babies waste milk.
8. Do you need to change or reduce how much milk you feed your baby when you start weaning?
Depending on what method of weaning you follow and who you listen to, the advice given on how many feeds a baby should have when weaning varies. Does a breastfed baby still need the same amount of feeds when they start weaning or will they reduce the supply themselves as they adapt to eating food?
Sioned’s Response: When you introduce your baby to solids at around six months you will progress from little tasters to bigger quantities at each meal time. Initially you should breastfeed first, followed by a meal until he is eating more. This usually lasts until about nine months. Once you feel he is eating more you can then tweak to either have less between meal feeds or offer cool boiled water at meal times.
9. How do you know your baby is getting enough if you only seem to be able to express a small amount of milk?
I have always been lucky that I have had a very good milk supply. Up to a few weeks ago I was always able to express approx. more than 150ml in 5-10 minutes using the Medela Swing (which I absolutely love by the way). However, I have noticed recently when I’ve tried to express in the afternoon or evening that I can’t express much more than around 40mls in double the amount of time. How do I know therefore whether my baby is getting enough milk?
Sioned’s Response: There is a knack with expressing, it is important that you trigger the milk ejection reflex with optimal stimulation just like how baby feeds followed by an expression phase. Medela’s two phase breast pump utilizes nature’s triggers but it is important that you have the right setting for the vacuum so that it is not painful and are using the correct shield size. Also the milk ejection reflex can become conditioned to baby and when mums are apprehensive about the volume when expressing this can affect the effective trigger of the milk ejection reflex.
Some tips to try are; express whilst she is feeding from one side, persevere and relax, massage the breast, try a few times a day to get your body to condition to let down with the breast pump you may find you are just a little worried.
10. Is breastfeeding really a reliable method of contraception?
I was advised by my Health Visitor that breastfeeding was a form of contraception. However my GP still advised that I begin taking contraceptives again during my six-week check. Can breastfeeding really be used as a reliable form of contraception?
Sioned’s Response: Breastfeeding amenorrhea is a reliable birth control method providing your baby feeds regularly from the breasts as this will suppress your fertility hormones. Many cultures use this method when they feed their babies exclusively for 2 years, resulting in natural spacing in families. However all it takes is a longer gap between feeds, a short time when you don’t feed or express, or baby sleeping through and that is enough to trigger the increase in progesterone and oestrogen, which can result in an egg being released before your periods return, thus leading to pregnancy. It is a safe method if you know how your body works and don’t mind the risk of getting pregnant again. If you are unsure of having a baby and have a toddler under the age of 18 months seek advice and you can take the mini pill, use the Mirena coil or use a barrier method.
So there you have it, ten breastfeeding myths completely and totally debunked thanks to the lovely Sioned and Medela!
Would you add anything to this list of breastfeeding myths?