Everything you ever wanted to know about breastfeeding (but were afraid to Google): Get the answers to the most asked questions about breastfeeding and clear up common misconceptions

By Kate Hogan and Dr. Jack Newman
June 03, 2019 01:22 PM
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Here’s a secret about breastfeeding: it can be hard in the beginning. Some moms experience pain, some don’t feel they’re getting their baby enough milk and others are just exhausted.

But there’s great news here: it can be an incredible experience for both mom and baby, and for those experiencing issues, there is a lot of help available.

To help start you on the right foot we spoke to one of the lead experts on breastfeeding, Dr. Jack Newman of Canada’s International Breastfeeding Centre, to clear up some myths and set you and your baby on a path to success. Below, read his answers to commonly asked questions.

What are the most common misconceptions about breastfeeding?

“This in itself could be a book! For starters:

  1. That breastfeeding is naturally painful. Breastfeeding should not be painful; in fact, sore nipples (and sore breasts) are signs that a baby is not latching on well. Although ointment can help, it should be considered a temporary solution only. (Read more about pain during breastfeeding here.) Many lactation consultants believe that difficulty latching to the point of pain for the mother is evidence of a tongue tie, a condition that is believed to cause a less-than-adequate latch. However, many health professionals are skeptical that tongue ties exists or don’t believe it leads to breastfeeding problems.
  2. That breastfeeding means a baby will want to eat much more frequently than a baby who is bottle fed. This comes from the notion that a baby is necessarily getting milk from the breast if he is latched on and making sucking movements. When it’s established that the baby is actually getting milk, he or she will eat about as frequently as a botttle-fed baby. How does one know if a baby is getting milk from the breast? Watch these videos of a baby drinking well, a baby nibbling and a baby ‘borderline’ drinking, read the accompanying, and then watch the videos again.
  3. That breastfeeding and bottle-feeding require the same function in babies. In fact, a baby does something completely different at the breast than while bottle feeding, even if there is breastmilk in the bottle.
  4. That mothers should breastfeed on just one side so the baby gets the ‘high fat milk.’ Feeding from both breasts is recommended and can help prevent a decrease in milk supply.”

If I’m having trouble breastfeeding in the beginning, why should I continue?

“Because breastfeeding is worth it. One thing that is not frequently mentioned is that breastfeeding is good for the mother as well as for the baby. [Some studies show that breastfeeding can] decrease the mother’s risk of breast cancer and also of risk of stroke and cardiac problems later in life.

But breastfeeding should not be hard during the initial days. Breastfeeding is ‘hard’ partly because it can be hard to get adequate help before leaving the hospital. In fact, an extreme undermining occurs frequently in hospital with mothers receiving nipple shields to help with a baby who is not latching on, or if the mother has sore nipples. However, we see nipple shields leading to a decrease in milk supply.”

I’m experiencing a lot of pain during breastfeeding; what I can do to help?

“Get good help with latching on. Painful nipples means a less than adequate latch. The sooner the mother gets help, the easier it is to fix the problem.”

Many cities have chapters of La Leche League, where new moms can get advice and find support groups to answer any questions. Private lactation consultants are also available nationwide; many will come to your home to watch you feed your baby, weigh the baby to see how much milk they are consuming in a given nursing session and help with getting a good latch or proper hold. Though they can be pricey, if you call your insurance company before scheduling an appointment you may be able to find someone covered in-network.

How can I establish a healthy milk supply in the early days?

“Have the baby skin to skin immediately after birth, and not just for five minutes. Give the baby time to latch on, which may take an hour or so. Get the best latch possible as soon as possible after the birth.

To maintain supply, learn how to determine if the baby is getting milk. Use breast compression, if necessary, to help the baby get more milk from the breast. Offer both breasts at each feeding.”

Is it okay to breast and bottle feed?

“Some mothers choose to do both, usually because of all the issues noted earlier. But of course, using bottles more than occasionally could result in the baby not latching on well, not getting milk as well as he could, and quite possibly causing the mother nipple soreness. Which frequently leads to more bottle feeding instead of the mother getting help. Supplementing a baby with a lactation aid at the breast can help overcome the breastfeeding problems for which many mothers use bottles.”

How can partners be supportive to a breastfeeding mom? 

“By helping the mother know she is doing the best for her baby, and letting her know how much you appreciate her efforts. By learning the signs of positive breastfeeding above, so that if things are not going well, the partner can encourage the mother to get help early on. If there are problems, the earlier they are dealt with, the easier it is to make things work well. And to offer to let her get rest whenever she is not breastfeeding, so she has the energy to continue to do it.”

I’m going back to work and want to be able to pump but also nurse; how should I begin the transition?

According to lactation specialist Sharon Lemon of Northwestern Medicine Delnor Hospital in Geneva, Illinois, the first step is to savor your time at home with baby. But from there, she offers these tips:

  • “If not using a nanny or family member for child care, get acquainted with your daycare provider. There may be an opportunity to nurse your baby before dropping them off to daycare, nursing them during your lunch break and/or nursing them when you pick them up for home.
  • Get to know your work environment and where there is a designated private space to pump and discuss pumping breaks with your manager.
  • Get a quality breast pump and begin using it three to four weeks after your baby is born. Most mothers will pump after the first morning feeding and/or a missed feeding.
  • Many mothers will become more serious with their pumping as they get two or three weeks closer to the first day back to work in their quest to have a supply in the freezer.
  • Network with other mothers for words of wisdom and personal experience. Join a breastfeeding support group and call your lactation consultant for advice.
  • Plan on introducing a bottle by three to four weeks after delivery, once breastfeeding is well established.”

My baby isn’t interested in taking a bottle and I’m going back to work soon, what can I do?

Lemon’s colleague Deanna Schult has this to say:

  • “Keep practicing several times a week to help baby keep up that skill.
  • Get a ‘lovey’ or some item that is used for only feedings that baby can snuggle with when taking a bottle.
  • Some parents find that paced bottle feeding is helpful; you can find out more about it on YouTube.
  • You may need to explore different bottle nipples and focus on slower flow, which can often feel more like breastfeeding to baby.
  • If possible, have someone other than mom introduce a bottle.
  • And a note on your ‘stash’ — when back to work you will be pumping every day for the next day’s feeds. While you will want to have some milk for emergencies, you do not need a freezer full of it.”

For more from Dr. Newman, check out his new book, Breastfeeding: Empowering Parents. His International Breastfeeding Centre also provides a free email answering service seven days a week; to help support his work, donate through the Canadian Breastfeeding Foundation.