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1.
Nursing mothers cannot breastfeed if they have had X-rays.
Not true!
Regular X-rays such as a chest
X-ray or dental X-rays do not affect the milk or the baby and the mother may
nurse without concern. Mammograms
are harder to read when the mother is lactating, but can be done
and the mother should not stop breastfeeding just to get this
done. Furthermore,
there are other ways of investigating a breast lump.
Newer imaging methods such as CT
scan and MRI
scans are of no concern, even if contrast is used.
And special X-rays
using contrast media? As
long as no radioactive isotope is used there is no concern and
the mother should not stop even for one feed.
Herein are included studies such as intravenous pyelogram,
lymphangiogram, venogram, arteriogram, myelogram, etc.
What about studies using radioactive nucleotides (bone scans, lung
scans, etc.)? The
baby will get a little
radioactive nucleotide. However,
as we often do these very same tests on children, even small
babies, and the potential loss of benefits if the mother stops
breastfeeding are considerable, the mother should, in my
opinion, continue breastfeeding. If you feel you must stop for a
period of time, express milk in advance so that the baby can be
fed your milk and not formula. After two half lives, 75% of the
compound will be out of your body. This is surely waiting long
enough (the half life of technetium, which is used in most
radioactive scans is only six hours, so that 12 hours after the
injection, 75% of it will be out of your body).
The exception is the thyroid scan using
I131. This test
must be avoided in
breastfeeding mothers. There
are many ways of evaluating the thyroid, and only very
occasionally does a thyroid scan truly have to be done.
If the scan must be done, doing it with I123
requires the mother to stop nursing for 12 to 24 hours only
depending on the dose. Check
first before taking the radioactive iodine—the test can wait
until you know for sure. In
many cases where the scan must be done, it can be put off for
several months. Incidentally,
lung scans with radioactive contrast no longer is the best test
to rule out a lung clot. CT
scan is now the preferred test to prove or disprove the
diagnosis. [See also handout #9a You Should Continue Breastfeeding-1)
2.
Breastfeeding mothers' milk can "dry up" just like
that. Not
true! Or if this
can occur, it must be a rare occurrence.
Aside from day to day and morning to evening variations,
milk production does not change suddenly.
There are changes which occur which may make it seem
as if milk production is suddenly much less:
- An
increase in the needs of the baby, the so-called growth
spurt. If this is the reason for the seemingly insufficient
milk, a few days of more frequent nursing will bring things
back to normal. Try
compressing the breast with your hand to help the baby get
milk (Handout #15, Breast Compression).
- A
change in the baby's behaviour.
At about five to six weeks of age, more or less,
babies who would fall asleep at the breast when the flow of
milk slowed down, tend to start pulling at the breast or
crying when the milk flow slows.
The milk has not dried up, but the baby has changed.
Try using breast compression to help the baby get
more milk. See
videos on how to latch a baby on, how to know the baby
is getting milk, how to use compression.
- The
mother's breasts do not seem full or are soft.
It is normal after a few weeks for the mother no
longer to have engorgement, or even fullness of the breasts.
As long as the baby is drinking at the breast, do not
be concerned (see handout 4 Is
My Baby Getting Enough Milk?).
- The
baby breastfeeds less well.
This is often due to the baby being given bottles or
pacifiers and thus learning an inappropriate way of
breastfeeding.
The birth control pill may
decrease your milk supply.
Think about stopping the pill or changing to a
progesterone only pill. Or
use other methods. Other
drugs that can decrease milk supply are pseudoephedrine
(Sudafed), some antihistamines, and perhaps diuretics.
If the baby truly seems not to be getting enough, get
help, but do not introduce a bottle that may only make things
worse. If
absolutely necessary, the baby can be supplemented, using a
lactation aid that will not interfere with breastfeeding.
However, lots can be done before giving supplements.
Get help. Try
compressing the breast with your hand to help the baby get milk
(Handout #15, Breast Compression).
3.
Physicians know a lot about breastfeeding.
Not true!
Obviously, there are exceptions.
However, very few physicians trained in North America or
Western Europe learned anything at all about breastfeeding in
medical school. Even
fewer learned about the practical
aspects of helping mothers start breastfeeding and helping
them maintain breastfeeding.
After medical school, most of the information physicians
get regarding infant feeding comes from formula company
representatives or advertisements.
4.
Pediatricians, at least, know a lot about breastfeeding.
Not true!
Obviously, there are exceptions.
However, in their post-medical school training
(residency), most pediatricians learned nothing formally about
breastfeeding, and what they picked up in passing was often
wrong. To many
trainees in pediatrics, breastfeeding is seen as an
"obstacle to the good medical care" of hospitalized
babies.
5.
Formula company literature and formula samples do not influence
how long a mother breastfeeds.
Really?
So why do the formula companies work so hard to make sure
that new mothers are given these samples, their company's samples? Are
these samples and the literature given out to encourage
breastfeeding? Do
formula companies take on the cost of the samples and booklets
so that mothers will be encouraged to breastfeed longer?
The companies often argue that, if the mother does give
formula, they want the mother to use their brand.
But in competing with each other, the formula companies
also compete with breastfeeding.
Did you believe that argument when the cigarette
companies used it?
6.
Breastmilk given with formula may cause problems for the baby.
Not true!
Most breastfeeding mothers do not need to use formula and
when problems arise that seem to require artificial milk, often
the problems can be resolved without resorting to formula.
However, when the baby may require formula, there is no
reason that breastmilk and formula cannot be given together.
7.
Babies who are breastfed on demand are likely to be
"colicky". Not
true! "Colicky"
breastfed babies often gain weight very quickly and sometimes
are feeding frequently. However,
many are colicky not because they are feeding frequently, but
because they do not take the high fat milk as well as they
should. Typically,
the baby drinks very well for the first few minutes, then
nibbles or sleeps. When
the baby is offered the other side, he will drink well again for
a short while and then nibble or sleep.
The baby will fill up with relatively low fat milk and
thus feed frequently. The
taking in of mostly low fat milk may also result in gas, crying
and explosive watery bowel movements.
The mother can urge the baby to breastfeed longer on the
first side, and thus get more high fat milk, by compressing the
breast once the baby sucks but does not drink.
(Handouts #3 Colic
in the Breastfed Baby and #15 Breast
Compression). See
videos.
8.
Mothers who receive immunizations (tetanus, rubella, hepatitis
B, hepatitis A, etc.) should stop breastfeeding for 24 hours (3
days, 2 weeks). Not
true! Why should
they? There is no risk for the baby, and he may even benefit.
The rare exception is the baby who has an immune
deficiency. In that
case the mother should not receive an immunization with a
weakened live virus (e.g. oral, but not
injectable polio, or measles, mumps, rubella) even if the baby
is being fed artificially.
9.
There is no such thing as nipple confusion.
Not true!
The baby is not confused, though, the baby knows exactly
what he wants. A
baby who is getting slow flow from the breast and then gets
rapid flow from a bottle, will figure that one out pretty
quickly. A baby who
has had only the breast for three or four months is unlikely to
take the bottle. Some
babies prefer the right or left breast to the other.
Bottle fed babies often prefer one artificial nipple to
another. So there is
such a thing as preferring one nipple to another. The only question is how quickly it can occur.
Given the right set of circumstances, the preference can
occur after one or two bottles.
The baby having difficulties latching on may never have
had an artificial nipple, but the introduction of an artificial
nipple rarely improves the situation, and often makes it much
worse. Note that
many who say there is no such thing as nipple confusion also
advise the mother to start a bottle early so that the baby will
not refuse it.
Questions?
(416) 813-5757 (option 3)
or drjacknewman@sympatico.ca or
my book Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate
Breastfeeding Book of Answers
in the USA)
Handout
#14. More and More Breastfeeding Myths. Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This
handout may be copied and distributed without further
permission,
on the condition that it
is not used in any context in which the WHO code on the
marketing of breastmilk substitutes is violated.
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